Personal genomics for humans (also called personalized medicine or precision medicine)

Personal genomics for humans (also called personalized medicine or precision medicine).

Personal genomics

  1. Assignment 1 is the first phase of a project that you will complete, in stages, during the term. You will begin by selecting a specific biotechnology that you would like to cover through the entire project. It can be an established technology, such as genetically-modified crops, or an emerging technology, such as CRISPR. The choice of biotechnology is up to you, but consider selecting something that relates to your major, career, or personal interests.
    CRJ students might consider an established or an emerging biotechnology for crime scene investigation. BUS students might consider a technology that will provide an opportunity to explore bringing new biotech products and services to market or the ethical considerations around marketing biotech to consumers.

    Choose one magazine or newspaper article that covers the specific technology that you will use throughout the project. It must be a recent article (no more than four years old). For instance, if you choose genetically-modified crops as your biotechnology, then you would need to select one recent article about genetically-modified crops for this assignment.
    Some biotechnologies that you may want to consider include:

    • Genetically modified crop plants
    • Genetically modified microorganisms (such as yeasts and bacteria for industry)
    • Genetically modified animals
    • Personal genomics for humans (also called personalized medicine or precision medicine)
    • Gene therapy
    • CRISPR
    • Emerging forensic uses of DNA (such as facial prediction)
    • Databases for DNA fingerprinting
    • Write a one to two (1–2) page paper in which you:
    1. Summarize the article in one (1) or more paragraphs, using your own words. Be sure to identify the article using an in-text citation in the body of the paper, as well as a reference in the reference section.
    2. Identify which biological concepts from the course and / or text are relevant to the topic covered in the article. Citing the course text, discuss the ways in which this course does (or doesn’t) provide background information to help you understand the article and the larger issues surrounding it.
    3. Explain why the article caught your attention. Relate the article to your life and to issues that are important to you.Discuss how or if the scientific knowledge about the topic covered in the article affects you directly or indirectly.
    4. Discuss your opinion on how research on this topic should befunded. State whether you think taxpayer monies should support research on this topic or whether such research in this area should be funded by the private sector. Rate the importance of research on this topic, relative to other areas of research.
    5. In addition to the target article, you should use at least one (1) additional resource, such as your textbook or another article.  Remember: an edited version of this assignment is going to be part of the larger paper that you write at the completion of the project.

      You must have a reference section which contains an SWS reference to your chosen article and all other sources, if any. Additionally, you must provide in-text citations (in SWS format) to your references at appropriate places in the body of the text. Integrate all sources into your paper using proper techniques of quoting, paraphrasing, and summarizing, along with your in-text citations. Double-space your paper. Use standard margins and fonts. Also, follow any additional formatting instructions provided by your instructor.

      A large portion of the grading of this assignment is based upon the coherence, depth, and accuracy of your writing.

      Objectives evaluated by this assessment:

    6. Categorize a wide range of organisms, from single-celled to multi-celled organisms.
    7. Describe how organisms acquire and utilize both energy and material.
    8. Describe the cell cycle, cell reproduction, and control.
    9. Investigate DNA and gene expression as well as technologies based on our understanding of them.
    10. Discuss interactions between organisms in ecosystems.
  2. By submitting this paper, you agree: (1) that you are submitting your paper to be used and stored as part of the SafeAssign™ services in accordance with the Blackboard Privacy Policy; (2) that your institution may use your paper in accordance with your institution’s policies; and (3) that your use of SafeAssign will be without recourse against Blackboard Inc. and its affiliates.

Personal genomics for humans (also called personalized medicine or precision medicine)

Continuing on the research that you started in Week 3, explain what your chosen biotechnology accomplishes and how it is implemented, and describe the body of knowledge that it is based upon.

Continuing on the research that you started in Week 3, explain what your chosen biotechnology accomplishes and how it is implemented, and describe the body of knowledge that it is based upon..

