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Homepage > Offices & Services > Center for Healthcare Innovation > ATHENS Subscription Service > Clinical Cases
Adding robust, real-life clinical cases can make the ATHENS experience more meaningful to students. Below are a number of cases that have been developed by the ATHENS project team and are available in two version. The CD Version is a composite of the screen prints for the case, allowing your college to enter the case into your medical center. The Build Version may be ordered and allows St. Scholastica staff to enter the case into your medical center.
To order any cases, please submit a letter on your college's letterhead specifying the Pristine case(s) and version you would like. Order letters should be sent to: ATHENS Subscription Offering
The Center for Healthcare Innovation
The College of St. Scholastica
1200 Kenwood Avenue
Duluth, MN 55811
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| 93-year-old admitted through ER for generalized weakness and slurred speech. (Patient lived independently with his wife prior to admission.) Upon admission, staff wasn't sure if case was neurological or cardiac in nature. Patient underwent a battery of tests (CT, MRI, Ultrasound, EKG) on second day of stay; all indications were neurological. Speech therapy and physical therapy were instituted. Patient responded very well to these therapies and was eventually discharged home where PT and nursing followed up. Social services were involved with setting up the program. Patient had a remarkable stay and a good outcome. |
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| Pristine, Twelve |
coronary artery blockage |
62-year-old with a clinical picture consistent with acute coronary syndrome in the setting of multiple cardiac risk factors. Patient went to medical clinic where she was noted to be having discomfort at rest which warranted hospitalization for further evaluation. Patient underwent cardiac catheterization and subsequent stent placement. Patient has multiple medical problems as well. Hospitalized for 1 day, discharged home.
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| 74-year-old with long standing progressive pain in the right hip. Radiographs reveal advanced osteoarthritis of the right hip. Her pain was unresponsive to medical management. Patient underwent total hip arthroplasty with no complications. Patient stayed for three days and received PT during this time. Patient was discharged to a nursing home for rehabilitative care, which was set up with the help of social services. |
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| 55-year-old patient had several months of headaches. She had an episode of syncope resulting in a fall and striking her head. On evaluation, a left frontal tumor was discovered which on CT was determined to be consistent with meningioma. Neurologically she was intact with the exception of daily headaches that were becoming increasingly severe. Patient underwent a stereotactically-guided left frontoparitel craniotomy with resection of tumor. Pathology was consistent with meningioma transitional type with no atypical features present. Patient stayed for 6 days; stay was uneventful. Discharged home with family care. |
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| 52-year old patient with a long history (many years) of chronic low back pain which developed into pain radiating into left lower extremity that had become excruciating. MRI of lumbar spine demonstrated severe relative stenosis at L4/5 secondary to a very large left paracentral disc herniation. She underwent left L4/5 discectomy and her postoperative course was unremarkable. She was discharged home on post-op day 3. Received OT and PT as part of rehab. |
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| Phelbitis secondary to IV |
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| 51-year-old female admitted with right upper extremity phlebitis secondary to an IV line that had been inserted at another hospital during a recent hospitalization for chest pain. After discharge from this hospital, her right upper extremity became painful and swollen. She was treated with IM Rocephin, however, her right upper extremity became more swollen and painful so she was transferred and admitted to SMDC. Patient did not have a high fever but blood cultures grew group A strep with associated bacteremia. She had marked lymphangitis and possibly pneumonia. Patient was given a PICC line and sent home for out-patient medication administration as she is an RN. She was hospitalized for two days to determine what the best course of action would be to combat the infection. (Note: Initial ER notes from the 1st hospital are included.) |
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| 57-year-old who came to the ER complaining of left scapula pain with no change in ability to move left arm. No history of trauma or chest pain. Positive shortness of breath slightly. No nausea or vomiting. No history of fevers, chills or cough. Positive previous history of Pulmonary Embolism (PE) with chest pain. CT scan revealed pulmonary emboli; patient admitted for treatment. Patient received IV treatment for 7 days. She did have fevers during this time. On her last day, she complained of jaw pain unrelated to her PE pain. Discharged home on anticoagulation program. |
