A 5-year-old boy is brought to the physician with itchy, bilateral erythematous skin lesions on the flexural surfaces of the elbow and knees for the past one week (image attached). He has had similar lesions on and off for the past four years. His mother mentions that his older sister also has similar lesions. His laboratory parameters show an increased number of eosinophils. Which of the following conditions is most likely associated with this disorder? Answers A - E A Bronchial asthma B Deforming joint disease C Gluten sensitivity D Hepatitis C virus infection E Underlying malignancy O O O O Question # 35 attachment Q
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- A 5-year-old boy is brought to the physician with itchy, bilateral erythematous skin lesions on the flexural surfaces of the elbow and knees for the past one week (image attached). He has had similar lesions on and off for the past four years. His mother mentions that his older sister also has similar lesions. His laboratory parameters show an increased number of eosinophils. Which of the following conditions is most likely associated with this disorder? Answers A - E A Bronchial asthma B Deforming joint disease C Gluten sensitivity D Hepatitis C virus infection E Underlying malignancy O O Question # 35 attachment12-year-old Morgan Boyd had a 7-month history of several episodes of sudden onset of swelling of her tongue, lips, and eyes. These recurrences lasted 1–3 days before subsiding without medical intervention. Her older brother, Stephen, had had a similar problem when he was 16 years old. The edema was not itchy and there was no urticaria. Morgan did not experience airway obstruction or abdominal discomfort during any of her episodes. She was not taking any medications and did not have any drug allergies. A diagnosis of hereditary angioedema (HAE) was made on the basis of (1) blood measurements of key complement components after remission and again during a subsequent attack of angioedema, and (2) C1INH quantitative and qualitative tests. Which of the following complement proteins would be well below normal range in Morgan in both of her blood tests? a. C1q b. C3 c. C4 d. C5 e. C9A 55-year-old man comes to the emergency department with epistaxis (uncontrolled nosebleed). He reports that he has “bleeder’s disease” and has had multiple episodes of inflammatory hemarthroses (joint bleeding). Physical examination reveals swollen, immobilized knees; mild jaundice; and an enlarged liver and spleen. CBC results indicate that the patient is anemic and has thrombocytopenia with a platelet count of 74,400/mL (reference interval, 150,000 to 450,000/mL). The PT is 18 seconds (reference interval, 12 to 14 seconds), and the PTT is 43 seconds (reference interval, 25 to 35 seconds).Diagnosis: Liver Disease Provide strong evidence of the diagnosis by creating a table of other possible parameters or test results (coagulation tests) that might be present in this type of condition.
- A 55-year-old man comes to the emergency department with epistaxis (uncontrolled nosebleed). He reports that he has “bleeder’s disease” and has had multiple episodes of inflammatory hemarthroses (joint bleeding). Physical examination reveals swollen, immobilized knees; mild jaundice; and an enlarged liver and spleen. CBC results indicate that the patient is anemic and has thrombocytopenia with a platelet count of 74,400/mL (reference interval, 150,000 to 450,000/mL). The PT is 18 seconds (reference interval, 12 to 14 seconds), and the PTT is 43 seconds (reference interval, 25 to 35 seconds). What is the most likely diagnosis? Support your answer. How can the PT result support your diagnosis? Can this be considered a vitamin k deficiency? Why or why not? Provide strong evidence of your diagnosis by creating a table of other possible parameters or test results (coagulation tests) that might be present in this type of condition.Alfred a 45 year-old African-Spanish male two days ago complained of awakening with severe, 8 out of 10 left knee pain, erythema, and swelling three days prior. He the pain was “in and all around the joint area.” he denied being able to ambulate without his wife’s assistance and stayed home from work as a teacher. He thought he “overdid it” playing with his kids. The pain persisted throughout the day despite taking two OTC NSAID tablets. The pain mostly subsided by the next morning. Peter also said that he had a similar episode of sudden onset pain upon waking in the morning in his right great toe, but thought he stubbed his toe. He denies injury, fever, rash, chills or decreased range of motion. Alfred’s History Height: 5’11’’; Weight: 239 lbs History of hypertension Takes 25 mg HCTZ a day Reports drinking beer on most weekends John’s Vitals upon examination Temp: 98.8°F HR: 79 bpm BP: 136/78 Resp: 17 Question: What are the parameters to confirm that it is therefore gout?A) The following signs and symptoms occurs with an anxious patient: Maculopapular rash, Artharlgia, Pyuria, wheezing and chest tightness. The lab. Results indicate the elevation in eosinophil and serum immunoglobulin E. Describe the different diseases he may suffer from? Explain your answer. B) How you can treat the patient who is suffering from dehydration resulting from severe diarrhea and metabolic acidosis.
