1. II. The Family CP
A. Introduction

2. Introduction Purpose of the presentation Why was this case chosen?
What points will the audience focus into?
Identifying data
Chief complaint
Patient’s most obvious concern
Concern of the main caretakers

3. Purpose of the CP Why was this case chosen? Unique family setting
Teenager
Other factors of management

4. Purpose of the CP Purposes: Re-evaluation/formulation of the problem
Development of a comprehensive treatment plan
Guidance on issues, impasses, sensitive events
Discussion of diagnostic features, therapeutic techniques or biopshycosocial dynamics

5. Focus of the CP Impact of illness to the patient and family
Coping mechanism
Family dynamics
Social resources

6. Identifying Data KRE 17-year old male
first year Aircraft Maintenance student
a 5 year history of undescended testis (L) 1 year history of inguinal mass ®
with known co-morbidities
residing in Palanan, Makati

7. Chief complaint (CC)
persistence and progressive inguinal pain accompanying the noted inguinal mass®

8. B. Clinical history of the patient
II. The Family CP
B. Clinical history of the patient

9. III. Clinical History of the Patient
Course of illness
History PE
Diagnosis

10. History Five PTA KRE noticed his undescended testis (L)
no accompanying pain nor mass
no consult done
guardians were unaware
1 year PTA,
noted inguinal mass ®
reducible
accompanying pain of 5/10 in the mass area
guardians still unaware

11. History Four days PTA persistence /progressive inguinal pain, 7/10
Informed guardians >>> St. Clare Hospital consultation
diagnosed with inguinal hernia.
UTZ at Clinica Caritas:
Reducible inguinal hernia ®
Undescended testis (l), inguinal region
Minimal hydrocoele ®
Normal sonogram of the kidneys, testis ® and urinary bladder
advised for herniotomy and orchidopexy
Saint Martin de Porres Charity Hospital (SMPCH)

12. PE
General: alert, coherent, cooperative, not in cardiorespiratory distress
Anthropometrics: height = 168 cm; weight = 57 kg; BMI = Normal
Vital signs: HR = 65; RR = 22 mildly tachypneic; Temperature = C afebrile
HEENT: anicteric sclera, pink palpebral conjunctiva, no TPC, no CLAD, flat neck veins
Cardiopulmonary examination: symmetrical chest expansion, clear breath sounds, no rales/crackles, no wheezes, apex beat at 5th left ICS, normal rate, regular rhythm, no murmurs
Abdominal: flat, no tenderness, no organomegaly, no masses, no surgical scars, normoactive bowel sounds
Extremities/Skin: full and equal pulses, no edema, no cyanosis, fair skin color, good turgor, no rashes, no lesions, pink nail beds, healthy hair/scalp
Inguinal exam: transilumination of the scrotum ®, external ring 2 x2 cm ®, absence of testis (L)

13. Diagnosis Impression:
Hydrocoele ®, Undescended testis (l), Incomplete reducible inguinal hernia ®
Pre-op work-ups and management:
CBC and urinalysis
normal results
D5LR IV, Nalbuphine HCL, Promethazine
Post-operation management
Co-amoxiclav, Paracetamol, Mefenamic acid and Mupirocin ointment