Tag: Myessayhelper

Jordan is a 35-year-old woman who presents with intermittent diarrhea with cramping that is relieved by defecation. The diarrhea is not bloody or accompanied by nausea and vomiting. Review of past medical history includes some childhood “stomach issues”, HTN, and a recent cholecystectomy. She works in the environmental department of a large hotel. . She denies alcohol and cigarette.

Diagnosis: Irritable Bowel Syndrome (IBS)

I. Discuss the epidemiology of IBS?

II. What is your treatment goals for this patient?

III. Discuss First line and second line drug therapy for IBS. Please include pharmacotherapeutic information.

After you complete the readings, what “health system components” do you believe must be in place to ensure a well-functioning system of primary care?

1. What are the health system components?

2. Should they be weighted on some scale of importance?

If so, what ones do you believe should be at the top of the 3. What is meant by primary care, and why is it a priority of all health systems?
4. Does the concept of primary care mean different things in wealthy and poorer countries?

“Bariatric Info Session: Tuesday at 7:00 PM.” Gabby looked at the flyer in her physician’s waiting room, wondering if this would be the week that she would muster the courage to get more information about gastric bypass surgery. Her doctor had been telling her for two years that her elevated BMI, combined with the fact that she had type 2 diabetes, would qualify her for insurance coverage if she decided to have the operation. But surgery seemed so drastic and irreversible. She had recently been motivated by a TV feature about a local woman’s weight-loss success story but then her coworker Tim told her that his cousin gained all of his weight back just a few years post-op.

Gabby felt ashamed that she hand’t been able to lose much weight on her own through diet and exercise, despite having worked with a personal trainer and registered dietitian. Her doctor had told her that part of the bariatric evaluation consisted of meeting with a psychologist to make sure that she would be a good candidate for surgery. She didn’t like the idea of talking to someone about her feelings, especially regarding the complicated role that food had always played in her life. And what about the strict diet she would have to follow in the weeks post-surgery-and the changes in eating habits she would need to maintain for the rest of her life? Gabby had already failed at so many diets that she didn’t know if she would have the willpower necessary to succeed. And yet her weight was a constant source of worry when she thought about her future.

Please answer the following questions in your discussion post:

1) If her weight wasn’t causing any health problems currently, should she still consider surgery?

2) Why must patients follow a very strict diet post-bariatric surgery?

3) What are some of the dangers or potential side effects of bariatric surgery?

Compare the different uses of industrial engineering methods within warehousing I noticed that a couple of student emails used the phrase ‘compare the different methods of industrial engineering’ but this is inconsistent with the wording of the task which states ‘compare the different uses’. Methods are standard but they can be applied to support different tiers of decision making. Some students have also mentioned that they can’t find books on the topic. This may be linked to their searching methods as I have found various sources. I also mentioned that you should read beyond standard textbooks and journal articles as the topic has a strong operational focus. Refer to the slides in the presentations which give an overview of sources of useful reports and white papers.

1. What are the major arguments contained within each of these documents? How do they compare to one another?

2. Are there parallels in their arguments to modern debates within American society? If so, in what specific way(s)?

Please remember to use specific evidence from these documents to support your arguments.

3.  Exceeds the stated MINIMUM length requirement for the associated writing prompt(s). 

4. You will be penalized for any submission that does not meet the stated minimum length requirement.

5. Because of the short length of these assignments, please avoid directly quoting the document unless it is absolutely essential to your argument. Instead, briefly paraphrase the passage(s) and focus instead upon providing your analysis and supporting your argumentation.

1. Why is HDL considered the good cholesterol?

2. Explain the role inflammation has in the development of atherosclerosis

3. A 53-year-old male with a history of systemic lupus erythematosus (SLE) presents to the ER with complains of sharp retro sternal chest pain that worsens with deep breathing. Diagnosis reveals Pleural friction rub and acute pericarditis.

A. What does a physician Assistant recognized as the result of the pleural friction rub?

4. An adolescent with complain of swollen lymph nodes, abdominal pain, temp 102F, and arthralgias for about 2 weeks, at the ER was given Tamiflu but the Tamiflu seems not to work and complain of high pitched onset, sore throat with reddened, cervical lymphadenopathy and tonsils 3+ without exudate. Rapid strep was positive. The Patient was diagnosed with acute rheumatic hear disease

A. Explain how positive strep test has cause the patients symptoms.

5. A 76-year-old obese patient who is 31 hours post op hip replacement complain of nausea and vomiting, dry mucus membrane, and unable to go for physical therapy. Physical exam reveals a swollen red colored calf and left leg tightness. Ultrasound reveal deep venous thrombosis (DVT)

A. Describe the factors that could have contributed to DVT

B. Explain how each factor cause DVT

6. A patient was sent home 10days ago s/p partial small bowel resection for crohns disease, she sudden start experiencing Shortness of breath, blood pressure 80/40, oxygen level 89% on room air, the physician suspect massive pulmonary embolus, while waiting for EMS to arrive the physician assistant place an EKG on the patient which reveals Right Ventricular Strain

A. Explain why large pulmonary embolus interferes with oxygenation

B. Explain why large pulmonary embolus causes right ventricular strain

7. Explain early asthmatic responses and the cells responsible for the responses

8. Explain late asthmatic responses and the cells responsible for the reactions

9. A 56-year-old female with history of smoking was diagnosed with emphysema. She as the physician if this means COPD.

A. Explain the pathophysiology of emphysema and how it relates to COPD

B. Explain the pathophysiology of chronic bronchitis and how it relates to COPD

10. A 60 year old patient with COPD has lost 7% of body weight during his doctor visit , patient admits to missing some meals and stated the meals take too much work to cook and prepare.