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| 31-year-old patient at 28.5 weeks, had been on bed rest at home and had a cerclage placed due to an incompetent cervix. Patient is also a Leiden factor V carrier and has been on subcue Heparin b.i.d. along with baby aspirin. She was transferred from another hospital due to ruptured membranes. (Note: The notes from the other hospital are included.) Medications were given due to the contractions, but she continued to contract. Therefore, the physician proceeded with removal of cerclage and did a repeat Cesarean section and tubal ligation. The baby survived. Ten months prior to this pregnancy, patient delivered a stillborn at roughly 20 weeks. Social services was available to mother during this time. Patient was hospitalized for four days and was discharged to the NICU to be available to her baby. |
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| 78-year-old female with known coronary artery disease; has two previous stents for Left Anterior Descending (LAD) and right coronary disease. This hospitalization she underwent left heart catheterization, right and left coronary artery cineangiography, ventriculography and DES stent deployment of the circumflex. She was admitted through the doctor's office for unstable angina. She was discharged after two days and was started on the Phase II Cardiac Rehab program. Stay was uneventful. |
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| 57-year-old admitted through ER, brought by ambulance for loss of consciousness with possible seizure, although unproven. Event was witnessed by family members. Patient underwent testing (MRI, CT Scan, EEG), but nothing concrete was found. She was discharged to the care of family the following day. |
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| 66-year-old white female with progressive herpes zoster to possible disseminated zoster in a patient with active systemic lupus erythematosus, on Plaquenil, and with history of diffuse large cell lymphoma status post bone marrow transplant. She was admitted to the hospital and started on intravenous Acyclovir at 10 mg per kilogram (600 mg) delivered every 8 hours. She tolerated the intravenous Acyclovir well while in the hospital and did have some persistent mild neuralgia at the site of her dermatome eruptions, although this was slowly and steadily improving by the day of discharge. She was hospitalized for 4 days. |
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| Pneumothorax with Thoractomy |
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| Patient is a 47-year-old nursing supervisor who had recurrent left-sided pneumothorax. She underwent left-sided video assisted thoracoscopy, apical pleurectomy, and chemical and mechanical pleurodesis. She had minimal air leak postoperatively. Chest tube was taken out on postop day 2. Repeat chest x-ray showed no residual pneumothorax, and the lung fields were clear. She was discharged home after 4 days of hospitalization. |
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| Colitis, acute tubular necrosis, acute labyrinthine |
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| 67 year old patient admitted from the office where she presented with a 4 day history of progressive bloody diarrhea. The patient was in FL on vacation, was well until 4 days prior to presentation. At that time, patient notes that she was just entering a restaurant and sitting down when she developed sudden onset dizziness, sweats and severe abdominal cramps followed immediately by profuse and frequent watery diarrhea. Patient reports very frequent bowel movements occurring every 15-20 minutes. She states these movements persisted over the ensuing days. She was seen at a walk-in care facility in FL 2 days prior to this admission where she was diagnosed with an infectious enteritis. In addition to the above, patient does note intermittent vomiting over the past two days. Was admitted for IV fluids and monitoring of kidneys. Patient was hospitalized for 8 days and discharged home. (NOTE: Due to the fact that this is case is older, there was no supporting documentation in the chart (MAR, Nursing notes)) |
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| 59 year old, white female in for breast biopsy/lumpectomy with sentinel node biopsy under general anesthesia. |
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| 35-year-old patient at 41+ weeks. She was complete and pushing for just over three hours. She had adequate epidural anesthesia. Over the last 30 minutes of pushing, thick meconium was noted. The patient was completely exhausted and requested assistance with delivery also. The KIWI cup was applied to the fetal head at the median flexion point. During four contractions over a ten minute period, the fetal head was finally delivered. The remainder of the baby was delivered and handed off to the waiting neonatal team. Viable male, weight 8 pounds, 2 ounces. Placenta delivered intact and spontaneous with a three vessel cord. Patient discharged 3 days later. |
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41-year-old @ 37 1/2 weeks, scheduled for regular app't today. Last night patient noted contractions. Presented to birthing center rather than OB clinic in active labor. Plan was for repeat c-section. C-section uncomplicated, patient hospitalized for 4 days, a little weepy day 3.
