Differential Diagnosis of UTI Symptoms

Differential Diagnosis

Positive Data

Negative Data

Recurrent kidney infection

Lower back pain, fever; pain localized to right lumbar and right CVA area; pain intensity 3-7 on Visual Analog Pain Scale (with 10 on VAS for natural childbirth)

No family history of renal disease; sister with history of kidney stones

day course of Cipro; symptoms returned in second week

Pain from back does not radiate to bladder or pubic area

Consuming cranberry juice and 4-6 glasses of water per day

Denies hematuria

Experiencing mild dysuria ("slightly stinging")

No edema; no lesions of genitalia

Drinking coffee, but not cola or tea

Denies frequency of urination; no history of recurrent UTTs or kidney infections

Mild dysuria; WBC 6-8 per high powered field

Renal calculi

Diagnostic indications

Antibiogram culture & sensitivity; UA; IVP

Therapeutic indications

Begin regimen of probiotic (Florajens 3); Prescribe RX for Septra DS one po bid for 10 days if UA…… [Read More]

Differential Diagnosis for Mrs Patrick and Give

differential diagnosis for Mrs. Patrick and give the most likely probable diagnosis.

A review of the case reveals that Mrs. Patrick could be suffering from Fibroblastic rheumatism, heumatoid Arthritis, Sarcoid arthropathy, Acute viral polyarthritis or heumatoid Arthritis.

Fibroblastic rheumatism is noted by Chkirate and Job-Deslandre (2001) to be a very rare disease of an unknown etiology. It however shares certain features of arthritis, nodules as well as arthraglia. The disease causes flexion contractures in most of the patients, a symptom which Mrs. Patrick lacks. In half the cases, thickened palmar fascia is presented.

Sarcoid artropathy

This is a chronic arthritis in the sarcoidosis and it may be polyarticular or oligoarticular. In most cases, it presents itself similarly to A.In most cases it affects knees, hands, ankles and wrists as well as interphalangeal joints and metacarpophalangeal. It is also normally associated with parenchymal pulmonary disease.It is distinguished from heumatoid Arthritis by:…… [Read More]

Differential Diagnosis and Treatment for Several Possible Maladies

Healthcare -- Nursing -- Case Study

I am required to make differential diagnosis, examine health issues and their management, order diagnostic tests and provide health teachings/health promotion for "Ted." Ted is a 55-year-old Caucasian man with general malaise and a 6-day history of a productive cough. During this time he had noticed a gradual accumulation of fluid in his legs and feet. He had not seen a health care professional in 3 years. His social history was significant because he smoked about a pack of cigarettes a week. Ted reported having a dry, hacking cough for years, but he attributed it to 30 years of smoking. The review of systems was unremarkable. Generally he appeared well nourished and in no acute distress. The physical exam showed the following: weight 142 pounds, height 5'8," blood pressure 150/92 mmHg left arm and 158/96 mmHg right arm, temperature 99.2 degrees F, and oxygen…… [Read More]

Diagnosis of Possible Anorexic

Geriatric

The author of this report has been asked to review the results and history of a woman who has come for treatment. She is a woman with Irish descent and there are some fairly disturbing signs that can be seen through her medical history, her current results, what she is taking in terms of drugs and her list of diagnoses. Each of those factors, facts and diagnoses will be explored in terms of the implications, the likelihood of a problem and so forth. While anorexia would be a pretty bad thing for this patient to have, it does indeed seem to be the most pressing and likely thing going on with this patient.

Vitals

Before getting to the primary and other diagnoses, there are a few things in the vitals and basic information that should be explored. First, the woman in question is a scant five feet tall and…… [Read More]

Planning for Diagnosis and Treatment

Diagnosis and Treatment Planning

Contemporary Approaches Used for Assessment and Diagnosis

The Center for Quality Assessment and Improvement in Mental Health relates screening tools used for screening for bipolar disorder to include the 'Mood Disorder Questionnaire' (MDQ); the 'Composite International Diagnostic Interview (CIDI) ipolar Disorder Screening Scale'; Differential Diagnosis of ipolar Disorder I & II vs. Major Depressive Disorders; and Obtaining a Family History Through the Use of a Genogram. The MDQ is designed for use as a tool to aid in screening for present and past incidences of mania and hypomania and includes 13 questions related to the symptoms of bipolar disorder in addition to items that assess the clustering of symptoms as well as any functional impairment. (CQAIMH, 2014, paraphrased) The Composite International Diagnostic Interview (CIDI) ipolar Disorder Screening Scale' can be used to make accurate identification of "both threshold and sub-threshold bipolar disorder." (CQAIMH, 2014, p. 1)…… [Read More]

Abnormal Psychology Theories Issues Diagnosis

The DSM explicitly "strives to be atheoretical, using merely observationally referent terms. The hope with this is to make the manual as acceptable as possible to professionals with different theoretical orientations (Gilles-Thomas 1989, Lecture 2). Specific criteria and systematic descriptions are offered as guidance for making diagnoses. "Essential features, associated features, prevalence rates, sex ratios, family patterns, and differential diagnoses are listed" and it is noted when "alternative or additional diagnoses…should be considered," such as the possibility that a manic episode could mask itself as schizophrenia (Gilles-Thomas 1989, Lecture 2). This might occur if the clinician was unacquainted with the patient and the patient's past history of depression, for example, and/or mood disorders in the patient's family.

