A 72 year old Caucasian male presents in your Primary Care practice for a “bump” on his nose. He noticed it several months ago but did not seek medical attention since it did not hurt or was not itchy. He thinks it has grown and bleeds easily when irritated.

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Past Medical History
•     Hypertension, controlled on Lisinopril 5 mg daily x 4 years
•     Allergic rhinitis, uses over-the-counter antihistamines
•     Denies surgeries or serious illnesses/hospitalizations
Family History
•     Father, hypertension
•     Mother, asthma, atopic dermatitis
•     Brother, atopic dermatitis
•     Sister, diabetes
Physical Examination
•     Vital signs; T 98.2, BP 126/78, RR 18, HR 80.
•     General: Well developed and well appearing. No lymphadenopathy.
•     Skin: pearly papule on tip of the nose, raised border with central depression.
Discussion Questions:
1.   Based on the presentation and PE, what do you think is the most likely diagnosis?  Include a brief rationale and cite.   In your rationale, include common assessment findings that support your diagnosis and what diagnostic test would confirm your diagnosis.
2.   Briefly discuss the guideline for sun exposure protection to decrease skin cancer. Cite.
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Case Study 1 A 35-year-old Hispanic female presents to the office. She complains of severe pain in her left 1st metatarsal (big toe) on the medial corner of her nail bed. She reports that the pain has gradually worsened over the last week and she can now barely walk. She has tried soaking her foot in Epsom salts and putting antibiotic cream on her toe, none of which have helped. On physical exam her toe is swollen and erythematous with tenderness. She also has purulent drainage present. PMHx: none SHx: married with two children Allergies: none What is your diagnosis (include staging)? What is the treatment plan? What post-procedure instruction should she receive?

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Clinical Procedure Case Studies
Complete the case studies by answering the questions beneath each scenario.
Case Study 1
A 35-year-old Hispanic female presents to the office. She complains of severe pain in her left 1st metatarsal (big toe) on the medial corner of her nail bed. She reports that the pain has gradually worsened over the last week and she can now barely walk. She has tried soaking her foot in Epsom salts and putting antibiotic cream on her toe, none of which have helped. On physical exam her toe is swollen and erythematous with tenderness. She also has purulent drainage present.
PMHx: none
SHx: married with two children
Allergies: none

What is your diagnosis (include staging)?
What is the treatment plan?
What post-procedure instruction should she receive?

Case Study 2
A 47-year-old male presents to the clinic. He has a 3-inch laceration on his right forearm and reports that he was replacing a bedroom window when the window broke, cutting his right arm. He reports that “it bled quite a bit.” He wrapped it in a shirt and came directly to the clinic. He does not know when he had his last Td shot, but he thinks it was at least 12 years ago.
On physical examination you observe a 3-inch laceration extending through the dermis layer of skin not affecting tendons or ligaments and determine if sutures are warranted.
PMHx: asthma
SHx: married with no children
Allergies: none
VS: T 98 BP 134/60 HR 78 R 18 02 sat 98%

What sequence of steps would you take to treat this patient?
What would be your post-procedure instructions to the patient?
Should he receive a Td immunization today?

Case Study 3
A 45-year-old male was in his garage grinding a piece of metal when he experienced sudden pain in his right eye. He went inside and flushed his eye with water, but he still felt like there was something in the eye.
On physical examination, his visual acuity in both eyes is 20/20. There is no obvious foreign body seen in the eye; however, the conjunctiva is injected. You consider that he may have a corneal abrasion.
PMHx: none
SHx: divorced with no children
Allergies: sulfa
VS: T 98 BP 136/60 HR 70 R 12 02 sat 97%

Describe the process involved with assessing a patient for a corneal abrasion.
What would your treatment be if this patient was positive for a corneal abrasion?
How would your treatment differ if there was a change in visual acuity?

The assignment Case Study 1 A 35-year-old Hispanic female presents to the office. She complains of severe pain in her left 1st metatarsal (big toe) on the medial corner of her nail bed. She reports that the pain has gradually worsened over the last week and she can now barely walk. She has tried soaking her foot in Epsom salts and putting antibiotic cream on her toe, none of which have helped. On physical exam her toe is swollen and erythematous with tenderness. She also has purulent drainage present. PMHx: none SHx: married with two children Allergies: none What is your diagnosis (include staging)? What is the treatment plan? What post-procedure instruction should she receive? has been handled previously by writers from ASAP Essays and Assignment Writing Website

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How It Works

To make an Order you only need to click on “Order Now” and we will direct you to our Order Page. Fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.

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All new clients are eligible for 20% off in their first Order. Our payment method is safe and secure.

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