DNA of an organism

 

 Begin with a description of the biotechnology and what it accomplishes. Then, explain whether it involves manipulating the DNA (or RNA) of an organism, or simply utilizing the DNA (or RNA) that is already there naturally.

 Provide a full and complete description of exactly how the technology works.  If your technology involves manipulating the DNA of an organism, then you should explain how that is accomplished. Depending on the specific technology, adding DNA to cells is often accomplished with a vector, such as a virus or bacterium, but there are mechanical means as well, such as microinjection or use of a “gene gun.”  If your technology involves interpreting the DNA in an organism (as one might do for personalized medicine), explain how that is accomplished. What are the means of collecting a sample? How is the sample processed? What exactly is being analyzed to generate the interpretation?

 Discuss the key biological principles that underlie the technology. Many of them are based on an understanding of genes and how they are expressed. Other technologies may be based on the concept of the genome, transcriptome, or proteome. Others are based on an understanding of non-coding DNA (such as the short-tandem repeats used in DNA fingerprinting). Many are based on an understanding of DNA replication, as well as basic heredity.  The expected length is a proxy for how much detail to go into. Go into enough detail to get at least one page of double-spaced text (about 300 words), but not much more than two pages of double-spaced text (about 600 words).  Your overall goal in this assignment is to show the instructor that you understand the underlying science behind the technology.

Continuing on the research that you started in Week 3, explain what your chosen biotechnology accomplishes and how it is implemented, and describe the body of knowledge that it is based upon.

Plant Astrgalus

Plant Astrgalus.

Astrgalus

You have already chosen a plant to research (I chose Astrgalus). Now you will begin to build your final term project.

Part 1: This section will include the following and each of these should have headings bolded and underlined

  • Title Page including your name, date, chosen herb (I Chose Astrgalus ), and word count 
  • Short introduction
  • Common Uses
  • Basic information
  • Treatments, cures
  • Growth habitats
  • Preparation for medicinal use
  • Include  pictures of your chosen plant. Make sure they are integrated nicely in the text, not separate or all at the end. Also make sure they are an appropriate size.
  • Include a word count. 1500 words minimum! -5 points for no word count and ZERO for a false word count.
  • Include your references

The format should be formal and college-level with proper grammar. When you turn in your paper as an attachment make sure the file is labeled with the name of the plant you studied labeled as Part 1

Before starting the paper, please re-read the Warning on Plagiarism. I am VERY tough on this. Pay attention to the Turnitin score which will appear when you post your paper.

Plant Astrgalus

what are the effects of high altitudes and or decreased air pressures on the respiratory system.

what are the effects of high altitudes and or decreased air pressures on the respiratory system..

High altitudes and decreased air pressure

John, a healthy twenty-eight year old electrical engineer, was driving home from work one evening when he experienced sudden stabbing pain in his right pectoral and right lateral axillary regions. He began to feel out of breath and both his respiratory rate and heart rate increased dramatically. As luck would have it, John passed a hospital each day on his way home and was able to get himself to the hospital’s emergency room. The emergency room physician listened to John’s breathing with a stethoscope and requested blood gas analysis and a chest x-ray. John answered a few of the doctor’s questions. The doctor noted that John had no history of respiratory problems but was a heavy smoker.

After viewing the chest radiograph, the doctor informed John that he had experienced a spontaneous pneumothorax, or what is commonly called a collapsed lung. The doctor explained that a hole had opened in John’s right lung and that this hole had allowed air to leak into the cavity surrounding the lung. Then, as a result of the lung’s own elastic nature, the lung had collapsed. The doctor said he could not be certain of the cause of thepneumothorax, but smoking cigarettes had certainly increased the likelihood of it happening. He told John he was fortunate the pneumothorax was small, which meant that relatively little air had escaped from the lung into the surrounding cavity, and it should heal on its own. He instructed John to quit smoking, avoid high altitudes, flying innon pressurized aircraft, and scuba diving. He also had John make an appointment for a re-check and another chest x-ray.