Also key to the efficacy of the DSM in approaching the ideologically and theoretically charged world of abnormal psychology is its multiaxial system. The multiaxial system "allows for a more holistic and comprehensive…… [Read More]

ADHD Diagnosis Treatment

Volume 2 Case Number 21
Attention Deficit Hyperactivity Disorder (ADHD) affects clients across the lifespan, although it is more common in children. Data from the Center for Diseases Prevention and Control (CDC) indicates that approximately 6.1 million children in the US had ADHD in 2016 (CDC, 2019). In some cases, however, ADHD is not detected early and progresses into adulthood, where it affects an individual’s ability to run a household, maintain employment, and care for children. The presenting client is a 30-year old female diagnosed with post-traumatic stress disorder (PTSD), poly-substance abuse, and long-standing schizoaffective bipolar-type disorder. The client reports involvement in criminal activity, impulsiveness, hallucinations, difficulty managing anger, persecutory ideation, poor academic performance, and self-mutilatory behavior. This text seeks to develop an individualized treatment plan for the client with co-occurring ADHD and PTSD.
Questions to Ask the Client
Clinical interviews are crucial for effective treatment. A fundamental question to…… [Read More]

Headaches From Too Much Computer Use

Diagnosis of Patient

The author of this report has been asked to diagnose a youth that has come in complaining of an inability to sleep. The girl seems to be in good overall health but she is having some pain. She does not pay a whole lot of attention to the doctor as the doctor enters the room. She briefly glances up and says hello but looks back down. The child apparently has a fixation on computer and phone use and the mother believes this is a factor. The child retorts that the use of the phone and the computer is instead a distraction from the pain she is experiencing. There are no previous childhood illnesses and the she has not been diagnosed with any chronic illnesses. There have been no hospitalizations or surgeries. Immunizations are completely up-to-date at this point. There have been no blood transfusions. The child denies…… [Read More]

Ankle Pain Diagnosis Management

Ankle Pain
Candace, a 15-year-old softball player, presents due to ankle pain that developed after she twisted her ankle during a game. Ankle sprains and pain are common occurrences in athletes to an extent that they continue to be the subject of interest in sports medicine (McGovern & Martin, 2016). As evident in Candace’s situation, ankle sprains and injuries are common among individuals who are physically active. Therefore, early diagnosis and management of these conditions is crucial toward enhancing the patient’s health and wellbeing. The diagnosis process requires obtaining information to support possible differentials of strain, sprain, tear, or fracture. Information for proper diagnosis and identification of these factors is obtained through history and objective assessment. Some of the information needed include history of ankle injury, severity of injury, history of fracture, anatomical features, and clinical history.
Once diagnosis is made, a suitable intervention plan for treatment or management of…… [Read More]

Dermatology Issues

Dermatology Differential Diagnoses

Dermatology Differential Diagnosis

Skin conditions can be notoriously difficult to diagnose. It is crucial to understand the epidemiology and pathology of common conditions in order to make a thorough diagnosis of the current case. Here, the research states that "key questions for the patient include the time of onset, duration, location, evolution, and symptoms of the rash or lesion. Additional information on family history, occupational exposures, comorbidities, medications, and social or psychological factors may be helpful" (Goldstein et al., 2012). All of this knowledge provided by the patient can ultimately help lead to differential diagnoses that can then prepare treatment.

In this current case study, there is a 33-year-old male suffering from a rash. The patient has a rash of 2-weeks duration located behind the knees and elbows bilaterally. It is itchy, red, somewhat raised, and dry. At times it has had clear drainage. Thus, the "papules…… [Read More]

Ulcerative Colitis Initial Presentation the Patient Is

Ulcerative Colitis

Initial presentation

The patient is an 18-year-old of the Filipino-American origin. He has no known family history of ulcerative colitis or chronic illnesses similar to colitis. He is a high school senior student.

Historical information

The patient complains of diarrhoea 3-4 times a month although it has been on and off for one year. There is no known allergy that the patient experiences.

Presenting Symptoms

He experienced rectal bleeding, rectal pain and often had an urgent need to empty his bowels. His diarrhoea had bloodstains with mucus at least once a month. This led to few red blood cells due to the low level of iron, which resulted from the bloody stool. He had belly pains, which he described as cramping and his belly felt sore if touched. He experienced constipation, but it was less frequent than diarrhoea. He had no signs of vomiting or nausea, but he…… [Read More]

Pancreatitis the Pancreas Is an Important Source

Pancreatitis

The pancreas is an important source of digestive enzymes and fluids, and plays a critical role in regulating blood sugar levels through the production of insulin and glucagon (NDDIC, 2012). Should the pancreas become inflamed there is the risk that the digestive enzymes will become activated within the pancreas, resulting in self-digestion. This disease is known as pancreatitis and even mild cases require hospitalization. This essay will review what is known about pancreatitis in the United States and the clinical guidelines for diagnosis and treatment.

Pancreatitis Pathophysiology, Epidemiology, and Etiology

The digestive enzymes produced by a healthy pancreas are secreted into the small intestine as zymogens, which are enzymes that have their catalytic domain blocked by a peptide group (Berg, Tymoczko, and Stryer, 2002). The intestinal brush border cells secrete enteropeptidase, which removes the peptide blocking the catalytic domain of trypsin. Trypsin then activates the digestive enzymes secreted by…… [Read More]

Tori J Is a 12-Year-Old Girl Who

Tori J. is a 12-year-old girl who was removed from her family at the age of 8, when she was placed with a foster family. Although her foster mother discussed some episodes of violence and defiance in the home, Tori was not initially violent or defiant in school. However, she frequently failed to complete her assignments, instead spending hours simply looking into space. She also spoke frequently to social workers and school counselors about problems in her foster home including allegations that she was not being fed sufficiently, that they would not purchase school supplies for her, and that there was emotional and physical abuse in their current home. These allegations were reported and determined to be unsubstantiated, but allegations of emotional and physical abuse and neglect in her family home were substantiated. The children were removed because of physical abuse and neglect. Interviews with Tori J.'s older brother reported…… [Read More]

Clinical Decision Making Guide Subjective

A level of 126 mg/dL or above, confirmed by repeating the test on another day, means that you have diabetes.

An oral glucose tolerance test measures your blood glucose after you have gone at least 8 hours without eating and 2 hours after you drink a glucose-containing beverage. This test can be used to diagnose diabetes or pre-diabetes. OGTT is more sensitive than the FPG test for diagnosing pre-diabetes, but it is less convenient to administer. The OGTT requires you to fast for at least 8 hours before the test. Your plasma glucose is measured immediately before and 2 hours after you drink a liquid containing 75 grams of glucose dissolved in water.

