MRU Lime Disease and Peripheral Vascular Disease Case Study Case Study 1 and 2 Students much review the case study and answer all questions with a scholar

MRU Lime Disease and Peripheral Vascular Disease Case Study Case Study 1 and 2

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 Study 1 & 2 Lyme Disease and Peripheral Vascular Disease

The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submited in this course are registered and saved in turn it in 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.

All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites) per case Study Lyme Disease
Case Study
A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints
of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s
symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his
thigh immediately after the trip. The following studies were ordered:
Studies
Lyme disease test,
Erythrocyte sedimentation rate
(ESR),
Aspartate aminotransferase
(AST),
Hemoglobin (Hgb),
Hematocrit (Hct),
Rheumatoid factor (RF),
Antinuclear antibodies (ANA),
Results
Elevated IgM antibody titers against Borrelia burgdorferi
(normal: low)
30 mm/hour (normal: ≤15 mm/hour)
32 units/L (normal: 8-20 units/L)
12 g/dL (normal: 14-18 g/dL)
36% (normal: 42%-52%)
Negative (normal: negative)
Negative (normal: negative)
Diagnostic Analysis
Based on the patient’s history of camping in the woods and an insect bite and rash on the
thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific
immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing
Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen
early in this disease. RF and ANA abnormalities are usually absent.
Critical Thinking Questions
1.
2.
3.
4.
What is the cardinal sign of Lyme disease? (always on the boards)
At what stages of Lyme disease are the IgG and IgM antibodies elevated?
Why was the ESR elevated?
What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.
Peripheral Vascular Disease
Case Studies
A 52-year-old man complained of pain and cramping in his right calf caused by walking two
blocks. The pain was relieved with cessation of activity. The pain had been increasing in
frequency and intensity. Physical examination findings were essentially normal except for
decreased hair on the right leg. The patient’s popliteal, dorsalis pedis, and posterior tibial
pulses were markedly decreased compared with those of his left leg.
Studies
Routine laboratory work
Doppler ultrasound systolic pressures
Arterial plethysmography
Femoral arteriography of right leg
Arterial duplex scan
Results
Within normal limits (WNL)
Femoral: 130 mm Hg; popliteal: 90 mm Hg;
posterior tibial: 88 mm Hg; dorsalis pedis: 88
mm Hg (normal: same as brachial systolic
blood pressure)
Decreased amplitude of distal femoral, popliteal,
dorsalis pedis, and posterior tibial pulse waves
Obstruction of the femoral artery at the midthigh
level
Apparent arterial obstruction in the superficial
femoral artery
Diagnostic Analysis
With the clinical picture of classic intermittent claudication, the noninvasive Doppler and
plethysmographic arterial vascular study merely documented the presence and location of the
arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography
to document the location of the vascular occlusion. The patient underwent a bypass from the
proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.
Critical Thinking Questions
1. What was the cause of this patient’s pain and cramping?
2. Why was there decreased hair on the patient’s right leg?
3. What would be the strategic physical assessments after surgery to determine the
adequacy of the patient’s circulation?
4. What would be the treatment of intermittent Claudication for non-occlusion?

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