Assignment: Knee Pain and Inflammation
Assignment: Knee Pain and Inflammation
Assignment: Knee Pain and Inflammation
ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Assignment: Knee Pain and Inflammation
Jonathon is a 56 year-old retired automobile mechanic who has not been to the doctor in approximately 6-7 years. He presents to your office complaining that 3 weeks ago he was awoken with severe pain and inflammation in his knee, which has been consistent since that initial night. Upon physical examination of his knee, it appears swollen and erythematous with periarticular involvement. Upon physical examination and laboratory results you notice the following:
Physical examination:
GEN: well nourished, obese male (310 pounds)
VS: BP 191/112 HR 75 RR 15 T 98.6, HT 5’8”
EXT: Knee joint inflammation
Laboratory (fasting):
Na 139 mEq/L
K 3.8 mEq/L
Ca 9.1 mg/dL
CL 102 mmol/L
HCO3 22 mEq/L
BUN 10 mg/dL
SCr 0.9 mg/dL
Serum Uric Acid 6.5 mg/dL
Alb 4.1 g/dL
Cholesterol 300 mg/dL
UA: pH 6.8, uric acid 250 mg/24h
What problems can be identified in this patient? Please provide a list of differential diagnoses, as well as indication of your primary diagnosis.What is your pharmacological plan for your primary diagnosis including the medication, dose, and mechanism of action?
Question 2
Discussion Part One (graded)
C.G. is a 69-year-old male with a history of right head and neck cancer that you have been following for one year. The carcinoma was initially localized to the head and neck-specifically at the left lingual tonsil region and went on to complete a total of 6 weeks of radiation and chemotherapy. Recently, the last PET scan indicated some metabolic activity in the left lymph node area along with other regions of abnormal metabolic activity in the body-particularly the liver and the lungs indicating metastasis. C.G. indicates that he is tired of the effects of chemotherapy and radiation and does not want to pursue any more treatment for cancer.
Background:
Right head and neck cancer with metastasis to liver and lungs; patient is refusing further treatment.
PMH:
Hypertension
Hyperlipidemia
Stomatitis
Anemia
Neutropenia
Current medications:
Carvedilol 12.5 mg po 1 daily
Furosemide 40 mg po daily
Surgeries:
2012: right radical neck dissection
Allergies:
None
Vaccination History:
Influenza vaccine last received 1 year ago
Received pneumovax at age 65
Received Tdap 5 years ago
Has not had the herpes zoster vaccine
Social history and Risk Factors:
Former smoker-stopped smoking at the time his cancer was diagnosed-2 years ago
Negative for alcohol intake or drug use
Patient does not have an advanced directive or living will. He is refusing further treatment for his cancer and his wife and children are in disagreement with him. The patient wants to know what his options are for the remainder of his life.
Family history:
Negative
Discussion Part One:
Provide differential diagnoses (DD) with rationale.
Further ROS questions needed to develop DD.
Identify the legal/ethical issues involved with the patient and describe your approach to addressing end-of-life care for this patient.
Use the following coupon code :
NPS10
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