If your blood glucose level is between 140 and 199 mg/dL 2 hours after drinking the liquid, you have a form of pre-diabetes called impaired glucose tolerance or IGT, meaning that you are more likely to develop…… [Read More]

Case Report Do Not Do Influenza or Step Throat

practitioner in a family medical practice, a physician will see an assortment of ailments. Many inflicted individuals first seek aid in a family practice setting. From that point multiple outcomes and referrals are possible. The treatment can also vary greatly. Treatment can range from a simple dose of antibiotics to surgery. In this aspect, family clinics and physicians are of great importance in American society. Branchial cleft cysts are fairly uncommon and there are three known types. As it is the result of a recessive genetic disorder, both parents must be carries for the ailment. "The birth defect may appear as open spaces called cleft sinuses, which may develop on one or both sides of the neck. A branchial cleft cyst may form from fluid drained from a sinus. The cyst or sinus can become infected" (McGuirt, 2005). This type of cyst is generally composed of squamous or columnar cell…… [Read More]

Epidemiological Considerations Anthracis Originates in Soil in

Epidemiological considerations anthracis originates in soil in a lot of regions of this world in which we live. Environmental aspects (for example plentiful precipitation subsequent to a phase of water dearth) might improve spore mass in soil, even though the precise impact of such features remains badly understood (Bell, Kozarsky, Stephens, 2002).

The organism by and large subsists in the endospore shape in environment; germination of spores exterior to an animal congregation might take place when the subsequent situations are encountered (Bell, Kozarsky, Stephens, 2002):

elative humidity >95%

Presence of sufficient nutrients

Temperature amid 8°C and 45°C

PH amid 5 and 9 (Bell, Kozarsky, Stephens, 2002)

Endospores are opposed to heat, drying, gamma radiation, ultraviolet light, and various antiseptics. Spores can continue in soil for decades, as exemplified by organic combat researches all through World War II on the Scottish island of Gruinard. All through 1943, as well as 1944,…… [Read More]

Neuroborreliosis Borrelia Burgdorferi or Bb

Treatment

The Infectious Diseases Society of America or IDSA came out with guidelines on the treatment of the infection.

A multidisciplinary group, which prepared these guidelines, included infectious disease specialists, rheumatologists, neurologists, pediatricians, and entomologists. The guidelines primary apply to the disease strain acquired in the U.S. And do not tackle the diagnostic evaluation of the disease. They recommended oral and parenteral therapies according to a timetable. Doxycycline or amoxicillin, cefotaxime or penicillin would be prescribed. The guidelines warned against the use of first-generation cephalosporins, fluoroquinolones, and benzathene penicillin.

Greater Recovery Among Children

Studies conducted on 177 children treated for Lyme neuroborreliosis in an endemic area in Sweden showed that 117 of them recovered complete in two months.

The children exhibited fatigue, facial nerve palsy, loss of appetite and fever as symptoms. Antibiotics were given to 69% of the children. At 2 months, 117 of them recovered completely. At 6…… [Read More]

Issues in the Field of Neuroscience

.....neuroscience is one of the most common scientific field of study that basically involves study of the nervous system. Most of the jobs in neuroscience involves dealing with some problems that do not necessarily involve working in the lab. An example of such jobs that interests me is neuropsychology, which is an area in neuroscience that focuses on the science of brain-behavior relationships. I find clinical neuropsychology as an interesting field of neuroscience since it combines concepts of psychology in the study of the nervous system, particularly brain-behavior relationships. Given the combination of neuroscience and psychology, clinical neuropsychology will enable me to feel empathy for my patients/clients when addressing their issues (Ogden, 2012). In light of my passion for this field, brain functions and neuroscience that I find interesting are neurobiological theories that explain dysfunctions in language, behavior networks, vision, memory, and emotion. These brain functions and neuroscience are interesting…… [Read More]

Andrea M Is a 21-Year-Old Female in

Andrea M. is a 21-year-old female in her fourth year of college with aspirations to become a civil rights attorney. She was first recommended to seek treatment when she experienced her first panic attack three years ago. At the time, a friend advised her to seek counseling. However, Andrea never did seek counseling at that time. Andrea has since been avoiding certain types of social situations, has gravitated towards jobs with as little social contact as possible, and fears that her anxiety may be impacting her performance in school and her ability to find viable work as an intern this summer. She loves "diving into my work" and becoming absorbed in her academics, but when it comes to attending classes, Andrea feels stressed and has been missing more classes than she has ever before. After not showing up to classes for two weeks, and an incident involving alcohol poisoning during…… [Read More]

Fact Sheet on Hypomagnesaemia

Hypomagnesemia

Fact Sheet on Hypomagnesemia

Hypomagnesemia: An overview

Etiology, pathophysiology, incidence & prevalence

Hypomagnesemia, otherwise known as magnesium deficiency, is defined as the patient possessing a serum Mg concentration of < 1.4 mEq/L (< 0.70 mmol/L) (Lewis 2009).

Differential diagnosis

Hypomagnesemia is often seen in alcoholics, in pregnant or nursing women, or patients with gastrointestinal disorders due to their inadequate intake of vital fluids and excessive secretion. Other complaints associated with the deficiency include hypercalcemia after removal of parathyroid tumor and diabetic ketoacidosis (Lewis 2009).

Evaluation

An evaluation of the patient, in addition to lab work, will involve a full examination and a review of his or her disease history associated with hypomagnesemia.

History

Given the causes include taking drugs such as furosemide; a full medical review of the patient's history must be considered (Lewis 2009).

Physical examination

Common symptoms can be both psychological as well as physical in nature…… [Read More]

Arterial Ulcerations Management of Arterial Ulcerations in the Diabetic Patient

Arterial Ulcerations:Management of Arterial ulcerations in the diabetic patient

Arterial Ulcerations: Management of Arterial ulcerations in the diabetic Patient

There Approximately 10 per cent of all leg ulcers are arterial ulcers. The legs and feet are often start to feel very cold and then they may have a color that looks either white or blue, shiny appearance. Arterial leg ulcers normally can be certainly painful. Pain normally starts to escalate when the person's legs are elevated and resting. ith this condition, most have learned tha they can reduce that pain just by lying down on the bed. The gravity will then cause more blood to start flowing directly into the legs. Ulcers normally happen when the breaks in the legs do not heal properly. They may be escorted by irritation. A lot of the times they do not heal correctly thus causing them to become chronic. People that have arterial…… [Read More]

Vaginosis a Growing Scourge Among

A newer and easy test is the OSOM Vlue, which mixes a swabbed specimen from the vagina with a reagent. The test yields sialidase activity or presence in the vaginal fluid in 10 minutes. Sialidase is produced by V pathogens (Mashburn).

pH Level

The most reliable criterion for detecting V is a pH>4.5 (Mashburn, 2007). A normal pH should, therefore, rule out V. A pH >4.5 can also indicate trichomoniasis or muco-purulent cervicitis. Vaginal inflammation more strongly suggests trichomonas or muco-purulent cervicitis, in turn associated with gonorrhea or chlamydial trachomatis (Mashburn).