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| 47-year-old with severe post-traumatic osteoarthritis of right knee. He underwent total right knee arthroplasty; surgery was uneventful. Patient was hospitalized for 3 days and underwent PT and OT evaluations after surgery. He was discharged home. |
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| 62-year-old with progressive spinal stenosis which became symptomatic at the L3-4 and L4-5 levels with pseudoclaudication symptoms. Associated with that was an extruded disc fragment at the L5 level with entrapment of the right S1 nerve root. Patient had fallen on the ice a couple days prior to surgery. He did see the doctor at that time, but chest x-ray revealed no evidence of rib fracture. He was hospitalized for 3 days and had PT and OT evaluations, which were complicated by his rib pain. Otherwise surgery and stay were uneventful. |
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| 62-year-old female admitted through the ER for some "atypical" angina symptoms of neck pain, shoulder pain and jaw pain associated with nausea and shortness of breath. Because of her diabetic status, she was admitted to rule out MI. She underwent cardiac testing (ultrasound, treadmill stress test) with negative results. Patient hospitalized for two days without complications. Patient has a history of multiple medical problems. She was diagnosed with chest pain with slight increase in troponin, but negative stress test. |
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| 66-year-old came to ER complaining of flank pain which had been intermittent for the past month. She felt the pain was deeper than musculature and also had some intermittent urinary symptoms. Patient had no chest pain or shortness of breath (does get short of breath often). CT scan to rule out kidney stones performed and was negative. It was felt that her previous UTI had not completely cleared. She was given a Rx and discharged home. |
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| 48-year-old female who underwent clipping for cerebral aneurysm. Patient had no neurological symptoms. Surgery went well but patient did experience nausea from bi-frontal pneumocephalus. She was hospitalized for 6 days and was discharged home. Patient does have polycystic kidney disease with familial history of aneurysm rupture. |
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| Patient is a 47-year-old male who has had a life-long problem with morbid obesity and underwent gastric bypass surgery. He was hospitalized for two days and discharged home. Stay was uneventful. |
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| Patient is an 87-year-old hospitalized for 12 days for CVA, admitted through the ER. Patient had a prior history of a left hemispheric CVA and had residual left side weakness. It was not known at time of admit if the current episode was seizure type activity from previous CVA or if it was an additional CVA. Testing did not confirm any of this. Patient developed complications that included difficulty swallowing and what appeared to be aspiration pneumonia. He started having significant respiratory difficulty as well as cough and fever on the second day of admit that was severe enough that hospital staff elected comfort measures only. Patient steadily improved. Patient transferred to a Rehab Unit for additional recovery. Physical therapy consulted. Patient, "just let me die." |
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| 48-year-old with a history of ASCAD who presented with increased dizziness and fatigue. Patient was seen in the clinic and given the option of noninvasive vs. invasive diagnostic study. Patient opted to have the invasive procedure which included left heart catheterization, coronary arteriography, left ventriculography, primary Integrilin therapy, descending aortography, rotational atherectomy, PTCA and drug-eluting stenting of the mid Left Anterior Descending (LAD) coronary disease. The patient indicated he would join the Heart-to-Heart program. Stay was uneventful and patient discharged home after procedures. |
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| 79-year-old with history of end stage osteoarthritis of the right shoulder. Had maximized outpatient treatment and was admitted for total shoulder arthroplasty. She is the caretaker for her husband who had a CVA a few months prior to surgery. Surgery was uncomplicated and patient received OT for ADL's. Patient was hospitalized for 3 days. She was discharged home under the care of her daughter. |
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| 52-year-old female admitted through the ER after complaining of 3-4/10 chest pain radiating to left neck and arm. She had similar episodes previously, but this episode lasted longer and prompted her to come to the ER. She had had a previous cardiac stress test and her physician felt that she should undergo a cardiac catheterization as there is a strong family history of coronary artery disease. This was done and she had essentially a normal cardiac catheterization. The chest pain improved so that she was discharged home. Length of stay was one day and was uneventful. |
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| Patient is a 56-year-old female who presented with persistent cough x 2 months after flu-like illness. Patient does not have a history of asthma, but does have reactive airway disease with past respiratory infections. In past week she had increased sputum, wheezing and cough. Patient denies coughing up blood, denies chest pain, denies fever with chills. Patient admitted through ER. She improved dramatically on medications and was released the next day. |
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| Patient is a 45 year old female admitted with groin pain and found to have acute lymphocytic leukemia. Undergoes chemotherapy. During the hospitalization she developed a Groshong catheter infection. |
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| Patient is a 24 year old male who sustained a closed head injury when he fell from the back of a slowly moving pick-up truck. There was no initial loss of consciousness, but he did experience a brief episode of confusion. He was seen in the ER where his neurological assessment was within normal limits then admitted for 24 hour observation. The patient did well for several hours then declined rapidly due to a sub-dural hematoma and brain edema. He expired at midnight of the day of admission. |
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