Mr. J, age 42, is a construction worker in Las Vegas who lives with his daughter and grandson, Sammy. He recently noticed that a mole on his face seemed to be getting larger and darker. At first, he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.
Discussion Questions
1. Relate Mr. J’s skin changes to the warning signs for malignant melanoma.
2. Discuss the normal progression of this malignancy. What is the significance of the bone pain that Mr. J is experiencing?
3. Discuss the treatment available for this patient and the prognosis for recovery.
Discussion Questions
Mr. J is babysitting his grandson Sammy, age 3 years, who ate his dinner and then said his tummy hurt. Mr. J suggested he lie down in the adjacent room while his parents finished dinner. A few minutes later, Mr. J heard Sammy vomiting. He rushed in to lift Sammy up. When vomiting ceased, he noticed Sammy continued to cough and seemed to be choking. He was struggling to breathe, and a wheezing sound was obvious. It appeared that he had aspirated some vomitus. Mr. J drove him to a nearby hospital for examination.
1. Discuss the specific effects of aspirating vomitus on Sammy, including the probable effects on his bronchi and lungs. Why might one lung be affected more than the other?
2. Discuss the pathophysiologic changes causing the signs and symptoms and any tests required to clarify the effects on Sammy.
3. Suggest some reasons for Sammy’s difficulty breathing and wheezing.
4. Discuss the potential complications of aspiration of vomitus.