The patient's pH level is 6, indicating V.

Wet Smears

These are an inexpensive and relatively easy screening procedure for the most common sexually transmitted diseases, such as V (Iglesias, Alderman & Fox, 2000). The practitioner should be appropriately trained and experienced in using this procedure. Hence, the proper protocol and quality control are needed to insure accurate diagnosis.…… [Read More]

Treatment to Patients the Main Objective of

Treatment to Patients

The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…… [Read More]

Treating Depression with ACT

Acceptance and Commitment Theory

It largely appears as though Jacob is experiencing signs of depression. There are a number of telltale signs which point to this assessment. One of these signs is he has recently experienced a life-altering event with the loss of his business. Such a loss is especially devastating for this individual because it was his sole source of income, which lends a degree of pragmatism to the sort of anxiety which can rapidly lead to depression (Cadigan and Skinner, 2015, p.293). This notion is compounded by the reality that he seems somewhat unilateral in his interests, claiming his former business was his sole hobby. As such, it appears he feels he has nothing else to turn to in such a time, which might heighten any feelings of depression. It is important to realize such perceptions on his part are likely aggravated by the frustration of being in…… [Read More]

Assessment of a Patient's Abdominal Pain

Assessing the Abdomen

Abdominal pain has proven to be a major issue facing emergency room doctors since the diagnosis process is relatively complex. Meisel (2011) contends that doctors in emergency rooms do not fancy diagnosing and treating abdominal pain because it entails dealing with bodily fluids, complex internal examinations, and a wide range of diagnostic tests and therapies. This comes at a time when abdominal pain is one of the major reasons American patients visit the emergency room (ER). Caring for abdominal pain is characterized by a high chance of misdiagnosis unlike other health issues. ER doctors are faced with challenging and time-consuming processes when trying to determine the actual cause of abdominal pain. This is a case study of a woman who visited an emergency room for severe abdominal pain and was diagnosed with diverticulitis. The case study entails an analysis of SOAP (Subjective, Objective, Assessment, and Plan) factors…… [Read More]

Analyzing Odyssey Dante Frankenstein

Depression in Adolescence

Depression in Adolescents

The link between symptoms, etiology, core biochemical processes, treatment outcome, and treatment response of affective (mood) disorders is yet to be adequately understood for allowing their categorization, such that it meets universal approval. Still, one has to make an attempt in this regard, and researchers propose a potentially-acceptable one, derived from extensive consultation.

In case of affective disorders, the basic disturbance is an affect (mood) change, typically extreme elation or depression (without or with related anxiety). An overall activity level change generally accompanies this change of mood, and a majority of other related symptoms either will be conveniently recognized in the context of these changes, or will be secondary to them. Most disorders have a tendency of repetition, and the commencement of individual bouts is usually linked to stressful circumstances or occurrences.

The key criteria of classification of affective disorders have been selected for…… [Read More]

Analyzing Depression in Adolescent

Depression in Adolescence

Depression in Adolescents

The link between symptoms, etiology, core biochemical processes, treatment outcome, and treatment response of affective (mood) disorders is yet to be adequately understood for allowing their categorization, such that it meets universal approval. Still, one has to make an attempt in this regard, and researchers propose a potentially-acceptable one, derived from extensive consultation.

In case of affective disorders, the basic disturbance is an affect (mood) change, typically extreme elation or depression (without or with related anxiety). An overall activity level change generally accompanies this change of mood, and a majority of other related symptoms either will be conveniently recognized in the context of these changes, or will be secondary to them. Most disorders have a tendency of repetition, and the commencement of individual bouts is usually linked to stressful circumstances or occurrences.

The key criteria of classification of affective disorders have been selected for…… [Read More]

Patient with Chest Pain

1. Subjective
Patient’s chief complaint: A man aged 69 comes to the emergency room with a sharp pain to his chest’s left side, lasting between 30 and 40 mins and then subsiding.
History of present illness: The pain has woken him up thrice in the last 7 days. He claims the pain first started roughly six months ago. Initially, however, the pain used to surface only occasionally, commonly while he was doing gardening. The patient’s past medical history reveals a diagnosis of hypertension twenty-five years back.
Precipitating/alleviating factors: The patient has been smoking a half-cigarette pack daily for the last forty-five years.
Family History: The patient has lost two brothers and his dad to heart disease. The patient does not report any other significant illness history in the family.
Social History: His typical pastimes include sharing a drink with pals and gardening.
Review of Systems: From a physical examination of…… [Read More]

Assessing a Patient with Stomach Pain

Assessing the Abdomen
The chief complaint of JR is that his “stomach hurts” and he is experiencing diarrhea, from which he has been unable to obtain any relief. His pain in his abdomen started 3 days earlier and he has taken no medication for it. The pain is midrange, though it was very high today when it began. He ate but experienced nausea afterwards. JR is 47, suffers from hypertension, diabetes and had an issue of gastrointestinal bleeding four years ago. He is on a number of medications to address his high blood pressure and diabetes. He has no known drug allergies, no history of colon cancer. His father and mother both had hypertension; his father has type 2 diabetes; his mother suffered from Gastroesophageal reflux disease and high fatty concentration in the blood (hyperlipidemia).
JR occasionally imbibed alcohol. He is overweight at 248 lbs with a 5’10” height. He…… [Read More]

How to Identify Psoriasis and What to Do About it

Psoriasis

The assessment tool to be used here to rate the severity of the patient's psoriasis will be the Psoriasis Area and Severity Index (PASI). PASI provides a "measure of fthe average redness, thickness, and scaliness of the lesions (each graded on a 0-4 scale), weighted by the area of involvement" (Feldman, Kreuger, 2005, p. ii65). I am choosing this tool because it is the most traditional and widely used way of rating the severity of psoriasis in spite of its limitations. Nonetheless, the PASI is admittedly the "gold standard for assessment of severe psoriasis (Feldman, Krueger, 2005, p. ii65).