- A 25-year-old man is brought to the emergency room after sustaining burns during a fire in his apartment. He has blistering and erythema of his face, left upper extremity, and chest with frank charring of his right upper extremity. He is agitated, hypotensive,and tachycardiac. Which one of the following statements concerning this patient’s initial wound management is correct() A) Topical antibiotics should not be used, as they will encourage growth of resistant organisms B) Early excision of facial and hand burns is especially important C) Escharotomy should only be performed if neurologic impairment is imminent D) Excision of areas of third-degree or deep second-degree burns usually takes place 3-7 days after injury E) Split-thickness grafts over the eschar of third-degree burns should be performed immediately in order to prevent fluid lossA 38-year-old woman came in the outpatient department because of headache.She has no vomiting, fever, changes in sensorium and nuchal rigidity. Shedescribed the headache as ”band-like” and has been occurring intermittentlyespecially during stressful situations. Vital signs and physical examinations areall normal. The physician diagnosed her as having tension headache andprescribed Acetaminophen 1g/ tab PO q6H for 3 days. The pharmacy only hasthe 250mg tablet preparation. How many tablets does she need to take perdose? How many tablets should the pharmacist give her to complete the entiretreatment regimen?A 25-year-old man comes to his physician 's office for a routinephysical examination During the examination, the physiciannotices orange-yellow tonsils and hepatosplenomegaly.Theroutine blood work ordered by the physician shows a tota lcholesterol level of 1 25 mg/dl, triglycerides 300 mg/dl,and HDL 4 mg/dl. What is the most likely diagnosis? What additional tests might the physician order?
- A 4-year-old boy has massive nosebleeds, post-traumatic inflammations of the knee and elbow joints, extensive hematomas. After the examination, the diagnosis "Hemophilia" was made. Questions: 1. What type of hemostasis is disrupted in hemophilia? 2. What the other kind of hemostasis do you know? 3. Indicate the causes of hemostasis.A 58-year-old homeless man with long-standing insulin-treated type 2 diabetes has been diagnosed with right lower extremity cellulitis. He has taken a prescribed oral antibiotic for the past week but has not noticed much improvement. For the past 2 days, he has complained of intermittent fevers and chills, nausea with poor oral intake, and proximally spreading erythema over his right leg. On the evening of admission, a friend notices that he is markedly confused and calls 911. In the emergency room, he is oriented only to his name. The patient is tachypneic, breathing deeply at a rate of 24/min. He is febrile at 38.8°C. He is normotensive, but his heart rate is elevated at 112 bpm. On examination, this patient is a delirious, unkempt man with a fruity breath odor. His right lower extremity is markedly erythematous and exquisitely tender to palpation. Serum chemistries reveal a glucose level of 488 mg/dL, potassium of 3.7 mEq/dL, and sodium of 132 mEq/L. Urine dipstick is grossly…A 58-year-old homeless man with long-standing insulin-treated type 2 diabetes has been diagnosed with right lower extremity cellulitis. He has taken a prescribed oral antibiotic for the past week but has not noticed much improvement. For the past 2 days, he has complained of intermittent fevers and chills, nausea with poor oral intake, and proximally spreading erythema over his right leg. On the evening of admission, a friend notices that he is markedly confused and calls 911. In the emergency room, he is oriented only to his name. The patient is tachypneic, breathing deeply at a rate of 24/min. He is febrile at 38.8°C. He is normotensive, but his heart rate is elevated at 112 bpm. On examination, this patient is a delirious, unkempt man with a fruity breath odor. His right lower extremity is markedly erythematous and exquisitely tender to palpation. Serum chemistries reveal a glucose level of 488 mg/dL, potassium of 3.7 mEq/dL, and sodium of 132 mEq/L. Urine dipstick is grossly…