The Clinical Case Presentation Paper

Clinical case presentation
you will be working in a group to create a PowerPoint to develop a case study based on your own experiences.

1. Differential diagnoses applicable to the patient, as well as rationale for why the differential diagnoses would or would not pertain to the patient.

Please see the attachment for the case to help you answer the question The Clinical Case Presentation Paper

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Another potential diagnosis for this particular patient is acute limb ischemia. Simon et al. (2018) established that an abrupt reduction in arterial blood flow to a limb might threaten its viability and strength. In the provided case study, the occurrence of thrombosis as a result of an occlusive atherosclerotic lesion and circulation failure can be considered to be a key etiology for acute limb ischemia. The 94-year old patient was reported to be experiencing acute onset of progressive pain in the right limb, and paralysis that had contributed to him using a walker to ambulate. However, findings from the physical examination indicate that the patient has normal peripheral pulses, and demonstrated no paresthesia, pallor or poikilothermia, systematic inflammation and this may help to rule out the diagnosis of acute limb ischemia. Nevertheless, conducting angiographic imaging, duplex ultrasound, Magnetic resonance angiography and CT Angiography may help to ensure accurate diagnosis and to ensure proper treatment plans are adopted (Gunawansa, 2017)The Clinical Case Presentation Paper.

Another potential diagnosis is acute deep vein thrombosis (DVT). Watanabe et al. (2017) noted that DVT occurs following the formation of a blood clot in the deep veins, mainly of the lower extremity. Some of the common signs and symptoms of DVT include pain, acute unilateral swelling, erythema, and arterial obstruction. In the provided case study, it may be established that the 94-year old patient presents with pain in the affected limb, thrombosis formation and atrial fibrillation. Equally, it is important to consider a number of risk factors including greater walking impairment, poorer functioning, age, hospitalization and the history of hypertension in order to ensure proper detection of DVT in elderly patients (Chechulova, 2022)The Clinical Case Presentation Paper. Considering that the patient presents increased metabolic acidosis, and no swelling of the limb, a DVT diagnosis may be less likely. Therefore, conducting venous ultrasound in line with the duplex ultrasound protocol may become a viable imaging test for determining whether the elderly patient is having lower extremity DVT.

Acute abdominal aortic occlusion is another potential diagnosis for the 94-year old patient. As noted in the case study, the patient presents numerous signs and symptoms including acute limb ischemia, right leg weakness, increased metabolic acidosis, thrombus formation and sudden pain in the right leg. Considering that vascular surgery was consulted, the patient’s clinical status and severe metabolic acidosis and acute limbic ischemia may strongly suggest a diagnosis of acute infrarenal aortic occlusion (Shikata et al., 2020)The Clinical Case Presentation Paper. Mousa et al. (2019) established that conducting Magnetic Resonance Angiography and computer tomography Angiography may have revealed whether the patient has infrarenal aortoiliac thrombosis. Considering that the patient in the case study experienced metabolic acidosis, transient leg pain, and thrombosis formation at the time of hospitalization in the ER, this catastrophic diagnosis is more likely.