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The importance of accurate patient history
History of medical records
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The patient is a 30 year old male with an active bacterial infection on his right leg attacking his Integumentary system. The patient is from Tanzania, Africa but came back to work in a factory that produces plastic. If he has Cellulitis, it can get bad enough to travel to other organs like the Liver and Kidney and cause failure. If this happens, Edema can form, usually on one half of the body; this is the Urinary system being attacked. The main system being attacked is the Lymphatic system because Cellulitis attacks the lymphatic draining system. For Cellulitis to travel to organs, it had to go through the blood, so the cardiovascular system is also in effect.
II) To test for Cellulitis you would do a physical exam that can reveal redness, swelling, warmth of the skin, swollen glands, or possible drainage, if there is an infection. You would also do a blood culture, complete blood count, and a culture of any fluid or material inside the infected area. We would do a blood test to see if the kidneys or liver are failing, this can be an effect of Cellulitis. The patient received blood tests already, but the blood tests came back negative. The blood pressure of the patient was 90/50, which is significantly low, and is also a symptom of Cellulitis. Cellulitis can also come from edema, which explains why the patient had edema in his right leg.
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III) Our diagnosis is Cellulitis.
Cellulitis is an inflammation of subcutaneous connective tissue. We think he got Cellulitis when he was living in Tanzania. Some symptoms of Cellulitis are swelling of the skin, pain and tenderness, swollen glands, and redness of affected area. Cellulitis mostly occurs in the legs. Cellulitis usually only affects one side of the body and the patient only had an infection on his right leg and foot. This explains why the skin was infected on his right leg. Cellulitis is treated very quickly with antibiotic therapy. Cellulitis can also come from edema, which explains why the patient had
edema. IV) We would treat him with antibiotics for Cellulitis and Edema. The Edema medication we would give him would be, Furosemide. To treat the Cellulitis we would give him Flucloxacillin, Erythromycin, or Clarithromycin. He could also take home drugs to treat Cellulitis. If we think he got this from an open wound being exposed to contaminated water, we would give him Doxycycline or Ciprofloxacin. He will recover quickly if he takes the medication. Cellulitis would not affect the patient’s life span in any way.
I am now reporting to you from the patient’s femoral vein. I am headed north to her right lung. The femoral vein is one of the largest veins in the body. The ride has been smooth so far. I have been seeing many different types of cells go by my submarine window. I just saw an army of white blood cells headed the same way that I am. They most likely are headed towards the bacteria infestation in the right lung. I am also hearing the heart beat; it is making a LUB- DUB sound. I can also hear the blood flow; it is making sort of a swooshing noise. That noise is reminding me of the ocean! The right femoral vein is now turning into the external iliac vein; I am now by the urinary system and reproductive system. This is also known has the pelvic region. As we continue north the eternal iliac vein is now called the common iliac vein. As we continue on, the common iliac vein is now called the inferior vena cava. We are getting closer to the heart! We are in the abdomen of the body. There are diff...