A second assessment tool could be the Physician Global Assessment (PGA), which can be used for extensive break-outs or localized plaques (Feldman, Krueger, 2005). The static form is the most reliable in assessing the severity of psoriasis and has become a standard assessment tool.

A third assessment tool in development…… [Read More]

GAD and Anxiety Disorders

Generalized Anxiety Disorder

Background/Definition/Epidemiology

Humans have a natural response to survival, stress and fear. Such responses enable an individual to pursue pertinent objectives and respond accordingly to the presence of danger. The 'flight or fight' response in a healthy individual is provoked via a real challenge or threat and is utilized as a means of acting appropriately to the situation. However, when an anxiety disorder manifests in someone, then an inappropriate/excessive state of arousal develops. People then feel symptoms of fear, apprehension, or uncertainty. These feelings or reactions may surface even when no real threat exists.

Generalized Anxiety Disorder (GAD), is a common anxiety disorder that affects roughly 5% of the United States general population. "GAD is commonly associated with psychiatric and medical comorbidities and is often chronic. GAD is associated with extensive psychiatric and medical utilization and, if left untreated, can cause impairment as severe as major depressive disorder…… [Read More]

Infectious conditions in a pediatric patient

Infectious Conditions in a Pediatric Patient

What will be your differential diagnoses for this patient?

Chickenpox

Measles

ubella

Scarlet fever

Erythema infectiosum (5th disease) -- human parvovirus

Exanthema subitum or oseola infantum

Non-polio entero-viruses (e.g., echovirus, coxsackievirus) (Long, 2016; de Graaf et al., 2016; Long, Pickering & Prober, 2012)

What specific physical exam findings support these differential diagnoses?

Chickenpox:

• Palmar redness

• Excoriating diaper-area rashes

Measles:

• Injected conjunctiva

• Excoriating diaper-area rashes

ubella:

• Excoriating diaper-area rashes

Scarlet fever:

• Magenta-colored lips

• Palmar redness

• Excoriating diaper-area rashes

Erythema infectiosum (5th disease) -- human parvovirus

• Excoriating diaper-area rashes

Exanthema subitum or oseola infantum

• Excoriating diaper-area rashes

Non-polio entero-viruses (e.g., echovirus, coxsackievirus):

• Excoriating diaper-area rashes

• ed macula

• Magenta-colored lips

• Palmar redness

Of the differential diagnoses you listed, which would be the most concerning?

Non-polio enteroviruses

What additional diagnostic tests will you recommend?…… [Read More]

Migraine Headache

Migraine Headaches

Patient

Nancy Smith

9/10/66 (46 years old)

Gender

Female

ace

African-American

eligion

Marital Status

Married

Occupation

Caregiver

Chief Complaint

Extremely painful headache that won't go away.

Differential Diagnosis:

Possible Diagnosis

Migraine Headache

Potential Diagnosis

Deep pounding headache more pronounced behind eyes;

- Headache has lasted more than 72 hours

- OTC Pain medications ineffective (Tylenol)

No accompanying nausea or vomiting

Physical Exam: Elevated blood pressure

Diagnostic Testing: Frequency of symptoms log; More than 72 hours of pain; Two or more of unilateral, pulsating, moderate or severe pain; not reporting nausea or sensitivity to light; lack of response to pain medication

TMJ (Tempormandibular Joint Disorder)

Unlikely Diagnosis

History: Emanating pain but no jaw spasm or difficulty chewing or biting

Physical Exam: No clicking or popping of TMJ when opening or closing mouth

-No inflammation of muscle around jaw

Diagnostic Testing: No jaw pain or face pain, no earache so…… [Read More]

Neurological Disease

Week 1
The field of neuroscience that interests me most is a research position at a hospital or university. I believe that being attached to a research facility within the medical community has the potential for high demand in the future, as a growing segment of the population ages and develops Alzheimer’s and dementia. Neurological disorders have a devastating effect on the person affected, and those around them. I see neurological diseases of the aging process as particularly devastating because the person slowly loses their life and their special connection with those who love them. I am interested in two areas in particular. I am interested in Alzheimer’s disease and other forms of dementia, and disorders of memory that occur at any age.
To be successful in this career path, it will be essential to focus on the research methodology and procedures for both human and animal studies. Any projects…… [Read More]

Dysphagia in the Elderly the

" (Stone, 2006) Treatment is stated by Stone (2006) to be "diagnosis dependent and may be medical or surgical." Practical modifications include simple steps such as crushing of pills or opening of capsules to ease and facilitate swallowing.

The work of Leibovitz, et al. (2007) entitled: 'Dehydration Among Long-Term Care Elderly Patients with Oropharyngeal Dysphagia" states that long-term care (LTC) residents in the nursing home "especially the orally fed with dysphagia are prone to dehydration. The clinical consequences of dehydration are critical. The validity of the common laboratory parameters of hydration status is far from being absolute, especially so in the elderly." (Leibovitz, et al., 2007) it is related however that "combinations of these indices are more reliable." (Leibovitz, et al., 2007) the study reported by Leibovitz et al. is one that assessed hydration status among elderly LTC residents with oropharyngeal dysphagia and in which a total of 28 orally…… [Read More]

Diagnosing HSV

Introduction
Patient AB has a history of sexually transmitted infection (STI). She has also had more than one partner in the last twelve months. The last known STI was chlamydia over two years ago. She also has an ulcer on external labia. While the bumps on her genitals are painless, they are a recent event, and says the bumps feel rough. While there several potential diagnoses available, not enough information has been given. A current blood test to screen for STDs/STIs would be beneficial along with hygiene habits like does she shave regularly. This essay is a thought process of what she could have from the collected information.
Subjective Portion of the Note Analysis
Patient stated her bumps are rough feeling and painless. She did not say how many sexual partners she has had. All she said was she had more than one in the last twelve months. She also…… [Read More]

Schizophrenia While All Mental Illnesses Continue to

Schizophrenia

While all mental illnesses continue to carry some sort of stigma, perhaps no mental illness is more widely misunderstood than schizophrenia. In fact, prior to the introduction of some of the more modern medications, it was virtually impossible to live a normal life if one had a diagnosis of schizophrenia. The complex interplay of symptoms experienced by most schizophrenics lent those patients the classic air of madness. Moreover, the combination of hallucinations, delusions, and disorganized thought contributed to the air of dangerousness (see APA, 2000). While the mentally ill, as a whole, are no more dangerous to themselves or others than the general population, the reality is that an individual with schizophrenia could be much more dangerous than the population as a whole. Moreover, there was no standard treatment of the patient with schizophrenia. Schizophrenia crosses all races and cultures, so that a wide variety of cultural treatments contributed…… [Read More]

Nursing Rash Patient Discussion

Scabies

Chief Complaint

The patient's chief complaint is a rash and scathes that appear as tunnels. There are small, grey-white linear lesions with a minute black speck at the closed end. The rash is persistently itchy.

