Assignment: Differential Diagnoses

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Assignment: Differential Diagnoses

Assignment: Differential Diagnoses

Below is the patient information and the required things. Attached is the guidelines for this as well. Must also include references.


· Subjective: What details did the patient provide regarding her personal and medical history?

· Objective: What observations did you make during the physical assessment?

· Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Assignment: Differential Diagnoses

Assignment: Differential Diagnoses

· Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.

· Reflection notes: What would you do differently in a similar patient evaluation?

Chief Complaint

Loss of menstrual cycle

History of Present Illness

36-year-old G7 P 3115 with history of T SVD ×3 and then low-transverse cesarean section in 2007 at 33 weeks secondary to monochorionic monoamniotic twin gestation presents for loss of menstrual cycle. LMP was 02/01/2017. Her periods come every 28 days and last 4-5 days. She is 8 weeks 6 days today with EDD of 11/08/2017 based off of LMP consistent with ultrasound today. She denies any bleeding has a little bit of nausea but nothing that she wants medication for. This was an unplanned pregnancy but is desired. She has been taking prenatal vitamins. She does have a complaint of some constipation. She has been ingesting a lot of protein drinks as well. Tobacco use: Patient has smoked for 17 years and has decreased to 3 cigarettes per day. She called 1-800 quit recently and they suggested a patch versus gum versus candy.

Review of Systems Constitutional: Negative. Respiratory: Negative. Cardiovascular: Negative. Breast: Negative. Gastrointestinal: Negative. Genitourinary: Negative. Gynecologic: Negative except as documented in history of present illness. Hematology/Lymphatics: Negative. Endocrine: Negative. Immunologic: Negative. Musculoskeletal: Negative. Integumentary: Negative. Neurologic: Negative. Psychiatric: Negative.

Physical Exam

Vitals & Measurements HR: 72 (Peripheral) BP: 93/63 HT: 62 in WT: 158.4 lb BMI: 28.97 Gen.: Alert and oriented, not acute distress Respiratory: Lungs are clear to auscultation, respirations are nonlabored, breath sounds are equal Cardiovascular: Regular rate and rhythm Gastrointestinal: Soft, nontender, nondistended Abdominal: Nontender nondistended, bowel sounds present, Genitourinary: Vagina: Within normal limits Labia: Within normal limits Cervix: No cervical motion tenderness, closed Uterus: Within normal limits Neurologic: Alert and oriented Psychiatric: Cooperative, appropriate mood and affect


1. Amenorrhea Patient had a partial OB nurse consult today and was told that she will need to return in 4 weeks to further discuss genetic counseling. She does desire first trimester genetic screening. She was advised to encouraged to continue prenatal vitamins. sHe was advised her expected weight gain goal of 25-35 pounds this pregnancy. She was also encouraged to make sure that she has at least 30 minutes of exercise daily. pap and other first trimester labs obtained today.


76856 us pelvic nonobstetric real-time image complete. Secondary amenorrhea

2. Constipation Patient given a prescription for Colace she was also advised to not do protein shakes in place of an actual healthy diet

3. History of low vertical cesarean section Performed in 2007 at 33 weeks secondary to monochorionic monoamniotic twins at 33 weeks. One layer closure with chromic. The patient does desire VBAC. Discussed options of TOLAC with VBAC vs repeat cesarean section. Risks of VBAC include: risk of uterine rupture 0.5-1% which increases to 2-3% with augmentation. This will need to be discussed at future visits as she approaches term


docusate, 1 cap(s) ( 100 mg ), PO, BID, PRN: for constipation, # 60 cap(s), 10 Refill(s),

urnls dip stick/tablet rgnt auto w/o microscopy,Amenorrhea

ABO/Rh , Amenorrhea

Antibody Screen, Amenorrhea

CBC w/Diff/Plt Amenorrhea

Hgb A1c, Amenorrhea

Rubella Antibody IgG, Amenorrhea

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

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Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
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For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
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Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

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