Case Background

Spontaneous pneumothorax occurs when a blister on the surface of the lung opens, allowing air from the lung to move into the pleural cavity. This occurs because alveolar pressure is normally greater than the pressure in the pleural cavity. As air escapes from the lung, the lung tissues will recoil, and the lung will begin to collapse. The lung will continue to collapse until the difference between the alveolar pressure and pleural pressure disappears or until the collapsing of the lung causes the opening to seal.

The pneumothorax decreases the efficiency of the respiratory system, which in turn results in decreased blood oxygen concentration, increased respiratory rate, and increased heart rate. If the pneumothorax is small, the air that escapes into the pleural cavity can be reabsorbed into the lung once the opening has sealed shut. If thepneumothorax is large, a needle or chest tube may have to be inserted into the pleural cavity to draw the air out and allow for the re expansion of the lung.

Utilizing the med terms you learned this week answer the following questions

Why was John instructed to avoid high altitudes and flying in non pressurized aircrafts?

That is, what are the effects of high altitudes and or decreased air pressures on the respiratory system.

Here are the discussion board requirements.

  • The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source.
  • classmates.
  • Plagiarism of any kind will result in a “0”.

what are the effects of high altitudes and or decreased air pressures on the respiratory system.

Describe a disease that is caused by a malfunctioning gene and can be cured by gene therapy.

Describe a disease that is caused by a malfunctioning gene and can be cured by gene therapy..

Malfunctioning gene

1. Genetic engineering and medicine

Choose one disease that has been cured by genetic engineering.

Briefly describe the disease; evaluate the cure.

2. Therapeutic cloning

Describe a disease that is caused by a malfunctioning gene and can be cured by gene therapy.

3. Genetic engineering and agriculture

Find an engineered agricultural crop or livestock.

Discuss the pro’s and con’s and any ethical concerns.

4. Reproductive cloning and conservation of endangered species

Find examples and discuss concerns.

5. Stem cell therapy

Find a disease that has been cured by this therapy.

What are some of the issues around stem cell therapy?

 

Describe a disease that is caused by a malfunctioning gene and can be cured by gene therapy.

Chief Complaint (CC): A dull pain in both knees with occasional clicking in one or both knees and the sensation of the patella catching.

Chief Complaint (CC): A dull pain in both knees with occasional clicking in one or both knees and the sensation of the patella catching..

Chief Complaint (CC)

Chief Complaint (CC): A dull pain in both knees with occasional clicking in one or both knees and the sensation of the patella catching.

History of Present Illness (HPI): RF is a 15-year-old male who reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. He states that the pain has been on and off for the last four months and initially only present after intense activity but has gotten worse since starting track this summer and seems to be present more often than before.

The patient states that the clicking comes and goes and isn’t always present in both knees at the same time. The catching sensation under the patella is more pronounced since he started doing the long jump in track. The patient states that he is able to bear weight as the pain is a dull ache. Icing his knees after sports and taking ibuprofen help to reduce the pain and swelling but both occur more frequently now making it difficult to participate in sports. The patient feels that he may be overdoing it with all of the sports he participates in and is worried about not being able to play soccer if it continues to get worse. The patient rates the pain 7/10 after intense activity.

Medications: Ibuprofen 200 mg oral tab, two tabs every 6 hours as needed for pain.

Allergies: No known drug, food, or environmental allergies.

Past Medical History (PMH): None

Past Surgical History (PSH): None

Sexual/Reproductive History: Patient is not sexually active at this time.

Personal/Social History: Patient denies smoking, alcohol use, and illicit drug use. The patient is very active with sports playing soccer, basketball, baseball, and track. He states that he tries to eat well mainly because of sports but doesn’t always make the best choices for snacks. He tries to avoid soda most of the time and reports drinking a lot of water.

Immunization History: Immunizations are up to date. Gets influenza vaccine annually.

Significant Family History:

Paternal grandfather has hypertension, and father has borderline hypertension. Maternal grandfather has type II diabetes.

