Internal Medicine
Curricular Elements:
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Objectives
Case I
Case II
Case III
Adult Vaccination
Cancer Screening
Diabetes Screening
PREVENTION & SCREENING
CASE # 1
B.L. is a 27-year-old female who resides in Maywood. She presents to your Woman�s Health Center with a black eye and eye pain after an altercation. She was struck in her left eye by her live-in boyfriend of six months. She denies any other trauma and states that the altercation began after an argument concerning money. She has been to the Loyola E.R. twice in the past year for other skeletal and soft tissue injuries that occurred after arguments with her boyfriend. She uses the E.R. for her medical care and has not seen a primary care physician since high school.
Medical History
Adult: 1) Sickle Cell Trait with mild anemia 2) GC diagnosed at age 23
Meds: None
Allergies: Sulfa
Surgery: None
Habits:
Smokes 1 pk/day since age 16, social drinker on weekends.
Denies
use of street
drugs at any time
Social:
Single, works as a manager in clothing store Carries a
handgun in
car, does not
wear seatbelts
Family:
Father, age 52, HTN & Sickle Cell Trait Otherwise
non-contributory
OB/Gyn:
G1P0A1
Last pap had CIN I - 3 years ago Sexually
active since age 16,
4 sex partners in last 2 years. Uses a spermicide for birth
control
Vaccines: None since high school, completed childhood series
Diet: Fast food for lunch and dinner
Exercise: None regularly
QUESTIONS FOR DISCUSSION
1. Which
vaccines is she eligible for? What are their indications,
efficacy,
and time intervals?
2. Which screening tests will she eventually need?
3. Please give your counseling recommendations concerning:
a) Injury and Violence prevention
b) Nutrition
c) Exercise
d) STDs and unintended pregnancy
e) Smoking cessation