Question

For the Week 5 Discussion board you will need to: 1) Read the following case study 2) List two possible pathologies that could be causing the patients signs and symptoms (this is called a differential diagnosis list) 3) Explain what test or tests should be preformed on the patient in order to determine which pathology is the proper diagnosis 4) Pick one of the possible pathologies that you listed and describe what the treatment and prognosis would be Case Study - Week 5 A 62 year old female presents with joint pain and swelling that started 2 weeks ago and has been gradually getting worse. She has noticed that she occasionally gets a slight fever and has been feeling fatigued lately.

Answer 1

The differential diagnosis for this patient in regards to the signs and symptoms are

• Arthritis (here swelling occurs in the joints causing pain ,also the inflammatory process could be probably because of some infection leading to fever)
• Rheumatic fever

The test which has to be done are

• X ray to rule out any synovial joint fluid loss or friction
• Blood test
  • RA factor
  • CRP ,ESR to rule out infection
  • CBC: basic test to assess the infection
  • Antinuclear antibody to find out any immune dysfunction or autoimmune disease

The possible pathology show in this patient is arthritis the treatment for this is

• Nonsteroidal anti inflammatory drugs are the first line drug to control inflammation and pain
• Hormonal therapy to treat any autoimmune disease
• Antibiotics to treat infection
• Antipyretics to reduce fever
• Non medical management:
  • Lifestyle changes
  • Daily exercise
  • Diet good in calcium
  • No alcohol ,smoking
  • No OTC drugs

The patient will have better prognosis if treated earlier