Lifestyle: RF is a freshman in high school who lives with both of his parents and older sister. RF plays soccer, basketball, baseball and participates in track for high school. RF also plays club soccer playing and traveling most of the year. RF is a good student, athletic, and enjoys being active. He also participates in winter sports and skis during winter break.  RF works part-time as a referee during the summers due to his commitment to school and sports.

Review of Systems:

General: No recent weight gain or loss of significance. Patient denies fatigue, fever, or chills.

HEENT: No headaches or dizziness. No changes in vision. He does not wear glasses, and his last eye exam was just under a year ago. Denies eye drainage, pain, or double vision. No changes in hearing. Has had no recent ear infections, tinnitus or ringing in the ears. Denies sinus infections, congestion, and epistaxis. He reports his sense of small is intact. Last dental exam was four months ago for regular cleaning. Denies bleeding gums or a toothache. Denies dysphagia or throat pain.

Neck: No history of trauma, denies recent injury or pain. He denies neck stiffness.

Breasts: Denies any breast changes. Denies history rashes. Denies history of masses or pain.

Respiratory: Denies a cough, hemoptysis, and sputum production. Patient denies any shortness of breath with resting or with exertion. Patient reports no pain with inspiration or expiration.

Cardiovascular/Peripheral Vascular: No history of murmur or chest palpitations. No edema or claudication. Denies chest pain. No history of arrhythmias.

Gastrointestinal: Denies nausea or vomiting. Patient reports no abdominal pain, diarrhea, or constipation. Last bowel movement was this morning. Denies rectal pain or bleeding. Denies changes in bowel habits. Denies history of dyspepsia.

Genitourinary: Denies changes in urinary pattern. No incontinence, no history of STDs or HPV, the patient is heterosexual and not sexually active. Denies hematuria. Denies urgency, frequency, and dysuria.

Musculoskeletal: No limitation in range of motion for all limbs though patient reports difficulty moving knees after excessive strain from sports.  No history of trauma or fractures. Patient reports dull pain in both knees. The patient states occasional swelling in knee joints after participating in sports. Patient reports clicking in one knee and sometimes both. The patient states that the pain is worse after participating in the long jump or running long distances. Patient denies history or presence of misalignment of either knee.

Psychiatric: Denies suicidal or homicidal history. No mental health history. Denies anxiety and depression.

Neurological: No dizziness. No problems with coordination. Denies falls or seizures. Denies numbness or tingling. Denies changes in memory or thinking patterns.

Skin: No history of skin cancer. Denies any new rashes or sores. Patient reports many blisters from sports which are treated with Neosporin, band-aids, and NewSkin spray. Denies eczema and psoriasis. Denies itching or swelling.

Hematologic: No bleeding disorders or history of blood transfusion. Denies excessive bruising.

Endocrine: Patient reports no endocrine symptoms. Denies polyuria, polydipsia. Patient denies no intolerance to heat or cold.

Allergic/Immunologic: Denies environmental, food, or drug allergies. No known immune deficiencies.

OBJECTIVE DATA:

Physical Exam:

Vital signs: B/P 118/74; P 65 and regular; T 98.6; RR 16; O2 100% on room air; Wt: 125 lbs.; Ht: 5’7”; BMI 19.1

General: RF is a well-developed, well-nourished Caucasian teenage male who appears to be in no apparent distress.

HEENT: Head: Skull is normocephalic, atraumatic. No masses or lesions.

Eyes: PERRLA, +direct and consensual pupil response. EOM intact, 20/20 vision bilaterally without correction. Fundoscopic exam normal, vessels intact, the optic disc with clear margins.

Ears: Bilateral external ears no lesions, masses, drainage or tenderness. Tympanic membranes intact, pearly gray, no bulging, no erythema, and landmarks appreciated bilaterally. Hearing intact bilaterally.

Nose: No nasal flaring, no discharge, no obstruction, septum not deviated. Turbinates pink and moist. No polyps or lesions bilaterally. Nares patent with no edema or erythema.

