J.R. is a 28-year-old male with a history of type 1 diabetes mellitus. He was diagnosed with diabetes at 5 years of age and uses insulin injections to control his blood sugar. J.R. states that his diabetes is currently controlled; however, he had difficulty managing his blood sugar during his teen years. J.R. currently wears glasses to see distant objects. During a recent eye exam, he had his eye pressure checked, and the doctor indicated that his pressure is slightly increased. J.R. is also being monitored for changes in his blood pressure and potential blood clots. Is J.R.'s vision problems related to his diabetes? What problems are associated with elevated eye pressure?
Yes. diabetes can damage the blood vessels in the back of the eye and result in impaired vision. However, J.R. may need eyeglasses to correct myopia, which is not related to diabetes. Myopia is a inherited problem in the length of the eyeball. Elevated eyeball pressure may be a sign of glaucoma. The elevated pressure damages the retina and blood vessels and can cause blindness.
A.S. is a 20-year-old college student who presents to the health clinic for "pink eye." She currently lives in a dorm and shares a suite with three other women. Other women in the dorm do not have any symptoms of pink eye, but A.S. was encouraged by her suite mates to get treatment because they believe that pink eye is highly contagious. A.S. currently wears contact lenses and was instructed to remove them and use glasses. A.S. has been waiting to change her extended-wear contacts because she currently does not have enough money to purchase a new box. What can A.S. do to prevent reinfection with pink eye? What treatment should A.S. expect to receive?
She should wash her hands before handling her lenses. She should replace her contact lend case and fill it with new solution each night. Pink eye (conjuctivitis) is usually bacterial and can be treated with antibiotic eye drops. Viral pink eye is not treated and usually resolves in about 2 weeks.
T.C. complained of an earache, and after a recent bout with a bad cold, he was rather irritable. The ear was "beet red" and felt warm. He could hardly hear on that side, but he knew there was nothing intentionally or accidentally poked into the ear. What disease best explains these symptoms? Give some recommendations for treatment.
He had a viral infection from the common cold that has spread into the middle ear (otitis media) and typically leads to a pus-forming bacterial infection. The doctor examines the ear drum externally using an otoscope to observe the tension on the tympanic membrane and notice any drainage. A warm heating pad gives some comfort and Tylenol (especially for children) is used to reduce pain and fever. Anitibiotics kill bacteria and stop bacterial growth, and this (combination) regimen approach is usually a successful treatment process.
Justine is a 45-year-old woman. Her boss insited she go see a therapist after she received numerous complaints from Justine's colleagues who find it very difficult to work with her. Justine tells the therapist that her colleagues are just jealous of her and her abilities and that she is the best employee the company has ever had. She also states that no coworker has a skill set that is even remotely close to hers. Justine tells the therapist she can complete a hundred times the work as anyone else in an 8-hour-day. She also tells the therapist that her coworkers are just lazy and stupid and they should stop complaining and realize how lucky they are to work with someone so billiant and amazing. What personality disorder might Justine be suffering from?
Narcissistic personality disorder - They believe they are special and unique, exaggerate their achievements or talents, often take advantage of others, behavior is arrogant, lack empathy. Estimated prevalance of this personality disorder is 1% of adults in the U.S.
Deacon is in the first grade. His teacher, Mrs. Russ, has noticed some persistent problematic behavior in Deacon. Mrs. Russ has noticed that he constantly squirms and fidgets in his seat. He has difficulty focusing on what they are doing in class. He almost never finishes any assignment or project he starts. Deacon never waits to be called on; instead, he just shouts out answers in class. What mental disorder do you think Mrs. Russ wants to discuss with Deacon's mom?
Attention-deficit/hyperactivity disorder - Inattention (trouble staying focused, difficulty remembering things and following instructions, makes careless mistakes), hyperactivity (constantly fidgets and squirms, moves around constantly, talks excessively), and impulsivity (freqently interrupts others, acts without thinking, does not wait his or her turn). 5% of school-age children and 2.5% of adults in in the U.S. have this disorder.
Sheila is a college freshman at a major university in New York. During the first week of school she went to a fraternity party with her roommates. She got tired and decided to leave the party early. Her rommmates did not want to leave the party so Sheila decided to walk back to their apartment alone. On her way back to the apartment she was violently assaulted by someone. She lay in an alley for hours, unconscious. Her roommates finally heard her moaning 3 hours later on their way back from the party. They called 911, and Sheila was rushed to the hospital. Sheila sustained several broken bones, a broken jaw, and had been sexually assaulted. She was in the hospital for a few days. When she got out of the hospital she told everyone she was fine. She did not want to talk about the assault, she just wanted to go to school and not think about it. Sheila's roommates have noticed that she rarely attends class. Sheila often screams in the middle of the night. Finally, Sheila's roommates take her to the university health center. After a thorough physical exam she is referred to a mental health professional. What mental disorder is Sheila probably suffering from?
