Lesson 3 Slides

1. Session 3:
Research and
Case Studies

2. Learning Objectives
Research at university
What case studies are and how they are used to understand what
studying is like at university
How to approach a case study
Walkthrough and assessment of a diagnostic case study
Q&A

3. Research at University
Lectures are seen as
an introduction to
content
2-3 hours of
individual study per
hour of lecture time
You will not know
everything from the
start!
Ask questions! Email
tutors/lecturers! Get
involved!
Utilise the
libraries!!!!

4. Cardiovascular
revision
 Normal blood pressure level is
<120/80mmHg
What causes this to be outside the
normal range?
 Normal resting heart rate range :
60-100bpm
 Normal levels of cardiac troponin
in the bloodstream is < 14 ng/L
What causes this to be outside the
normal range?

5. What are case studies and why do we use them?
Used to provide insight into general biomedical
principles
Presentation of a ‘patient’ with symptoms – provokes
research and analysis
Gain valuable problem solving and analytical skills as
well as enhancing your biomedical knowledge

6. How to approach a case study
Collect all information
together and sort into
categories – signs and
symptoms
Signs – recordings
taken such as blood
pressure, heart rate or
temperature
Symptoms – anecdotal
information given by
the patient like pains
or dizziness
Assess the relevance
of these
Whether a symptom is
severe or unusual or if
a sign is significantly
veering from the
normal values
Extra research – you
won’t know every
disease/illness
Crosscheck data from
trusted sources that
are in line with the
data given
Not all information
will be useful! Some
might even distract
from the real diagnosis

7. Case study 1

8. Case Study 1
 Mr. Johnson is A 57-year-old man who has the following symptoms:
 Chest pain
 Dyspnea (shortness of breath)
 Nausea
 Unexplained Weakness
 The man declares he is diabetic and a smoker and experienced 3 hours of chronic
chest pain prior to the visit to the hospital.
 Doctors run a series of simple, physical tests with the following results:

9. Signs and Symptoms
 Heart rate of 100bpm
 Blood pressure of 140/90mmHg
 Heart Murmur
 No Lung irregularities
 30ng/L of cardiac troponin T in the bloodstream
Are any of these significant?

10. Electrocardiograms
Patient:
Normal:
Can you spot the
abnormality?

11. Let’s zoom in!
Patient
Normal

12. Diagnosis
Non-ST elevation myocardial infarction
(NSTEMI)
Essentially a light form of heart attack
– less severe than other types
Caused by a lack of oxygenation of the
coronary tissue – from clogged arteries
or low haemoglobin production
Still life threatening, but less likely to
cause death than other, more
identifiable heart attacks

13. How could you tell?
 High blood pressure
 Heart murmur
 Cardiac troponin T concentration of 30ng/L heavily indicative of myocardial
infarction (MI)
 ST portion of the ECG shown to be more depressed than on a healthy heart
 Reported symptoms from the patient are indicative of MI
Look again at your booklets. Did you notice any of
these?

14. Pharmaceutical treatment
 Antiplatelet medications (aspirin): inactivate platelets,
leading to less blood clotting
 Angiotensin-converting enzyme (ACE) inhibitors: targets
angiotensin, interfering with its ability to increase blood
pressure, causing an overall decrease in blood pressure.
 Beta-blockers: cause your heart to beat at a slower rate
and with less force.
 Nitroglycerin: widens your blood vessels, reducing blood
pressure and improving blood flow and chest pain
 Statins: lower the cholesterol level in the blood

15. Lifestyle treatment
and prevention
 Maintain a healthy lifestyle,
providing the best chance for
your heart to be healthy
 Balanced diet
 High amounts of exercise
 No smoking

16. Myocardial infarction summary
 NSTEMI myocardial infarction is a form of heart attack
 Caused by atherosclerotic plaque erosion or rupture which results in vasoconstriction and occlusion
of blood vessels
 Lack of blood flow and oxygen to the cardiac myocytes which results in myocardial ischemia
 Signs and symptoms include high blood pressure, chest pain, high heart rate, cardiac
murmurs...
 Tests will reveal high cardiac troponin T levels in the blood stream
 12 lead ECG will reveal an ST wave depression due to the lack of blood flow to a portion of the
heart muscle which causes an imbalance of the electrical activity
 Risk factors: overweight/obese, age, type 2 diabetes, smoking, unhealthy diet, lack of exercise
 Treatments: Antiplatelet medications (aspirin), Angiotensin-converting enzyme (ACE)
inhibitors, Beta-blockers, Nitroglycerin, Statins.
 Lifestyle changes: healthy diet, no smoking, exercise.

17. In Summary
 Private study and research at university is very dependent on individual involvement
and extra study.
 Case studies are an important tool in furthering diagnostic ability and analytical
thinking.
 Not all information is important, a key skill is analysing information and assessing its
importance and relevance.
 Enhance problem solving, analytical and communication skills.

18. This is just the beginning!
Big Case Study next session!
Any Questions???