Throat: Oropharynx clear and mucosa moist. No erythema or exudate. Uvula midline, palate rises symmetrically.

Mouth: No lesions, no thrush. Moist mucous membranes. Healthy dentition present. Tongue midline.

Neck: Supple, non-tender. Full range of motion. Trachea midline. No masses. Thyroid and lymph nodes not palpable.

Chest/Lungs: Thorax non-tender with symmetric expansion. Respiration regular and unlabored, without a cough. Tactile fremitus equal bilaterally and greater in upper lung fields.  Breath sounds clear with adventitious sounds. All lung fields with resonant percussion tones.

Heart: Regular rate and rhythm; normal S1, S2; no murmurs, rubs, or gallops. Apical pulse not visible. Apical pulse was barely palpable. JVP appears to be approximately less than 6 cm with HOB elevated to 45 degrees. No carotid bruits or JVD appreciated.

Peripheral Vascular: Pulses 2+ bilateral pedal and 2+ radial bilaterally. No pedal edema. Popliteal pulses 2+ bilaterally.

Abdomen: Abdomen round, soft, and non-tender without rash, palpable mass or organomegaly. Active bowel sounds. Tympany over most quadrants with areas of dullness noted upon percussion. No abdominal bruits.

Genital/Rectal: Adequate tone, no masses noted, eternal genitalia intact.

Musculoskeletal: Normal passive and active ROM in upper and lower extremities. No focal joint inflammation or abnormalities appreciated in upper extremities. + tenderness to palpation at the inferior pole of the patella bilaterally. + Q angle greater than 10 degrees bilaterally. Clicking present with movement in right knee. Normal alignment of the knees bilaterally. All upper and lower extremity joints without effusions or erythema. Spine without tenderness and range of motion is full. Greater tenderness was noted in knees bilaterally when extended, and quadriceps are relaxed. Normal muscle strength present against resistance.

Neurological: CN ll-Xll grossly intact. Awake, alert, and oriented to person, place and time. The patient can move all limbs on command and spontaneously.

Skin: Warm, moist, and intact. Skin is pale. + edema right knee. No peripheral cyanosis. No clubbing. No rashes or bruises present.

ASSESSMENT:

Lab Tests and Results:

CBC- Normal

Erythrocyte sedimentation rate (ESR) – Normal

Diagnostic test:

Passive extension-flexion sign- positive- which is tenderness on palpation of the tendon at the inferior pole of the patella.

McMurray test- Negative for locking during joint movement.

X-ray- negative

MRI- Showed high signal intensity within the proximal posterior central aspect of the tendon at its origin.

Differential Diagnosis:

  1. Patellar tendinitis: This is the most likely diagnosis based on the patients HPI, ROS, physical assessment, and diagnostic studies. The patient’s chief complaint was a dull pain in the knees with occasional clicking in one or both knees. The patient is athletic and participates in many sports that continuously put a strain on his knees. The quadriceps angle was greater than ten which suggests patellar tendinitis. The patient plays sports that include a lot of running and jumping which adds strain to the knee joints. The patient was also positive for tenderness on palpation at the inferior pole of the patella bilaterally. Lastly, the MRI was positive for high signal intensity within the proximal posterior central aspect of the tendon where it originates from.
  2. Osgood Schlatter’s disease: A possible diagnosis as it is a common problem which typically occurs during times of fast growth usually in fit, active boys. Osgood Schlatter’s disease is associated with pain just below the kneecap in one or both knees, often worse after sports especially high impact activities using the quadriceps muscles. However, limping is often a present, and the patient denied limping in the ROS. Pain is greater with stair climbing and kneeling, and the patient did not admit to either. Flexion and extension will increase pain in the tibial tubercle which was not present upon physical exam of the patient.
  3. Chondromalacia patellae: This is a possible diagnosis due to the presence of knee pain upon palpitation and increased pain with activity. However, chondromalacia patellae are more common in females or persons with a history of knee trauma. The patient is male and denied trauma to either knee. The patient denied a history of misalignment which is also related to chondromalacia patellae. An x-ray of the knee would show irregularities of the patellofemoral joint.
  4. Medial meniscus tear: This diagnosis is a possibility because it can occur after a twisting injury and the patient participates in sports such as soccer, basketball, and skiing that involve twisting movements. Clicking may be present with a medial meniscus tear which the patient reported and was also appreciated upon physical assessment in the right knee. McMurray test was negative for locking during joint movement. The patient denied difficulty with weight bearing.
  5. Juvenile rheumatoid arthritis (JRA): Possible due to knee joint soreness and stiffness, however, both typically improve with activity. Joint swelling may also present with JRA and was reported by the patient in his ROS. The patient denied weight loss and fatigue which are common symptoms. The patient also denied night pain. A CBC would show anemia, leukocytosis, and thrombocytosis. The ESR would be elevated.