Renal and hepatic function tests include creatinine test, blood urea nitrogen (BUN) test, alkaline phosphatase (ALP) test, bilirubin test, and others. Urinalysis includes urine osmolality tests and urine culture tests. The sooner one’s sepsis is diagnosed and managed, the better the chances are one has to survive. There are three identifiable stages of sepsis. The three stages are, in order, sepsis, severe sepsis, and septic shock. The stage of sepsis is achieved when an infection enters the bloodstream and enacts inflammatory responses throughout the body. This stage is not as life threatening as the next two stages but should be assessed and treated for as soon as possible. The stage of severe sepsis is achieved when an infection disrupts the flow of blood to the brain or renal organs resulting towards organ failure. There can be an occurrence of gangrene in the arms, legs, fingers, and toes exhibiting tissue death caused by blood clots. If treatment is not given quickly in this stage then septic shock is bound to occur. The stage of septic shock is achieved when the overall blood pressure drops drastically leading to respiratory, cardiac, or organ failure and likely death This stage demands
The majority of clinical cases of laminitis occur at pasture where there is an accumulation of rapidly fermentable non-structural carbohydrates (NSC) such as fructans, simple sugars or starches (Geor, 2010). Pasture-associated laminitis has major economic and welfare implications in the equine sector. Increased risk factors include insulin resistance, increased insulin secretory response, hypertriglyceridaemia and obesity (Asplin, et al., 2007;Carter, et al., 2009 and de Laat, et al., 2010). Insulin resistance has been associated with a number of problems in the horse, most notably laminitis. Insulin resistance can be defined as a physiological condition in which cells have a diminished response to normal actions of the hormone insulin. Insulin is produced but the cells become resistant and are less capable in transporting glucose from the bloodstream to muscle and other tissues. In horses, insulin resistance is associated with a number of diseases such as Equine Metabolic Syndrome (Powell, et al., 2002; Hoffman, et al., 2003;Vick, et al., 2006 and Frank, et al., 2009), Equine Cushing Disease (McGowan, et al., 2004 and Walsh, et al., 2009) and Laminitis (Treiber, et al., 2006;Bailey, et al., 2007;McGowan, 2008 and Geor, 2008). Obesity and insulin resistance in ponies has become a common problem and there is a growing awareness on the role that diet and exercise has to play (Jeffcott, et al., 1986; Frank, et al., 2006 and Vick & Adams, 2007). Over-expressed adipocytokines, such as leptin, have been suggested to impair insulin signalling and cause the up regulation of inflammatory cytokines. This then further contributes to impaired insulin signalling and endothelial dysfunction (Radin, et al., 2009). The restriction of energy throu...
Batten disease or Neuronal Ceroid Lipofuscinoses (NCL) is nervous system disorder that is inherited. There is a few different age categories related to such disease but it usually manifests itself in childhood. Although Batten disease is the juvenile form of NCL, most doctors use the same term to describe all forms of NCL. Batten disease or NCL may be recognized by parents or doctors that notice a child begin to develop vision problems or seizures. In some cases the early signs are subtle, taking the form of personality and behavior changes, delayed speech, slow learning, clumsiness or stumbling.
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Necrotizing fasciitis is a bacterial infection that is very serious and sometimes fatal. This disease spreads very quickly and destroys soft tissue in your body. This disease is caused by multiple bacteria: group A strep, E.coli, Klebsiella (causes pneumonia), Clostridium (causes diarrhea), Staphylococcus (causes staph infections), and Aeromonas hydrophila (causes diseases in almost all organisms, hard to resist). The bacteria group A strep is the leading cause for necrotizing fasciitis.
Pathophysiology of infection, inflammation response, and sepsis leading to septic shock (the cascade) is a major area of interest in the literature. Under normal circumstances, when a pathogen enters a human host and tissue damage occurs, the host initiates an inflammatory response to repair the tissue. The main types of pathogens include viruses, bacteria, and parasites (Porth & Matfin, 2009; Raghavan & Marik, 2006). Cellulitis is an example of an acute infection, which affects the skin and or subcutaneous tissue often in lower limbs. Cellulitis is caused by streptococcus pyogenes and staphylococcus aureus (multi-resistant bacteria) and is transmitted by direct contact, entering the body via broken skin such as ulcers and or following trauma. The presentation of cellulitis often includes pain (localised), erythema, fever and swelling. Infections such as cellulitis have a propensity to become systemic through distribution in the blood and lymph (Hadzovic-Cengic et al., 2012). The inflammation response to an infection involves the release of both pro and anti-inflammatory mediators. When excessive pro-inflammatory mediators such as cytokines are released they cause inflammation in a systemic manner that can cause sepsis or systemic inflammatory response syndrome (being the non-specific response to non-infectious cause) (Sagy, Al-Qaqaa, & Kim, 2013). Pro-inflammatory mediators also activate the complement system, which results in increased inflammation and upregulation of specific receptors that lead to cellular injury and apoptosis seen in severe sepsis and organ dysfunction (Ward, 2008). Organ dysfunction can occur in one or more organs such as the lungs, liver, kidneys and or heart and often results from a lack of...