Post traumatic stress disorder - Develops after a traumatic or terrifying event. Has flashbacks, nightmares, and severe anxiety, as well as uncontrolled thoughts about the event. Estimated 4% of adults in the U.S. have this disorder. Can develop at any age but median age of onset is 23.
a 68-year-old woman visit her physician and reports that her back hurts. Physical exam finds kyphosis and that she has lost height since her last visit a few years ago. What is a likely diagnosis for this case? Name two treatment possibilities that the physician might suggest. Name something that might have helped prevent this condition, especially if it had initiated and applied at an earlier age.
Osteoporosis is common in older women. Pain and height loss and kyphosis may all be due to vertebral fractures and bone loss. Calcium supplements and mild exercise such as walking with a cane or walker may increase muscle strength and thus prevent falls and fractures. Calcium-supplemented diet and weightbearing exercise throughout adolescence and adulthood can reduce risk of developing osteoporosis later in life.
A 55-year-old carpenter reports persistent swelling and pain in the knuckles of his right hand. What information do you need to determine the type of joint disease he has?
History, physical exam, and occupation suggests osteoarthritis. The joints of the hand, fingers, hips, and knees are common sites of osteoarthritis. An x-ray or CT can show joint damage. Anti-inflammatories and analgesics are the medical treatments.
A 20-year-old woman has worsening pain in her leg below the knee. She says she feels "a little weak and out of sorts" and has stopped her jogging routine. How can you determine whether she has a type of arthritis, a bone infection, a fracture, or a joint sprain?
She reports pain in her bone, not in her joint. This could be shin splints, which require rest. Bone infection would be accompained by fever and systemic symptoms such as weakness. A tumor would also cause pain and weakness. An x-ray can rule out tumors and bloodwork can rule out infections.
A 4-year-old girl has red lesions with a honey-colored crust under her nose and on her cheek. According to her mother, the lesions appeared shortly after she developed a cold. On examination, the doctor notes that the girl's lymph nodes are still swollen. What is your diagnosis? What is the cause? What is the treatment?
It is Impetigo; Staphylococcus aureus or Streptoccocus pyogenes are potential causes. Treatment is antibiotic medication.
A 25-year-old man complains of intense jock itch. On examination, the doctor observes raised lesions on his penis and red circular patches on his groin. The patient lives in a transient hotel, and his hygiene is poor. What are the possible causes for this rash? What diagnostic tests should the doctor order?
Tinea cruis, candidiasis, peiculosis, and scabies. Visual examination and culture are the diagnostic tests performed.
A 39-year-old woman who plays tennis for hours a day during the spring and summer notices a lesion on her ear that bleeds. What are the possible diagnoses? What diagnostic tests should be ordered?
Basal cell carcinoma or squamous cell carcinoma; treatment includes a visual examination and biopsy.
Fifteen-year-old Jeremy has a bad case of acne. According to his mom, Jeremy's acne is from too much late-night TV, frozen pizza, and cheddar popcorn. What factors contribute to acne? What treatments are available? Can acne be prevented?
Hormone, overproduction of sebum, bacteria, lack of or uneven exfoliation of skin cells. Treatment may include topical antibiotics and antibacterials, retinoid, oral antibioltics, oral contraceptives, and isotretinoin. Prevention of acne includes not overcleansing the skin, not using harsh scrubs, avoiding products with high concentrations of alcohol, and keeping the hands away from the face.
Dudley has small, painful vesicles near his mouth. What is your diagnosis? How did Dudley become infected? What treatments are available?
Cold sores caused by the herpes simplex type 1 virus. HSV-1 is spread by kissing, close contact with herpetic lesions, or contact with skin that is shedding the virus. Antiviral drugs are the treatment of choice.
Leylah joined a gym to get in better shape. Since she has been working out at the gym, she has noticed hard, thick patches of skin with dark specks on the sole of one of her feet. They are very painful. What is your diagnosis? What is the cause? What is the treatment?
They are likely plantar warts, caused by human papillomavirus. removal by medication, electrocautery, cryosurgery, laser surgery. Avoid touching warts, walking barefood on warm moist surfaces, trauma to the skin