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

Huether, S. E., & McCance, K. L. (2017). Disorder of the joints. In alterations of musculoskeletal function (6th ed., pp. 991-1038).

Rath, E., Schwarzkopf, R., & Richmond, J. (2010). Clinical signs and anatomical correlation of

patellar tendinitis. Indian Journal of Orthopaedics44(4), 435-437 3p. doi:10.4103/0019-

5413.6931

Chief Complaint (CC): A dull pain in both knees with occasional clicking in one or both knees and the sensation of the patella catching.

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm.

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm..

GENITOURINARY

CC “ankle pain in both ankles; worse in right ankle, after hearing ‘pop’ while playing soccer.”

HPI: A.S. is a 46 year old Caucasian female who presents with bilateral ankle pain which she describes as chronic for the last 3 months. She acutely injured her right ankle 3 days ago while playing soccer. The pain is described as aching with intermittent sharp characteristics. Associated symptoms include limited ROM. The pain is worse with weight bearing and OTC pain medications have included alternating doses of Tylenol and Motrin with moderate relief.

Current Medications:

Motrin 200 mg by mouth every 4-6 hours as needed for pain

Hydrochlorothiazide 12.5mg by mouth daily for 6 months for HTN

Allergies: PCN- rash, no known food/environmental allergies

PMHx: HTN; immunizations are up to date- last tetanus 12/2017; flu shot 10/2018 cholecystectomy 2015

Soc Hx: A.S. is employed as a Registered Nurse and remains active by playing soccer three times a week. She is married with two teenage daughters. She denies tobacco and alcohol use.

Fam Hx: Maternal grandmother deceased at age 56 from MI. Maternal father deceased at age 75 from complications of COPD. Paternal grandparents unknown. Father history is unknown. Mother is alive with type 2 diabetes that is well controlled with oral agents. Sibling age 43 alive and well. Children are alive and well with no medical hx.

ROS:.

GENERAL:  No weight loss, fever, chills, weakness or fatigue.

HEENT:  Eyes:  No visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  No hearing loss, sneezing, congestion, runny nose or sore throat.

SKIN:  No rash or itching.

CARDIOVASCULAR:  No chest pain, chest pressure or chest discomfort. No palpitations or edema,

RESPIRATORY:  No shortness of breath, cough or sputum.

GASTROINTESTINAL:  No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY:  No burning on urination.

NEUROLOGICAL:  No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: pain and swelling to right ankle, limited weight bearing and ROM in b/l ankles, worse in the right ankle. No muscle cramping.  No back pain.

HEMATOLOGIC:  No anemia, bleeding or bruising.

LYMPHATICS:  No enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  No history of depression or anxiety.

ENDOCRINOLOGIC:  No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  No history of asthma, hives, eczema or rhinitis.

O.

GENERAL:  AAOx 3, limping gait, no distress. No fever.  Skin is warm, dry, and intact. Skin of the lower extremities is warm and pink in color.

