I-Human Case Study: Thomas Warren, a 72- year-old male, presents with a complaint of an unusual mole.

I-Human Case Study:
Thomas Warren, a 72-
year-old male,
presents with a
complaint of an
unusual mole.
-Human Case Study: Thomas Warren, 72 Years
OldChief Complaint:Thomas Warren, a 72-year-old
male, presents with a complaint of an unusual mole
on his back that he noticed about 3 months ago. He
reports that the mole has changed in size, color, and
shape.Subjective:History of Present Illness
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
(HPI):Onset: Noticed the mole 3 months
ago.Location: Middle of the back.Duration:
Persistent since first noticed.Characteristics: The
mole has become larger, darker, and has irregular
borders. It has also becomeitchy
occasionally.Associated Symptoms: No bleeding,
oozing, or pain.Aggravating Factors: None
reported.Relieving Factors: None reported.Previous
Interventions: No previous treatments or
evaluations.Past Medical History
(PMH):Hypertension (well-controlled with
medication).Hyperlipidemia.Type 2 Diabetes
Mellitus.Osteoarthritis.No history of skin cancer or
previous skin lesions of
concern.Medications:Lisinopril 20 mg
daily.Atorvastatin 40 mg daily.Metformin 500 mg
twice daily.Ibuprofen 200 mg as needed for arthritis
pain.Allergies:No known drug allergies.Family
History:Father: Deceased at 85, history of coronary
artery disease.Mother: Deceased at 78, history of
hypertension.No family history of skin cancer.Social
History:Retired accountant.Lives with spouse.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old
male, presents with a complaint of an unusual
mole.Non-smoker.Occasional alcohol use (1-2 drinks
per week).No history of recreational drug
use.Limited sun exposure in the past due to indoor
occupation, uses sunscreen occasionally.Review of
Systems (ROS):General:No weight loss, fever, or
fatigue.Skin: Reports the mole on the back,
occasional itching. No other skin changes or
lesions.HEENT: No headaches, vision changes,
hearing loss, or sore throat.Cardiovascular: No chest
pain, palpitations, or edema.Respiratory: No cough,
shortness of breath, or wheezing.Gastrointestinal:
No nausea, vomiting, abdominal pain, or changes in
bowel habits.Genitourinary: No dysuria, frequency,
or hematuria.Musculoskeletal: Chronic joint pain
due to osteoarthritis, no new joint pain or
swelling.Neurological: No dizziness, syncope, or
focal neurological deficits.Endocrine: Diabetes wellmanaged, no new symptoms of hyperglycemia or
hypoglycemia.Objective:Vital Signs:Blood Pressure:
130/80 mmHgHeart Rate: 76 beats per
minuteRespiratory Rate: 16 breaths per
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
minuteTemperature: 98.6°F (37°C)Oxygen
Saturation: 98% on room airPhysical
Examination:General: Alert, oriented, and in no
acute distress.Skin: A single mole on the mid-back,
approximately 1.5 cm in diameter, asymmetrical
with irregular borders, variegated color (tan, brown,
and black areas), slightly raised, and no ulceration
or bleeding.HEENT: Normocephalic, atraumatic, no
lesions or abnormalities noted.Cardiovascular:
Regular rate and rhythm, no murmurs, rubs, or
gallops.Respiratory: Clear to auscultation bilaterally,
no wheezes, rales, or rhonchi.Gastrointestinal: Soft,
non-tender, no
hepatosplenomegaly.Musculoskeletal: Normal range
of motion, no acute joint swelling or
deformities.Neurological: No focal deficits, cranial
nerves II-XII intact.Diagnostic Tests:
I-Human Case Study: Thomas Warren, a 72-year-old
male, presents with a complaint of an unusual
mole.Dermatoscopy: Shows irregular pigment
network, asymmetry, and multiple colors.Skin
Biopsy: Excisional biopsy performed for
histopathological examination.Assessment:Primary
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
Diagnosis:Suspicious moleon the back suggestive of
malignant melanoma based on ABCDE criteria
(Asymmetry, Border irregularity, Color variation,
Diameter >6mm, Evolution).Differential
Diagnoses:Benign melanocytic nevus.Dysplastic
nevus.Seborrheic keratosis.Plan:Immediate
Plan:Surgical: Complete excisional biopsy of the
mole performed.Laboratory: Send biopsy for
histopathological analysis to confirm
diagnosis.Further Management:Referral: Referral to
a dermatologist and oncologist if biopsy confirms
melanoma.Follow-Up: Schedule follow-up
appointment to discuss biopsy results and further
management.Patient Education:Educate the patient
on the importance of regular skin checks and
protection against UV radiation.Advise on the signs
of skin changes that need immediate medical
attention.Preventive Measures:Recommend using
broad-spectrum sunscreen with an SPF of at least
30.Encourage wearing protective clothing and
avoiding peak sun exposure.Monitoring:Monitor
wound healing post-biopsy.Assess for any new or
changing skin lesions at follow-up
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
appointments.Step-by-step explanationIHumanCaseStudy:ThomasWarren,72YearsOldChief
Complaint:Thomas Warren, a 72-year-old male,
presents with a complaint of an unusual mole on his
back that he noticed about 3 months ago. He reports
that the mole has changed in size, color, and shape.
GLOBALISATION
Increased meat consumption (average annual
consumption 50kg per person ) - westernisation -
deforestation for cattle crazing - beef and lamb emit
the most methane of any meat source
GLOBALISATION
Loss of language in Papau New Guinea - ANSWER7,000 tribal groups - most of which speak their own
language
Young people in these communities give up their
tribal way of life and move to cities so stop speaking
their local language
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
I-Human Case Study: Thomas Warren, a 72-year-old male, presents with a complaint of an unusual
mole.
2014: 1 in 4 tribal languages at risk of extinction
GLOBALISATIO