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Manav Rachna University Lyme Disease Case Study

Manav Rachna University Lyme Disease Case Study

Question Description

I’m working on a health & medical case study and need support to help me understand better.

Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.

Case Study 1 & 2 Lyme Disease and Peripheral Vascular Disease

The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submited in this course are registered and saved in turn it in program.

Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites) per case Study

Lyme DiseaseCase StudyA 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaintsof headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’ssymptoms began shortly after a camping vacation. He recalled a bug bite and rash on histhigh immediately after the trip. The following studies were ordered:Studies ResultsLyme disease test, Elevated IgM antibody titers against Borrelia burgdorferi(normal: low)Erythrocyte sedimentation rate(ESR),30 mm/hour (normal: ≤15 mm/hour)Aspartate aminotransferase(AST),32 units/L (normal: 8-20 units/L)Hemoglobin (Hgb), 12 g/dL (normal: 14-18 g/dL)Hematocrit (Hct), 36% (normal: 42%-52%)Rheumatoid factor (RF), Negative (normal: negative)Antinuclear antibodies (ANA), Negative (normal: negative)Diagnostic AnalysisBased on the patient’s history of camping in the woods and an insect bite and rash on thethigh, Lyme disease was suspected. Early in the course of this disease, testing for specificimmunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosingLyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seenearly in this disease. RF and ANA abnormalities are usually absent.Critical Thinking Questions1. What is the cardinal sign of Lyme disease? (always on the boards)2. At what stages of Lyme disease are the IgG and IgM antibodies elevated?3. Why was the ESR elevated?4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.


Peripheral Vascular DiseaseCase StudiesA 52-year-old man complained of pain and cramping in his right calf caused by walking twoblocks. The pain was relieved with cessation of activity. The pain had been increasing infrequency and intensity. Physical examination findings were essentially normal except fordecreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibialpulses were markedly decreased compared with those of his left leg.Studies ResultsRoutine laboratory work Within normal limits (WNL)Doppler ultrasound systolic pressures Femoral: 130 mm Hg; popliteal: 90 mm Hg;posterior tibial: 88 mm Hg; dorsalis pedis: 88mm Hg (normal: same as brachial systolicblood pressure)Arterial plethysmography Decreased amplitude of distal femoral, popliteal,dorsalis pedis, and posterior tibial pulse wavesFemoral arteriography of right leg Obstruction of the femoral artery at the midthighlevelArterial duplex scan Apparent arterial obstruction in the superficialfemoral arteryDiagnostic AnalysisWith the clinical picture of classic intermittent claudication, the noninvasive Doppler andplethysmographic arterial vascular study merely documented the presence and location of thearterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriographyto document the location of the vascular occlusion. The patient underwent a bypass from theproximal femoral artery to the popliteal artery. After surgery he was asymptomatic.Critical Thinking Questions1. What was the cause of this patient’s pain and cramping?2. Why was there decreased hair on the patient’s right leg?3. What would be the strategic physical assessments after surgery to determine theadequacy of the patient’s circulation?4. What would be the treatment of intermittent Claudication for non-occlusion?

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