Assignment: Fungal Infections

Assignment: Fungal Infections

Assignment: Fungal Infections

No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.PSYCH: Normal affect. Cooperative.Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A:Primary Diagnosis: Proximal subungual onychomycosisDifferential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail PsoriasisSpecial Lab: Fungal culture confirms fungal infection. Please see below:      Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy.

Q For Week 6, please address the following:

1-  Specify when to refer the patient after therapy and why? Provide rationale.

2- According to the recommended guidelines, what are the non-pharmacological approaches to  Onychomycosis ?

3-Provide patient education. Keep in mind the past medical history of this patient

hypertension ,, diabetes mellitus 2 , salt intake , obesity
Anterior cross section showing the valves and chambers of the heart
What blood-tight partition divides the left heart from the right heart?

Which portion of the ECG represents a small deflection sometimes seen just after the T wave, representing the final phase of ventricular repolarization?

Does heart size increase or decrease with age? why?
Make a chart describing the characteristics of the following types of chest pain:

Angina
Esophageal
Pain from a peptic ulcer
Biliary
Arthritis or bursitis
Cervical
Musculoskeletal (chest)
Psychoneurotic
A patient is complaining of prolonged fever, signs of neurologic dysfunctions, and the sudden onset of congestive heart failure. What should be expected?

Name the five traditionally designated auscultatory areas

Is the absence of S3 and S4 an unusual finding?

Splitting of S2 is greatest during which part of respiration?

Describe a pericardial friction rub.

Not all murmurs are the result of valvular defects. Name four other causes of murmurs

Which four cardiac defects make up the tetralogy of Fallot?

TY is a 67-year-old female patient who presents for follow-up for her hypertension and hyperlipidemia. Her PMH includes a diagnosis of aortic stenosis diagnosed 2 years ago, IBS, and a seizure disorder. Her family history includes her father, who died at age 55 years of a myocardial infarction and her mother, who is deceased, who had hypertension, diabetes, and coronary artery disease. Her social history is positive for smoking 1 PPD for 30 years; she quit 9 years ago. She is negative for alcohol and drug use. She lives in a two-bedroom condominium on one floor.

On examination, describe the murmur that you would hear for aortic stenosis.

Describe the cause of aortic stenosis. What is the cause for TY?

If TY’s past medical history did not include a diagnosis of aortic stenosis as well as cardiac risk factors, what other causes are there for a heart murmur?

If TY’s past medical history did not include a diagnosis of aortic stenosis as well as cardiac risk factors, describe a subaortic stenosis.
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