CARDIOVASCULAR: chest is symmetric with symmetrical expansion, PMI noted at fifth intercostal space at the midclavicular line, normal S1 and S2, no m/r/g, no edema in legs, dorsalis pedis 2/4 bilaterally, normal hair distribution in legs and no pigmentation of b/l legs.

MUSCULOSKELETAL: limited ROM and weight bearing in b/l ankles, worse in right ankle. No clubbing, cyanosis, or edema.

NEUROLOGICAL: mood and affect appropriate, CN II-XII intact. Motor: 5/5 in upper and lower extremities, DTRs 2+ bilaterally.

Diagnostic results:

Ankle x-ray- If the Ottawa ankle rule is positive (bone tenderness at posterior malleolus, bone tenderness at posterior medial malleolus, or inability to bear weigh > 4 steps) ankle radiographs are indicated (Polzer, Kanz,  Prall, Haasters, Ockert, Mutschler, & Grote, 2012).

If ankle radiographs negative- assess ligament in affected extremity as compared to un-injured extremity by doing the crossed leg test, squeeze test, external rotation test, anterior drawer test, and talar tilt test. These tests will assist in determining the need for an MRI and also grading the sprain  (Polzer, Kanz,  Prall, Haasters, Ockert, Mutschler, & Grote, 2012).

Labs may include a uric acid level which is elevated with gout and a WBC which would be elevated with  osteomyelitis. MRI imaging may also be indicted.

A.

Sprain- because the patient heard the “pop” sound, her injury is likely related to an ankle sprain in which the ligaments and tissue that surround the bones of the ankle are injured causing swelling, pain, and limited ROM  (PubMed Health, 2018).

Fracture- a fracture would be unlikely if the patient was able to bear weight after the injury. The area would also become ecchymotic with limited to no ROM (PubMed Health, 2018).

Osteomyelitis- the extremity would be warm, erythematous, not usually associated with an acute injury, potential fever present, usually associated with a systemic infection or a wound (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

Gout- associated with hot, swollen joints, pain and limited ROM (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

Bursitis- limited ROM, swelling, pain, warmth, and point tenderness (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide  to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Polzer, H., Kanz, K. G., Prall, W. C., Haasters, F., Ockert, B., Mutschler, W., & Grote, S. (2012).

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthopedic Reviews, 4(1), e5. http://doi.org/10.4081/or.2012.e5

PubMed Health. (2018). Ankle sprains: overview. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072736/

Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm.

Modeling Policy With Simulations:Evaluation of the Lungs and Thorax

Modeling Policy With Simulations:Evaluation of the Lungs and Thorax.

Lungs and Thorax

There are several ways to examine lungs and thoracic cavity. The easiest method is simple observation. Noting if there are accessory muscles are used, cyanosis present, deformities of the thoracic cavity, audible noises with respiration, and delays in inspiration or expiration call all give clues as to the patient’s respiratory status (Bickley, 2017).

Palpation is the next method of examination. When palpating the thoracic cavity, feel tender areas. Crepitus is a clue that air has leaked into the subcutaneous tissue. The clinician should test for expansions by placing both hands on the patient’s back. The thumbs should be located at the tenth rib and the fingers should be loosely parallel to each other and on the lateral portion of the rib cage. As the patient breaths the clinician’s hands should apart in an equal manner (Bickley, 2017).

Percussion is another important tool. While percussion does not help with lesions deep in the thoracic cavity, it does allow for the clinician to understand whether air, fluid, or a solid mass lies five to seven centimeters bellowed the percussed area (Bickley, 2017).

Auscultation is an excellent skill for a clinician. Every clinician should know the different adventitious lung sounds and their clinical significance (Bickley, 2017).

Factors that Influence Change in the Evaluation

Patient history, presenting symptoms, and abnormal findings, all help guide a physical assessment.  Some common thoracic and lung presenting symptoms include pain in the chest, back, and substernally, shortness of breath or wheezing, as well as a cough with or without hemoptysis (Bickley, 2017).