Cellulitis is an acute spreading bacterial infection of the connective tissue, dermis and subcutaneous layers of the skin (ProQuest 07/2012 pg.5). Characterized by redness, swelling, warmth, tight/shiny skin and pain. It is sometimes accompanied by fever, swollen lymph nodes, chills and fatigue. Cellulitis first appears on pink-to-red minimally inflamed skin. The area of infection rapidly becomes deeper red and increases in size as the infection spreads. Occasionally, red streaks may radiate outward from cellulitis. Blisters or pus filled bumps may also be present (skinsight 12/2012 pg.5). The main culprit is the bacteria Streptococcus and Staphylococcus which can enter through a break in the skin.
The most noticeable signs of lymphedema of the affected limb or body area include swelling on part of or all of the limb or area, a heavy feeling, tightness, difficulty moving or bending the hand, wrist, foot, or ankle, achiness, recurring skin infections, fatigue, and thickening and hardening of the skin. Swelling for lymphedema ranges from non-visible, people can see slight swelling with a heavy feeling; reversible, swelling at the distal end of the extremity and it reduces upon elevation; irreversible, fibrosis is present with thickening and one extremity is bigger than the other; and severe, limbs become abnormally larger than the rest of the body. In the course of cancer treatments lymphedema might not occur until months or years later. People with this condition are more at risk for developing cellulitis, lymphangitis, or edema may worsen over time. If left untreated cellulitis can lead to septicemia, abscesses, ulcerations, and/or
Patient comes in with a complaint of chronic right lower extremity pain due to a surgery that he had back in 2011. He apparently does have hardware in the proximal tibial area and apparently, this has been chronically infected. He is supposed to have this hardware removed by his orthopedic surgeon but he got incarcerated prior to having that done. He is also following with infectious disease. He states he has had an infection in there for at least 2-3 years and currently is on Bactrim suppression therapy. He also has some acne on his face that he would like to try Cleocin for which has worked well in the past. Otherwise, his pain has been his biggest issue. He understands that we cannot prescribe narcotics but he states that
Urinary Tract Infection, also known as UTI, occurs in two common locations, the bladder and kidneys. The kidneys are important organs that aid in filtering out waste products from blood and maintaining water distribution throughout the body. The waste products are filtered out via bladder, which is the reason of the bladder being the second site for the infection. A normal human being has two kidneys, one on left and right side, a bean shaped organ, and is located at the back of the abdomen. “Each kidney is about 11.5 cm long, 5-7.5 cm broad, 5 cm thick, and weight about 150 grams” (HealthInfoNet, Paragraph 2). Furthermore, a bacterium named Escherichia coli lives in both the kidneys and the GI tract. E. coli is part of the human body and produces
A picture of an infected leg (right) The normal human leg is located on the left. Gangrene deposits appear on the kneecap.
4. Analysis A 55- year-old female at VA admitted to TLC for rehabilitation after her heart endocarditis surgery (tricuspid valve). Pt reported developed edema after surgery due to prolong staying at bed. Currently pt conditions is edematous on her lower bilateral extremity and cellulitis
Patient profile: Heterosexual Muslim Woman who has been in the United Stated for three years. She came from Pakistan. She is 42 forty-two years old, from low socioeconomic standing, English language barrier, and is Muslim rituals and practices. She came to emergency department with her husband due to shortness of breathing, high fever, severe cough. She was dignosed with new onset of pneumonia and currently on antibiotic. she also has history of Vitamin D deficiencies and diabetes mellitus type II. She admitted to medical-surgical floor for observation...
Introduction What is Cellulite? Cellulite is simply lumpy flesh that forms around your hips, belly, buttocks and looks a little dimpled. Women are more affected by cellulite than man. A condition that plagues roughly 85% of women over the age of 20. Cellulite Cure