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Janet, a 20 year-old college student, is experiencing a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. Janet gets frequent “colds” every spring and fall.

Physical Examination

Vital Signs: Temp, 98.8; BP 110/68; Pulse 72; Respirations 18

Skin: Flaking erythematous rash on the flexor surfaces of both arms

Head, Eyes, Ears, Nose, and Throat: Tender over maxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red, irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous, with clear postnasal drainage

Lungs: Clear to auscultation and percussion

Discussion Questions:
1. Provide three differential diagnoses based on Janet’s subjective and objective data and discuss your reasoning for each.

2. What additional history questions would be useful in your evaluation of Janet?

3. Discuss the pathophysiological process of your primary diagnosis.

4. Differentiate the types of hypersensitivity mechanisms.

5. As per your analysis, what type of hypersensitivity reaction is Janet experiencing?

 

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A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria. 

1. Discuss   A 12-year-old boy is brought to the office for evaluation of hives. He has no significant past medical history and no history of allergies. He has just joined the middle school soccer team and noticed that he gets hives about 10 minutes into practice. The hives are itchy and consist of irregular blotches on his legs and trunk, about 10–20 cm in size, and they persist for about 30 minutes. He does not experience swelling of the lips or oropharynx and denies any wheezing or shortness of breath. His physical examination is normal without skin lesions or oral swelling at that moment, and his lungs are clear. After evaluation, he is diagnosed with urticaria. 
2. Discuss the likely cause of the patient’s urticaria. 
3. Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient. 
4. Describe the relationship between the patient’s symptoms and the concept of inflammation.  
5. What pharmacological and non-pharmacologic treatment options are available?   
6. Discuss the complications of urticaria. 
7. What teaching would be appropriate to provide the parent and child about urticaria?  
8. Support your response with at least one current evidence based resource the likely cause of the patient’s urticaria.  
9. Describe the cellular mechanism of urticaria and how it leads to the signs and symptoms experienced by the patient.  
10. Describe the relationship between the patient’s symptoms and the concept of inflammation.  
11. What pharmacological and  non-pharmacologic treatment options are available?   
12. Discuss the complications of  urticaria.  
13. What teaching would be appropriate to  provide the parent and child about urticaria?  
14. Support  your response with at least one current evidence  based resource  and non-pharmacologic

 

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Fred, a fit and healthy 44-year-old, was working outside one warm summer afternoon. When he returned home by the end of the day, his lower back felt sore and he felt nauseated. His wife made him dinner, but he was not hungry and chose to go to bed instead. Fred’s symptoms progressed, and soon he was rolling on the bed with excruciating pain. He said his back hurt as well as his stomach and groin area. The pain would ease off only to return a short while later, and when it did, Fred would begin to sweat and run to the bathroom to vomit. His wife became concerned and she helped him into the car and rushed him to the hospital.

Please answer the following questions and submit your assignment via Blackboard by the due date.

1. At the hospital, an abdominal radiograph showed the presence of renal calculi in Fred’s right ureter (urolithiasis).  What is the pathophysiological mechanism of stone formation in the kidney? 

2. In the hospital, Fred’s urine is being strained for the presence of stones that he may have passed. What is the importance of this action?

3. What are the 4 primary types of renal calculi and what are the risk factors for each of these types of renal calculi? 

4. Hydronephrosis can be a complication of renal calculi. Why is hydronephrosis such a serious complication? 

5. View the following youtube video entitled “How do kidney stones form?”   https://www.youtube.com/watch?v=kd1OgaoHkNk&ebc=ANyPxKpOSV5R2ZhGO16_RyRrOJqxvxX0LqasixjcubWhDn5frqXcvCZuFFZQG3nvVpZSTFL0HxuUpkycrKY94szkE_ucwYOCQg 

Identify two key points that you learned about renal calculi in the video? 