Precipitating/Alleviating Factors/Past Medical History

There are no obvious precipitating factors. The patient is young and otherwise healthy. The patient has a normal diet, and reports no surgeries, history of illness, medications (except OTC Tylenol) or allergies. The patient works in an oil field, however, and in the course of that work may have been exposed to hazardous chemicals, which are common in that industry. The patient's family does not have any medical history that appears related to the rash. The patient is sexually active with one partner. The patient's financial and living situation is stable. It is not known if the partner has a similar rash, but this would be important information because scabies…… [Read More]

Social Deprivation Language and Learning

..set of critical stages for normal psychologic development." (2001) Kandel relates that prior to formal studies being conducted on material deprivation: "...a few anecdotal examples of social isolation were collected by anthropologists and clinicians. From time to time children had been discovered living in an attic or a cellar, with minimal social contact, perhaps spending only a few minutes a day with a caretaker, a nurse or a parent. Children so deprived in early childhood are often later found to be speechless and lacking in social responsiveness." (Kandel, 2001) According to the National Joint Committee on Learning Disabilities in the work entitled: "Issues in Learning Disabilities: Assessment and Diagnosis": Diagnosis, assessment and treatment must be in the nature of 'differential diagnosis' in making identification between varying disorders, syndromes and other factors that impact the acquisition of the skills of listening, speaking, reading, writing reasoning or mathematical abilities." (National Joint Committee…… [Read More]

Pediatric Depression and Evidence Based Practices

Pediatric depression affects millions of children worldwide (Giardino & Benton, 2016) and presents prevalently as a child ages. "The risk for depression increases during childhood" (Bonin, 2016). A comparatively common mental health problem that usually continues intermittently into maturity, pediatric depression may be brought on by various factors. It may be triggered by biologic processes, damaging experiences, or a combination of both. A main determiner for pediatric depression remains up for debate. What is certain, is that chemical changes in the brain bring in the closing common pathways to depression.

To help a child struggling with depression, it is important to understand and learn to identify the signs and symptoms. Major depressive episodes seen in pediatric depression frequently last anywhere from two weeks and include a minimum of five symptoms. A list of symptoms is provided below.

Depressed (or irritable) mood

Diminished interest or loss of pleasure in almost all…… [Read More]

Diagnosing for Various Scenarios

Jennifer experienced fever and palpable cervical nodes. This means she could have an infection as a result her tonsils. The infection could have led to lymphadenopathy. Since most patients that contract lymphadenopathy experience localized lymphadenopathy, Jennifer most likely has localized lymphadenopathy. "Distinguishing between localized and generalized lymphadenopathy is important in formulating a differential diagnosis. In primary care patients with unexplained lymphadenopathy, approximately three fourths of patients will present with localized lymphadenopathy and one fourth with generalized lymphadenopathy" (Ferrer, 2015, p. 1).

Palpable nodes are often swollen nodes that can be a result of an infection. Because her fever climbed over time and stayed relatively high, Jennifer may be experiencing acute infection since her patient history revealed no signs of previous disease. Causes for lymphadenopathy are often obvious.

"The cause of lymphadenopathy is often obvious: for example, the child who presents with a sore throat, tender cervical nodes and a positive…… [Read More]

The Aviator Howard Hughes OCD and Bipolar

Hughes would be diagnosed with bi-polar disorder, with differential diagnoses consisting of obsessive-compulsive disorder (OCD) and agoraphobia. As DSM-V (2013) states, the diagnostic criteria for Bipolar 1 Disorder are as stated, "For a diagnosis of bipolar 1 disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes" (p. 123). This diagnosis may very well apply to Howard Hughes, as throughout the film The Aviator, he demonstrates an impulsive personality and is not adverse to taking enormous risks, in which his entire fortune and even life are on the line. He alternates between manic-depressive moments, where he shuts himself away for months, and moments where he emerges as a king-of-the-world type of figure (as in the court room scene towards the end of the film, when he defends himself). These…… [Read More]

Myelodysplastic Syndrome

Myelodysplastic Syndromes, which were previously considered rare, are currently known as some of the most frequently occurring hematological neoplasms, perhaps affecting over 30,000 patients each year within the U.S. The nation's regulatory permission of lenalidomide, azacitidine and decitabine, from 2004 to 2006 appeared to indicate a new age in the improvement of therapy for disease modification for these disorders. However, no indications of drugs being approved for MDS appear to be present in the U.S. for the past 8 years. There are no curative drugs available so far. However, some compounds under development may be approved soon. Consequently, diagnoses of MDS are still quite a heavy load, both on patients and medical care systems (Bejar & Steensma, 2014).

Background

Myelodysplastic Syndromes are a set of distinct disorders of the bone marrow that prevent the victim's bone marrow from producing sufficient fit blood cells. The disorders are often called "failure of…… [Read More]

the diagnostic criteria and treatments for PTSD

Post-traumatic stress disorder (PTSD) is classified under the rubric of Trauma and Stress related disorders in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The rubric of Trauma and Stress related disorders is itself relatively new, starting only with the DSM-5, with previous editions classifying the disorder as an anxiety disorder (Sascher & Goldbeck, 2016). Unlike anxiety disorders, all disorders classified under the Trauma and Stress umbrella are differentiated by the presence of a precipitating traumatic event (McGraw-Hill Education, 2012). In other words, one of the main diagnostic criteria of PTSD is exposure to a traumatic or stressful event: such as “death, threatened death,” violence or violation: witnessed or directly experienced (National Center for PTSD, n.d.). Military veterans are of course repeatedly exposed to such traumatic events, which is why the prevalence of PTSD is relatively high among this population cohort. In…… [Read More]

Psychological Counseling Interview Counselor Tom

Okay?

