Expert answer:Fever
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BIO 246
Instructor: Ginger Bohlen
Case Study #1
Karl is a 54-year old African American male who came into the walk-in clinic in Denver
complaining of shortness of breath, fatigue, and swelling in his feet and hands. He has not been to a
doctor in years. He says that he is just getting over a sore throat and cough after three weeks of fighting
it off. When asked if he has been experiencing anything else out of the ordinary, he says that is legs
cramp but that it only happens when he is walking and goes away a couple of minutes after he stops.
He just started making himself take a break and walk for twenty minutes each day over the past week
but doesn’t understand why his legs hurt and cramp so much when he is walking.
He recently got transferred from Miami to Denver to “get the Denver office up to speed.” Since
he got promoted three years ago, he has been a very successful high level manager who works at least
70 hours a week. Under his management, the Miami corporate office made record profits.
He admits that he has “let his body go” in the past three years and hasn’t been exercising like he
used to. He has gained 30 lbs since he took the promotion, doesn’t eat a “real” breakfast or lunch, and
usually catches some dinner on the way home late at night. He drinks about four cups of coffee a day
and diet pop. He only takes a daily multivitamin. He grew up in a house where his parents smoked but
he has never smoked. His father died of a heart attack at the age of 74.
He is 5’11 and weighs 243 lbs. At rest, his blood pressure is 166/110 mmHg, pulse 86 bpm,
respirations 24 /min., and temperature 100.2 F. The doctor listens to his lungs and hears some wet
sounds in his left lower lobe. Upon examining Karl’s legs and feet, the doctor finds a very weak pulse in
the dorsalis pedis and significant edema from the crural region down. He has varicose veins in his legs
as well.
The doctor orders some blood work and the results show high hematocrit, high blood glucose, high
insulin, and high lipids.
For full credit, thoughtfully respond to the following questions, relating to class material when possible:
1) List as many factors that you can think of which could be contributing to each of the following:
• Fever
• Fatigue
2) What may be causing the leg cramps that occurs when he walks but goes away when he stops?
…
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