 This is the grading  criteria :
Grading:Subject Knowledge and Accuracy (6 points)

• Normal physiological principles, processes, and mechanisms are explained at the molecular, cellular, and organ levels.
• Physiological processes and mechanisms relating to the pathology are clearly explained.
• Answers focus on substantive ideas that are supported by relevant facts and examples.
• Explanations are clear and incorporate appropriate vocabulary.
• Thoughtful and convincing responses clearly demonstrate depth of subject knowledge.
• Information is derived from good quality, credible sources.
• All questions are answered completely.
• All content is current and accurate.

Bibliography / Citations / Writing (3 points)

• Two (2) or more sources used for the assignment (your textbook can be one of the sources).
• All material that is not considered “common knowledge” is cited. 
• All quotations and/or paraphrasing are cited according to APA format. 
• The full reference for each citation is found in the bibliography.
• References are listed alphabetically at end of assignment in the bibliography.
• Bibliography and citations follow APA format.
• Writing is free of grammatical errors.
• Sentences are complete, clear, and concise.
• Spelling is correct.

This book should be used as reference also:
Porth’s Pathophysiology: Concepts of Altered Health States (9th edition) ISBN-13: 978-1451146004ISBN-10: 1451146000 

 

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This is the case study:

  

Laura Gray is an active woman, 82 years of age, who lost consciousness and collapsed at home. Her daughter found her mother on the floor, awake, confused, and slightly short of breath. The daughter called EMS. EMS evaluated Mrs. Gray and determined that she may have had a stroke. They notified the nearest designated comprehensive stroke center that they would be arriving with the patient within 15 minutes. The daughter reports that her mother had had an episode of sudden-onset numbness and tingling in the right limb, with slight confusion and slurred speech, 3 days previously. The episode lasted only 5 minutes and then the symptoms went away.  Additional information provided by the daughter indicates that Mrs. Gray has been treated for hypertension for 10 years but notes that she is often not compliant with her antihypertensive medicine. The patient smoked for the past 40 years, drinks occasionally, and is of normal weight. 

Please answer the following questions and submit your assignment via Blackboard by the due date.

1. What risk factors does Mrs. Gray have for a stroke? 

2. Describe how a Transient Ischemic Attack is different than an Ischemic Stroke? 

3. In the hospital, Mrs. Gray is immediately scheduled for a CT scan of her brain. What is the importance of this action?

4. Based on her history and her recent stroke, what type of dementia is Mrs. Gray at risk of developing? 

5. According to the National Stroke Association, Atrial Fibrillation raises a person’s risk for stroke by 500%. Go to the National Stroke Association web site and identify the connection between Atrial Fibrillation and stroke. http://www.stroke.org/understand-stroke/preventing-stroke/afib-stroke-connection 

6. View the following youtube video “Stroke” by Necleus Medical Media (Sample Version) https://www.youtube.com/watch?v=pcmrgwNCPwM and identify the primary differences between ischemic and hemorrhagic stroke. 

This is the assignment guidelines: 

• Normal physiological principles, processes, and mechanisms are explained at the molecular, cellular, and organ levels.
• Physiological processes and mechanisms relating to the pathology are clearly explained.
• Answers focus on substantive ideas that are supported by relevant facts and examples.
• Explanations are clear and incorporate appropriate vocabulary.
• Thoughtful and convincing responses clearly demonstrate depth of subject knowledge.
• Information is derived from good quality, credible sources.
• All questions are answered completely.
• All content is current and accurate.

Bibliography / Citations / Writing (3 points)

• Two (2) or more sources used for the assignment (your textbook can be one of the sources).
• All material that is not considered “common knowledge” is cited. 
• All quotations and/or paraphrasing are cited according to APA format. 
• The full reference for each citation is found in the bibliography.
• References are listed alphabetically at end of assignment in the bibliography.
• Bibliography and citations follow APA format.
• Writing is free of grammatical errors.
• Sentences are complete, clear, and concise.
• Spelling is correct. 

This is the book that should be at least one of the references: 

 

Book Name : Porth’s Pathophysiology

Edition : 9th Edition | | ISBN : 1451146000

Author Name : Sheila Grossman; Carol Mattson Porth;

 

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