Rheumatology Case

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Kim Lee, a 55-year-old married female, presents to a primary care office for evaluation of joint pain. The patient states she has been experiencing joint pain for the past six weeks. The pain started in her lower back and progressed to her knees, hips, wrists, and now fingers and toes. She has taken Motrin, Tylenol, and Aleve with slight relief of these symptoms. She is not sleeping at night. The patient has no past medical history. The patient takes no prescribed medications and has no allergies to medications.
Answer the following questions:

  1. What additional subjective information do you need to obtain from this patient?
  2. Please complete a focused physical exam for this patient providing a rationale for your assessment.
  3. Please provide a list of four differential diagnoses for polyarticular pain with a brief reference rationale.
  4. Please provide a list of four differential diagnoses for myalgia with a brief reference rationale.
  5. What diagnostic tests will you order to evaluate this patient and why? Are there any limitations to the tests that you may consider ordering?

Sample Solution

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Concepts of Motivation

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In 1999 Deci and his colleagues came to the following conclusion, “Careful consideration of reward effects reported in 128 experiments lead to the conclusion that tangible rewards tend to have substantially negative effect on intrinsic motivation. When institutions, families, schools, businesses, and athletic teams, for example – focus on the short-term and opt for controlling people’s behavior they do considerable long-term damage”
(Pink, 2009, p.39). After conducting adequate research:
Write about a documented scenario, which supports the concepts identified in this quote. (An example may be from a local school, business, athletic team, etc.)
How does the scenario provide support for concepts identified within the quote?

Sample Solution

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Pop song piracy: Disobidient music distribution since 1929

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Chapter 1: Tim Pan Alley’s Near-Perfect Distribution System
Chapter 2: Bootlegging Song Sheets
Chapter 3: The Content and Uses of Song Sheets
complete a short writing concerning the topics covered by the readings, Writings are to be no less than 300 words, and no more than 400 words, in length, and will be assessed taking into account five areas: 1) word count; 2) summarize the key changes in scholarly perspective over time on the particular topic for each module; 3) critical compare and contrast opposing claims; 4) clear expression of your perspective on the subject matter; and, 5) use of proper grammar and punctuation.

Sample Solution

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Health Promotion, Chronic and Acute Illness

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Select one acute and one chronic women’s health issue (e.g., urinary tract infection and osteoporosis).
Describe and outline the issue, prevalence, and significance.
Describe health promotion and screening for each issue.
Outline diagnostic tests or laboratories needed for each issue. Elaborate on what you would expect or anticipate in the diagnostic testing with each illness you choose.
List and describe common treatment or management modalities for each issue.
Discuss patient education and follow up that is needed for each issue.
Identify health screening and promotion needs for women across the lifespan specific to the chronic illness.
For each selected issue, compare and contrast traditional versus nontraditional treatment options.
Examine how you would collaborate with other members of the health care team for best practice.

Sample Solution

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