L5 Teacher Master Patient Packet

In this summary of Cases 1-12 you will see what your students have in their packets. Only in this packet are red notes throughout to help you give hints. Some information, like vocabulary, you can provide or have them look up. I suggest you have this available for your reference when you teach lesson 5. The top of each page has which case it is part of for easy reference.

Don’t get overwhelmed or let your students focus too much on the medical jargon. I know there is a lot there; I didn’t simplify it in the name of giving your students a real view into treating patients. There is plenty there that they can recognize and the main goal of the activity is to put together a timeline for each patient, so stress paying attention to dates.

I hope you will let your students get creative with their timelines. For simplicity, the cases for each patient are in chronological order. Please let me know if this (or the patient names or tag numbers) becomes too obvious to your students.

To summarize:

Patient A: SarowCase 1- photos and admit informationCase 2- x-rayCase 3- MRICase 4- non-releasable/placement at Hogle ZooHighlights: gunshot, bubble brain, transferred to zoo

Patient B: Steep StairsCase 5- photos and rescue reportCase 6- release exam and observationsCase 7- ultrasound/pupCase 8- restrand/photos/releaseHighlights: shark bite, pregnant, released, pup, restranded, 2nd shark bite, released

Patient C: SleeptightCase 9- photos and admit informationCase 10- branchoscope/mites/releasedCase 11- restrand/blood testsCase 12- euthanized/necropsy reportHighlights: pneumonia, lung mites, released, restranded, leptospirosis (kidney failure), euthanized

CASE 1

Patient is a California sea lion.

CASE 1

CASE 1

CASE 2

One test used to diagnose patients is radiographs or x-rays. X-rays use electromagnetic radiation other than visible light, especially X-rays, to view structures with different densities inside a body. The denser a structure is, the whiter it appears on an x-ray. Use the normal x-ray to indentify abnormalities in the x-ray from case 2.

Normal California sea lion x-ray of head

Case 2: CSL x-ray of head

CASE 2

CASE 2

This bullet was removed from the skull of a California sea lion.

CASE 3

One test used to diagnose patients is Magnetic Resonance Imaging or MRI. MRI scanners use strong magnetic fields and radiowaves to form images of the body. MRIs are commonly used to look at brain tissues. Use the example of a normal brain scan to find the abnormalities in this case.

Normal California sea lion MRI of brain

Case 3: CSL MRI of brain

CASE 3

CASE 3

CASE 4

Patient is a California sea lion.

CASE 4

CASE 4

CASE 4

CASE 4

CASE 4

CASE 4

Patient was renamed ‘Rocky’ by the Hogle Zoo, he is the CSL on the right. He is doing well with his exhibit-mate, Maverick.

CASE 5

Patient is a California sea lion.

CASE 5

CASE 5

CASE 6

CASE 6

CASE 6

CASE 7

CASE 7

One method used to diagnose patients is through sonographs or ultrasound images. An ultrasound machine uses high frequency sound to create an image of soft tissues in a body. Ultrasounds were done on the abdonmen of case 7. Given an adult female patient with a large abdomen in the early spring, what do these ultra sound images confirm?

CASE 7

Note from Channel Island Marine and Wildlife Institute on June 12, 2012:

Mom #1 gave birth to pup #1 on the “D” dock, middle finger, of Ventura West Marina in the Ventura Harbor early Sunday morning (6/10). Around 1:00pm on Sunday, the pup fell off of the dock into the harbor. The mom quickly went into the water and pulled the pup to the rocks. Mom and pup exhibited normal bonding behaviors. They were vocalizing loudly, sniffing each other and mom used her mouth to help the pup get into position for nursing. The pup has been seen and heard nursing vigorously. Both appear to be outwardly healthy. This mother was in rehabilitation with TMMC and the tag number is 27319.

CASE 8

Patient is a California sea lion in Southern California. Email from a rescue volunteer:

August 16, 2012I’ve run Marine Animal Rescue in LA County for the past couple of decades. www.marspecialists.org Some weeks ago Lifeguards contacted me late evening about a tagged, stranded sea lion at Will Rog-ers Beach. Tag 27319. Because the sea lion was tagged, showed no signs of distress and was in an area where it wouldn’t be disturbed, I decided to leave the animal for the night and check it first thing in the morning. Lifeguards reported that the body weight was good and the animal didn’t appear to be sick. The sea lion did let people get close without getting upset. But with some tagged sea lions that happens. The sea lion was on a rock jetty, not on the beach. When one of our volunteers checked the animal early the next morning, the sea lion was gone. It has not been seen since then.

I will keep you posted on any other sightings of this animal or any other animals that make it down this far!

August 20, 2012She’s back!

She came back today at Will Rogers Beach. Her body weight looks good so I believe she’s eating. She did respond when I got close by volcalizing her displeasure. She’s out of public reach now. I really don’t think she needs to be rescued at this point.

We’ll keep an eye on her!

CASE 8

CASE 8

CASE 9

Patient is a California sea lion.

CASE 9

CASE 9

CASE 10

One tool used to diagnose patients is a branchoscope or a camera that goes into the airway or lungs. Usually recorded as video, it allows veterinarians to look for abnormalities and collect samples from the respiratory system. Do you see anything abnormal on case 10’s branchoscopy? What do you think it is?

Normal California sea lion bronchoscopy of airway

Case 10: CSL branchoscopy

CASE 10

Sample collected with branchoscope

Vet notes:

The animal was very underweight and on physical examination it was apparent he had a pneumonia. When we see these sorts of indications we think about slow growing organisms like fungi or even odd things like cancer cells that have spread to the lungs, but we didn’t expect to see what we found.

We ruled out the fungi by doing some blood tests to see if any of the high antibody levels were targeting fungi. If this were a fungal pneumonia some of the elevated immunoglobulins should be against the infecting fungus. None were…

We treated with antibiotics to see if we got a response to treatment indicating that we had a bacterial pneumonia, even though it would be unusual to be in this age group and to be chronic. “Sleeptight” didn’t get any better. So our next step was to take a look inside the airways and down into the small bronchioles of the lungs with a bronchoscope. When we did we got our answer and it was surprising. Mites! Bugs living in the airways! Lots and lots of them! No wonder the lungs were inflamed and the changes were chronic! Buggy lungs! Lung mites or pulmonary acariasis is rarely reported in pinnipeds or other mammals.

The good news is that with the correct diagnosis, we instituted the correct treatment, and the prognosis is good. Subjectively, “Sleeptight” appears to feel better all ready.

CASE 10

CASE 10

CASE 11

Patient is a California sea lion.

CASE 11

CASE 11

CASE 11

One test used to diagnose patients is blood tests. The blood tests tell veterinarians if an animal is fighting an infection or doesn’t have the right amount of important vitamins and minerals. They compare a patient’s test levels to normal levels for California sea lions. Just slightly outside of the normal range is usually alright; results far outside of the normal range needs to be investigated further. Blood tests are repeated over time to see how an animal’s condition changes. What do you notice about case 11?

Previous blood results at TMMC

CASE 11

CASE 11

CASE 11

Restrand blood results at TMMC

CASE 12

Unfortunately, some animals die while at TMMC. When this happens, our researchers perform a necropsy, or an animal autopsy, in order to see what killed the animal. During a necropsy, every organ system is examined and any abnormal results are recorded. Reveiw the necropsy report to see what was wrong with case 12.

CASE 12

CASE 12

CASE 12

CASE 12

CASE 12

CASE 12

CASE 12