Reference no: EM132859617

A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.

• Students-this case does not have a dx, so you will have to provide it. Look carefully at the labs and explain what they mean. Look at the medications and consider if they have anything to do with the case. Look at all of the aspects of this patient's health and lack of health. Read the questions that are posted for Week 8 and please make sure you address all of them as well as address what I have written above. Please make sure you discuss the pathophysiology in-depth, which is something some students are not doing. This is seen in primary care, so it is an especially good dx for you to learn about. I will be looking also for you to discuss medications that are used to treat this and discuss any dietary issues associated with this illness
• An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other.
• Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role
• An understanding of the symptoms of alterations in neurological and musculoskeletal systems is a critical step in diagnosis and treatment. For APRNs this understanding can also help educate patients and guide them through their treatment plans.

In your Case Study Analysis related to the scenario provided, explain the following:

Question 1: Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.

Question 2: Any racial/ethnic variables that may impact physiological functioning.

Question 3: How these processes interact to affect the patient.