An asthmatic patient should be evaluated to make sure there is no wheeze present, that they are not frequently short of breath and using their rescue inhaler, and that they have not lost lung function (Cramer, Davidson, & Alic, 2015; Bickley, 2017).

Pain in the thoracic cavity can be cardiac, gastric, pneumonia, anxiety, or even a lesion on the lung (Frey, 2015; Bickley, 2017). Patient history and a focused assessment can help narrow down a diagnosis and treatment plan (Bickley, 2017).

References

Bickley, L. S. (2017). Bates’ Guide to Physical Examination and History Taking, 12th Edition. [Vitalsource]. Retrieved from https://online.vitalsource.com/#/books/9781496354709

Cramer, D. A., Davidson, T., & Alic, M. (2015). Asthma. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine (5th ed., Vol. 1, pp. 545-553). Farmington Hills, MI: Gale. Retrieved from http://link.galegroup.com.prx-herzing.lirn.net/apps/doc/CX3623300200/GVRL?u=lirn50909&sid=GVRL&xid=644b6d6a

Frey, R. J. (2015). Lung Abscess. In J. L. Longe (Ed.), The Gale Encyclopedia of Medicine (5th ed., Vol. 5, pp. 3088-3091). Farmington Hills, MI: Gale. Retrieved from http://link.galegroup.com.prx-herzing.lirn.net/apps/doc/CX3623301121/GVRL?u=lirn50909&sid=GVRL&xid=f4e0f075

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Modeling Policy With Simulations:Evaluation of the Lungs and Thorax

Conduct research on nonprofits that partnered with Africa to reduce AIDS/HIV during the second Bush administration.

Conduct research on nonprofits that partnered with Africa to reduce AIDS/HIV during the second Bush administration..

AIDS/HIV

  1. Explain how the nonprofits filled the need.
  2. Describe why nonprofits were able to fill the need when other entities were not able too.
  3. Describe the intended and unintended consequences of these partnerships.

Use two to four scholarly resources to support your explanations.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin.

Save Link Assignment Partnering with Nonprofits
View RubricDue Date: Oct 17, 2018 23:59:59       Max Points: 110

Details:

Conduct research on nonprofits that partnered with Africa to reduce AIDS/HIV during the second Bush administration. In 750-1,000 words, do the following:

  1. Explain how the nonprofits filled the need.
  2. Describe why nonprofits were able to fill the need when other entities were not able too.
  3. Describe the intended and unintended consequences of these partnerships.

Use two to four scholarly resources to support your explanations.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.

New AttemptTitleAttached DocumentsCitation ReportSimilarity IndexFinal Submission Click ‘New Attempt’ to start assignment or attach documents

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Conduct research on nonprofits that partnered with Africa to reduce AIDS/HIV during the second Bush administration.

Etiology And Treatment

Etiology And Treatment.

Etiology

Discuss the etiology and treatment of your principal and secondary diagnoses for the following case study using a minimum of five peer-reviewed sources on etiology and a minimum of five peer-reviewed sources on treatment.

The skills you developed and the feedback you received after completing this required assignment, will significantly help you in completing the following LASA. For example, both assignments (RA and LASA), require you to complete similar tasks such as identifying the principal and secondary diagnoses, providing a rationale for the diagnoses, and offering differential (alternative) diagnoses. In this assignment, you will  Your paper should have separate sections for the etiology of each principal and secondary diagnosis, therapeutic modalities for each principal and secondary diagnosis, justification of the selected therapeutic modalities for the disorders, application of the treatment for the disorders, and a reference page for your sources. Your citations and references should be in APA style, and your paper should be 8–10 pages in length.

Sexual Disorders: https://digitalbookshelf.argosy.edu/#/books/1260520749/cfi/6/40!/4/2/2/2/4/2@0:0
Mental Health and the Law: https://digitalbookshelf.argosy.edu/#/books/1260520749/cfi/6/46!/4/2/2/2/4/2@0:0

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Etiology And Treatment