Client: Thank you Christina, I look forward to seeing you next week.

Zal (1990, p. 136) states that it can indeed be a very fragile and emotionally battered individual that comes to your office for evaluation. An adequate treatment plan for panic disorder must therefore comprise many specific aspects. The first of course is to make the diagnosis and share it confidently and directly with the patient. As the first person to encounter the patient with some understanding of his or her symptoms, you are in a unique position to do an enormous therapeutic service by giving them a clear, precise definition of their illness and once and for all showing them that their symptoms have meaning. Let them know that it is only since 1980 that panic disorder has a name and that it is only during this decade that even psychiatry is beginning to understand this malady.…… [Read More]

Security Consulting Firm

Critical Pathway: Chronic enal Failure

Advanced Pathophysiology

egents Online Degree Program

Critical Pathway: Chronic renal failure

Chronic renal failure is often occasioned by chronic kidney disease, immune disorder, trauma among other conditions. It does not have any specific symptoms and might include feeling unwell generally and experiencing a reduced appetite. It is diagnosed following screening of individuals who are identified to be at risk of kidney problems, like individuals with diabetes or high blood pressure and others who have blood relative with chronic kidney disease. It always seems complex when trying to come up with the right diagnosis for a patient.

M.A. is a 60-year-old man who has a stage V chronic kidney disease mainly as a result of diabetic nephropathy and a 12-year of type 2 diabetes. He has symptomatic peripheral vascular insufficiency, and 3 years ago he had undergone coronary artery bypass 3. Within the ten months that…… [Read More]

Is the Ankle Sprained Broken or Dislocated

Musculoskeletal Examination

Is the ankle swollen?

Does it hurt when you do not put pressure on it?

How did you hurt your ankle in the past?

Was it a tear or a sprain or a break?

Does your ankle look twisted?

Is there any numbness in your ankle?

Are you able to put any weight at it all, or is it impossible to put any weight on it?

Is there any bruising?

You did not hear a cracking sound, it was distinctly a popping sound?

Can you describe the pain when you put pressure on it from 1-10: 1 being hardly any pain and 10 being intolerable?

Can you roll your foot around from side to side?

Can you move your foot at all if you hold your leg out from where you are seated?

Differential Diagnoses:

The differential diagnosis consists of a likely high ankle sprain. The popping sound…… [Read More]

Genitourinary in Women the Things to Expect

Genitourinary

SENSOY INDOO/OUTDOO ENVIONMENT

What further questions do you have for Laura at this visit?

1,) Are you having frequent urination?

Do you have any pain in your abdomen?

Do you noticed that there is a change in color and odor of your urine?

Do you have painful intercourse?

Do you have any nausea, vomiting?

Do you have any fever, or chills?

Any history of mental illness?

Do you have any changes in sleep pattern?

Do you have any kind of abnormal uterine bleeding?

What is your differential diagnosis list for this visit thus far with rationale?

Cystitis in Females

Multiple Sclerosis

Prostatitis

Spinal Cord Neoplasms

Spinal Cord Trauma and elated Diseases

Spinal Epidural Abscess

Urinary Obstruction

Urinary Tract Infection in Males

Uterine Prolapse in Emergency Medicine

Vaginitis

Based on your differential diagnoses list, identify what body systems you'd examine along with pertinent positive/negatives in each system and any diagnostic…… [Read More]

Pigmentation the Problems Relating to Skin Pigment

Pigmentation

The problems relating to skin pigment are associated with symptoms of the skin appearing faded or deeper than the usual or often spotted and blemished. (Skin pigmentation disorders) The unusual skin development and unusual pigmentation of the skin is seen to present at the time of birth or develop at the later stages. (Benign Skin Growths and Pigmentation Disorders) The skin pigmentation disorders seem to arise over a large number of races and conditions. (Nacinamide Helps to Lighten Skin) Some problems like albinism are considered exceptional phenomenon about a single case arises in every 17000 people. Other cases like age spots are very common. (Skin pigmentation disorders) Irrespective of the fact that it is quite harmless in its effects in most of the cases, however, the growth and pigmentation disorders warrant thorough watching for any other variations that may mark a development of cancerous skin cells. There are several…… [Read More]

Patient Analysis for a Nurse Practitioner

1. Subjective
Patient’s chief complaint, reason for visit
Ms. Richards arrived complaining that she was experiencing severe anal pain, so much so that using a tissue was also proving impossible. She claimed the pain began a couple of days earlier and has aggravated considerably since.
History of Present Illness
Ms. Richards arrived complaining of anal pain which commenced a couple of days earlier and has aggravated since. With regard to her intimate relationships, Ms. Richards states that though she has a boyfriend, their relationship isn’t serious as the two are also seeing other people. According to internal assessment reports, patient has normal hair distribution, an intact perineum, and intact urethral meatus without any discharge or inflammation. However, patient experiences unbearable pain on vaginal opening palpation, redness, and edema. Further, a mass has been identified on the right, with spontaneous, dark-yellow, smelly secretion with palpation over the Bartholin's glands.
Physical examination…… [Read More]

Premenstrual Dysphoric Disorder PMDD Virtually

They also state that PMS is also normal for reproductive women.

Some critics go even farther, and blame the woman for the symptoms she is experiencing (Sellers, 2003). They suggest that the emotional and behavioral difficulties called PMDD are nothing more than basic conditioning, that the woman is rewarded for negative behavior. Sick days and other accommodations, they argue, allow the woman to skip school or work with a phony excuse, and allow them to avoid situations they find generate anxiety in them, such as difficult social interactions (Sellers, 2003).

However, the fact that the women show significant improvement during the luteal phase when taking effective medication argues against the critics' claims. In particular, the same SSRI's that work relatively rapidly in PMDD can take up to twelve weeks to help with non-PMDD depression (Steiner, 2000).