A. Explain why patient with COPD are at risk for malnutrition

11. What is pathologic process that can causes patient with pneumonia to have low oxygenation/hypoxia level

Identifique un estudio publicado en español con diseño de correlación. Prepare una presentacion en PowerPoint que incluya lo siguient.

1- porque le interesó el artículo?

2- el problema

3- resumen del metodo

4- resumen del análisis de datos

5- conclusion del artículo

For months, Michael was having trouble swallowing, and he often felt as if he had a lump in his throat. His voice sounded hoarse, and he had a dry cough, which he attributed to smoking. Even more troubling, Michael was plagued by mild chest pain. He was especially worried because his dad died of heart disease. Michael managed a retail store, and on the nights when he worked late, he often ate dinner right before bed. This led to indigestion and insomnia. Taking antacids usually helped his stomach and the pyrosis—but not the pain in his chest. One night, the pain was especially severe; though it eased a short time after it started, he was still having trouble swallowing. Concerned, Michael went to see his physician’s assistant the next week. Because of Michael’s concern about his heart, his PA ordered an electrocardiogram (EKG). When the results turned out to be normal, Michael wondered if his symptoms—especially the trouble swallowing—might be due to a gastrointestinal problem. His PA agreed and gave him a referral to our clinic.

THE EVALUATION:

In taking Michael’s medical history, I learned that he had an irregular eating schedule. I asked about his diet, and Michael told me that he had a passion for chocolate, spicy foods, and coffee. I performed a physical exam and did not find any abnormalities. Because Michael reported having trouble swallowing, I wanted to make sure that there was no serious damage to his esophagus from his digestive problems. I had him undergo an esophagogastroduodenoscopy, a test that involves being sedated while an endoscope is inserted into the mouth and down the stomach. The endoscope allowed me to check for a hiatal hernia. Hiatal hernias can also cause reflux and pyrosis.

THE DIAGNOSIS:

Based on Michael’s description of his symptoms, I suspected that he had gastroesophageal reflux disease (GERD), which occurs when the lower esophageal sphincter at the bottom of esophagus relaxes, allowing stomach acid to leak back into the esophagus. Over time, the stomach acid can irritate and damage the delicate lining of the esophagus. Fortunately, he did not have any significant buildup of scar tissue (in some GERD sufferers, scar tissue builds up in the esophagus, which can lead to blockages as well as cancer-causing tumors). Michael also did not have a hiatal hernia. What he had was a classic case of GERD.
Although most people with GERD suffer from frequent pyrosis, some do not. Some patients have chest pain, a lump in the throat, a cough, or hoarseness—which is exactly what Michael had described. Most patients can be diagnosed with GERD based on symptoms alone: iIf they respond to treatment, then the diagnosis is confirmed.

THE TREATMENT 
In order to ease his symptoms and prevent future damage, I prescribed a proton pump inhibitor (PPI) drug, which reduces the acid that is secreted in the stomach. I explained to Michael that medication was just part of the equation: He also had to make lifestyle changes. I urged Michael to limit his intake of coffee, chocolate, and fried or spicy foods, all of which can stimulate acid production in the stomach. In addition, he had to lose weight and stop smoking. GERD occurs when stomach acid leaks back into the esophagus, and smoking weakens the sphincter that separates the esophagus from the stomach. Excess weight puts pressure on the stomach, which may cause acid to back up into the esophagus. Finally, I advised him to eat smaller meals. Not only would eating smaller meals help him lose weight, but it would also prevent his stomach from becoming too full, which puts pressure on the lower esophageal sphincter and increases the chance that the food will reflux.

CASE CLOSED:

Over the next 3 months, Michael lost 8 pounds. He was taking his medication, and he had cut back his coffee consumption to one cup per day. Although he could not resist chocolate and Mexican cuisine, Michael started viewing these foods as occasional treats. He recently started a smoking cessation program at the local hospital. As a result, his chest pain had virtually disappeared, and he was no longer having trouble swallowing. His voice even sounded less hoarse. Now that his symptoms have eased, I was certain that I had diagnosed him correctly.

Discussion Questions

1. The esophagus is a muscular tube through which ingested food passes from the pharynx to the stomach. It is aided in this action by gravity and peristalsis. What is peristalsis?

2. GERD is an abbreviation for gastroesophageal reflux disease. Define the word parts that make up the word gastroesophageal.

3. The doctor decides that Michael does not have a hiatal hernia. What is this?  What are they symptoms of a hiatal hernia?

4. Michael underwent an endoscopy of his esophagus and stomach. Name two lower gastrointestinal system procedures that involve an endoscope, and describe why they are done.

Read the Consumerization of Technology at IFG Case Study on pages 234-238 in the textbook. Answer the Discussion Questions at the end of the Case Study.

1. In discussion with Josh, Tonya foreshadows “some serious obstacles to overcome.” Describe these obstacles in detail.

2. How can Josh win support for his team’s three-point plan to use technology to help IFG reach its customers?