What are special tests used to differentiate type of Tendon tears in the knee ? Explain how they are performed (Always on boards)

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A 15-year-old gymnast has noted knee pain that has become progressively worse during the past several months of intensive training for a statewide meet. Her physical examination indicated swelling in and around the left knee. She had some decreased range of motion and a clicking sound on flexion of the knee. The knee was otherwise stable.

Studies

Results

Routine laboratory values

Within normal limits (WNL)

Long bone (femur, fibula, and tibia) X-ray

No fracture

Arthrocentesis with synovial fluid analysis

Appearance

Bloody (normal: clear and straw-colored)

Mucin clot

Good (normal: good)

Fibrin clot

Small (normal: none)

White blood cells (WBCs)

<200 WBC/mm3 (normal: <200 WBC/mm3)

Neutrophils

<25% (WNL)

Glucose

100 mg/dL (normal: within 10 mg/dL of serum glucose level)

Magnetic resonance imaging (MRI) of the knee

Blood in the joint space. Tear in the posterior aspect of the medial meniscus. No cruciate or other ligament tears

Arthroscopy

Tear in posterior aspect of medial meniscus

Diagnostic Analysis

The radiographic studies of the long bones eliminated any possibility of fracture. Arthrocentesis indicated a bloody effusion, which was probably a result of trauma. The fibrin clot was further evidence of bleeding within the joint. Arthrography indicated a tear of the medial meniscus of the knee, a common injury for gymnasts. Arthroscopy corroborated that finding. Transarthroscopic medial meniscectomy was performed. Her postoperative course was uneventful.

Critical Thinking Questions

  1. One of the potential complications of arthroscopy is infection. What signs and symptoms of joint infection would you emphasize in your patient teaching?
  2. Why is glucose evaluated in the synovial fluid analysis?
  3. What are special tests used to differentiate type of Tendon tears in the knee ? Explain
    how they are performed (Always on boards)

What impact did an undescended testicle have on this young man’s risk for developingtesticular cancer?

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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 Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism 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.

Testicular Cancer Case Studies

A 21-year-old male noted pain in his right testicle while studying hard for his midterm college examinations. On self-examination, he noted a “grape sized” mass in the right testicle. Thisfinding was corroborated by his healthcare provider. This young man had a history of delayed descent of his right testicle until the age of 1 year old.

Studies

Results

Routine laboratory studies

Within normal limits (WNL)

Ultrasound the testicle

Solid mass, right testicle associated with calcifications

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HCG (human chorionic gonadotropin)

550mIU/mL (normal: <5)

CT scan of the abdomen

Enlarged retroperitoneal lymph nodes

CT scan of the chest

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Multiple pulmonary nodules

Diagnostic Analysis

At semester break, this young man underwent right orchiectomy. Pathology was compatible with embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a leave of absence from college, and after banking his sperm, this young man underwent aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes.

Critical Thinking Questions

  1. What impact did an undescended testicle have on this young man’s risk for developingtesticular cancer?
  2. What might be the side effects of cytotoxic chemotherapy?
  3. What was the purpose of preserving his sperm before chemotherapy?
  4. Is this young man’s age typical for the development of testicular carcinoma?

Which is Not a quality needed when working with a child to help solve a problem with a peer?

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Which is Not a quality needed when working with a child to help solve a problem with a peer?

a. Firmness

b. Politeness

c. Empathy

d. Persistence

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What has your experience been with patient involvement in treatment or healthcare decisions? 

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Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

  • Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
  • Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
    • Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

Rubric:

 

Main Posting–

Levels of Achievement:Excellent 45 (45%) – 50 (50%) Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Good 40 (40%) – 44 (44%) Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.Fair 35 (35%) – 39 (39%) Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.Poor 0 (0%) – 34 (34%) Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.Feedback:

Main Post: Timeliness–

Levels of Achievement:Excellent 10 (10%) – 10 (10%) Posts main post by day 3.Good 0 (0%) – 0 (0%)  Fair 0 (0%) – 0 (0%)  Poor 0 (0%) – 0 (0%) Does not post by day 3.Feedback:

First Response–

Levels of Achievement:Excellent 17 (17%) – 18 (18%) Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.Good 15 (15%) – 16 (16%) Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.Fair 13 (13%) – 14 (14%) Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Poor 0 (0%) – 12 (12%) Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.Feedback:

Second Response–

Levels of Achievement:Excellent 16 (16%) – 17 (17%) Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.Good 14 (14%) – 15 (15%) Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.Fair 12 (12%) – 13 (13%) Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.Poor 0 (0%) – 11 (11%) Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.Feedback:

Participation–

Levels of Achievement:Excellent 5 (5%) – 5 (5%) Meets requirements for participation by posting on three different days.Good 0 (0%) – 0 (0%)  Fair 0 (0%) – 0 (0%)  Poor 0 (0%) – 0 (0%)