Critics also argue that "PMS provides an excuse for what would otherwise be unacceptable…… [Read More]

Alzheimer's Disease Has Developed Into a Major

Alzheimer's disease has developed into a major health concern for the elderly population throughout the world. This degenerative brain disorder was first described by Alois Alzheimer in 1907. Today Alzheimer's is one of the most prevalent forms of brain disorders contributing to as much as 50 to 70% of all reported cases of dementia. Over the years the study of early onset Alzheimer's disease (pre-senile AD) has kind of overshadowed the study of late onset Alzheimer in elderly group. However the disease statistics indicate an increasing susceptibility of the older population. Approximately 5% of the population above 65 years of age and around 20% of the people above 85 years of age are affected by Alzheimer's disease. Hence what was previously ignored as an inevitable old age symptom (senile dementia) is now being properly recognized as an illness. This new perspective of AD has resulted in a drastically altered understanding…… [Read More]

Using Drugs to Treat hepatitis C

Pharmacotherapy for Gastrointestinal and Hepatobiliary Disorders
While it is suspected that the patient HL is suffering from a possible GI/hepatobiliary disorder, more information is required before making a diagnosis of this nature. The patient’s personal history needs to be expanded upon and a physical examination should be conducted to verify any signs and symptoms in order to complete a diagnosis.
The patient is suffering from nausea, vomiting, and diarrhea. The symptoms indicate that a diagnosis of gastrointestinal (GI) and hepatobiliary disorders are affecting the patient. Culver and Chapman (2016) indicate that hepatobiliary disease is commonly associated with extremely low CD4+ counts, typically < 20 cells/µL. In order to evaluate any disorder in the liver, exams should rule out HBV and HCV infection as a differential diagnosis. So those viral infections have to be tested for before proceeding to make a diagnosis.
The patient’s Hep C infection is quite likely, especially if…… [Read More]

Facial Reanimation in Facial Paralysis

The brain while expanding pushes the skull outward in the same perpendicular to the closed structure. This will be marked by the occurrence of 'papilledema' 'pseudoproptosis' as also 'optic atrophy.' (39) This results in the orbital socket being smaller and the eyes getting 'protoposed'. The intercranial pressure is bound to be high. The symptoms in such cases will be optic atrophy, head ache and papilledema. Or in the case of 'Crouzon's disease' where occurs a marked hooked nose and a frontal lobe which makes the disease also called the parrot head disease. Surgery in both these types of situations become mandatory as the result of the cranial pressure could result in death. (39)

egarding the facial surgery discussions always centre on perfecting features and cosmetic changes. The debate must rather be on the goals of the surgery and the overall benefits that can accrue to the patient in terms of…… [Read More]

Evelyn C Is a 36-Year-Old Homemaker and

Evelyn C. is a 36-year-old homemaker and mother of two children from a previous marriage. She has a drinking problem that frequently results in her being inebriated when her children return home from school. Her drinking was initially triggered by arguments with her husband, John. ecently, she failed to pick up her children from school because she was intoxicated, and created a tremendous scene at her children's school when she eventually went to pick them up. She seems unaware of the impact that her behavior has on her children and seems to think that people are responding disproportionately to any inconvenience caused by her drinking.

The DSM-IV-T uses five different levels, or axes, to diagnose patients presenting with signs of mental illness or mental disorder. The five axes are meant to be used together to help paint a broad picture of the patient in order to develop the most comprehensive…… [Read More]

Subjective and Objective Measures to Tackle Constipation

Constipation, Unspecified

Management STATEGIES FO CONSTIPATION

Subjective

Precipitating/alleviating factors

The patient is a 34-years old male who works as a chef at a restaurant. This patient has been at the hospital for over five years and hence is one of the established patients here. The patient is well groomed, indicating his trust as a source of information. The patient denies any form of allergies to food and drugs. The patient has been considering herself as healthy except for this recent chronic constipation. The patient states that she has been having this problem for the last one year. Even with currently prescribed drugs, the patient claims to have no relief from constipation. The patient denies any form of allergies together with immunizations. The patient denies smoking, illicit drug use and use of alcohol. Moreover, the patient denies any form of previous surgeries, blood transfusions together with depression and anxiety.

Associated symptoms…… [Read More]

Cycle of Violence With Children

Despite these compelling findings, many youth are not routinely assessed for such violence exposure and its ramifications by the educational, child welfare, social service, and juvenile justice systems with which they frequently interact." (2007) This exposure is not only related to outcomes of a negative nature as well as heightened drug use and greater HIV related risk behaviors." (Vioson, 2007) the work of McDowell (2006) entitled: "Caring for Child Victims: Countering the Effects of Domestic Violence" published in the Journal of Specialists in Pediatric Nursing states that children are affected by family violence and that holistic assessment by the nurse is "essential to understanding the stressor of domestic violence." (McDowell, 2006) it is important to understand that less than one-third of domestic violence cases are reported. This author specifically charges the pediatric nurse in having the knowledge and skills necessary to identify childhood trauma from having witnessed family abuse.

Summary…… [Read More]

Henderson a Cognitive Behavioral Study of Steven

Henderson

A Cognitive Behavioral Study of Steven Henderson: Case Conceptualization and Treatment Plan

Theories of Counseling

Coun510_D04

This is a case conceptualization of a 26-year-old man who experienced sexual abuse as a child and the haunting memories of the abuse have led to difficulties in his personal, social, and educational functioning as an adult. The client is experiencing anxiety, depression, problems with motivation, an inability to confide in those close to him, and difficulties in developing educational and occupational goals for himself. He complained of very low self-esteem and believes that his inability to deal with his past sexual abuse has led to these issues. The case conceptualization explores the proposed treatment of this individual's issues using a cognitive behavioral approach. Empirical evidence for the use of cognitive behavioral treatment for trauma victims is discussed. The specific issues that the individual is experiencing as a result of the abuse are…… [Read More]

Dlb and Patient KM

¶ … medication for patient named KM is Prothiaden. Prothiaden is used to treat depression as well as limit the feelings of anxiety in those taking it. The case file indicates a normal MRI and no previous diagnosis of neurological disorders like Parkinson's disease. Patient KM has complained of depression and anxiety related to the passing of her mother. Progressive functional and cognitive decline has presented ever since mother died four years ago.

Although the patient worked until the age of 60 as an accountant, within the last 18 months patient has experienced fluctuations in mood, confusion, mild word finding difficulties and spatial disorientation. She also has visual hallucinations and violent dreams. She experienced recent falls and a slowing of motor skills. These symptoms extend to the inability to carry out motor sequences with either hand or double alternating hand movements. Although she can detect shapes well, she has poor…… [Read More]