DQ Reply 8 634

Need help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- Minimum One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA 6th edition style needs to be followed.

4- Each response should have reference at the end of each reply

5- Reference should be within last 5 yearsNeed help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- Minimum One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA 6th edition style needs to be followed.

4- Each response should have reference at the end of each reply

5- Reference should be within last 5 yearsDQ-1

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease affecting the joints, as well as, tissues and organs (Lin, Anzaghe, & Schulke, 2020). The immune system attacks healthy tissues in the joints, including the synovial membrane, resulting in joint damage. RA increases with age, typically between 65 to 74 years, and is more prevalent in women than men. Individuals with RA will have early symptoms including low-grade fever, weakness, fatigue, muscle pain, and stiffness (Lin et al., 2020). Ultimately, individuals will experience joint deformity and loss of function, which mostly involves the fingers, wrists, knees, ankles, and toes (Parker & Elam, 2017). The elbows, shoulders, and neck can be involved as well. Symptoms of RA are typically gradual in onset and include stiffness, redness, warmth to touch, and swelling. There is a loss of mobility, range of motion, and extension due to the formation of contractures.

A laboratory workup is needed as patients with RA will have serologic titers of anti-cyclic citrullinated peptide (CCP) antibodies which is a specific blood test for RA and rheumatoid factor (RF) (Park & Elam, 2017). The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) may be elevated in RA patients. In aid in the differential diagnosis of RA, an antinuclear antibody (ANA) measurement, CBC, platelet count, serum uric acid measurement, and human leukocyte antigen (HLA) tissue should be done. These tests can help distinguish RA from other arthritic and immunologic pathologies. The joint fluid should be assessed as RA joint fluid is typically more yellow to opalescent with an elevated WBC and platelet count, and to rule out infections and gout (Parker & Elam, 2017). Diagnostic tests are the most important tool as it can identify the disease’s progress. X-ray studies may show a narrowing of the joint space, bony erosion, reduced bone density surrounding the joints, and joint subluxation (Parker & Elam, 2017). Additionally, an MRI and ultrasound may be beneficial to identify synovitis.

References

Lin, Y.-J., Anzaghe, M., & Schulke, S. (2020). Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells, 9(4). doi:10.3390/cells9040880.

Parker, E., & Elam, A. (2017). Rheumatoid arthritis: Diagnosis and treatment. The Clinical Advisor: For Nurse Practitioners, 20(5), 19-25. Retrieved from https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/1894948446?accountid=7374

DQ-2

It is a difficult task to manage a sprain/strain on joints and ligaments. The clinical characteristics of a sprain injury are abnormal stretching or partial tearing of ligaments that support a joint. Unlike sprain, a strain is involving a muscle or a tendon. This involves overstretching of tendons or muscles. Any joint may be involved based on the manner of injury such as a fall or twisting or blow. Most common joints sprains involved are the knee, ankle, wrists. Most common sites of strains are back and hamstrings. Assessment findings are edema over, and around injured joints usually not present immediately after injury. Erythema or ecchymosis may be present. The patient may have heard a pop at the time of injury. The screening tools I will use for this type of injuries are an X-ray. This diagnostic scan is to rule out any fractures. MRI may be used to determine more substantial injury has occurred. Obvious deformities may be apparent in severe injuries and fractures. These injuries require adequate assessment of circulation, motor, sensation at the distal end of the injury. Treatment for these types of injuries require immobilization and compression, elevation of the involved joint and rest are necessary for joint to heal. This will help minimize the swelling of the injury. Application of ice on the joint may be needed to decrease the inflammation and pain. After the 24 to 48 hours of injury heat compresses may be applied for 20 minutes intervals 4 times per day. Heat treatment has been shown to increase circulation in muscle spasm, sprain and promote healing (Falcon, C. R. (2019). Rom exercises to improve symptoms, prevent stiffness, increase strength and regain flexibility. Patient may need crutches if unable to bear weight. The patient may be prescribed NSAIDS. Nsaids are an excellent source of treatment that can benefit and outweigh the adverse effects (van den Bekerom,Sjer,Somford, Bulstra,Struijs,Kerkhoffs,2015). A short course of narcotic analgesics for moderate to severe pain may be prescribed as well.

Falcon, C. R. (2019). Muscle sprains, spasms, and disorders. Magill’s Medical Guide (Online Edition).

van den Bekerom, M. P. J., Sjer, A., Somford, M. P., Bulstra, G. H., Struijs, P. A. A., & Kerkhoffs, G. M. M. J. (2015). Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 23(8), 2390–2399. https://doi.org/10.1007/s00167-014-2851-6

DQ-3

Osteosarcoma is the most common form of bone cancer in the body (Kimura et al., 2017). Osteosarcoma is a high-grade primary bone malignancy cancer with a high rate of metastasis and recurrence (Kimura et al., 2017). Osteosarcoma commonly affects the long bones of the body and usually arises within the second decade of life (Kimura et al., 2017). It rarely affects the head and neck, and usually occurs later in life, in the third and fourth decade (Kimura et al., 2017).

There are classifications of osteosarcoma which are: conventional, telangiectatic, small-cell, low-grade central, secondary, periosteal, parosteal, and high-grade surface cancers (Kimura et al., 2017). Conventional osteosarcoma is the most commonly diagnosed type of osteosarcoma which can be further classified into three subtypes: osteoblastic, chondroblastic, and fibroblastic (Kimura et al., 2017).

The occurrence rate of metastasis is approximately 80%, with a 5-year survival rate of 30%, however, 20% of patients diagnosed with osteosarcoma already have a distant metastasis which causes symptoms and aids in the discovery of osteosarcoma (Kimura et al., 2017).

Diagnosis usually begins with a physical exam, noting bony prominences for asymmetry or loss of function (Isakoff, Bielack, Meltzer & Gorlick, 2015). Diagnostic tools include an x-ray of the affected area, CT, MRI, PET, and a bone scan (Isakoff et al., 2015). Once areas of concern have been identified, a biopsy would be recommended in order to help classify the type of cell to determine the type of osteosarcoma (Isakoff et al., 2015). Since this is a bone cancer-growth disorder, most deformities will be found on radiological imaging (Isakoff et al., 2015); (Kimura et al., 2017).

Treatment for osteosarcoma includes a variety of options (Isakoff et al., 2015). First, surgical removal of the primary tumor along with any metastasis would be performed (Isakoff et al., 2015). Next, an adjunct regiment of multi-drug chemotherapy based on biopsy results, after surgery can improve a 5-year survival rate to 65% (Isakoff et al., 2015). However, the type of surgery also includes the considerations of how it will affect daily life of the patient (Isakoff et al., 2015). This will determine the type of surgery such as amputation versus reconstruction (Isakoff et al., 2015).

There are three pictures included that show osteosarcoma of a long bone at the knee area. One is of an Xray, one is of a 3d-model, and last is a CT image.

References:

Isakoff, M. S., Bielack, S. S., Meltzer, P., & Gorlick, R. (2015). Osteosarcoma: Current Treatment and a Collaborative Pathway to Success. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 33(27), 3029–3035. https://doi.org/10.1200/JCO.2014.59.4895

Kimura, Y., Tomihara, K., Tachinami, H., Imaue, S., Nakamori, K., Fujiwara, K., Suzuki, K., Yasuda, T., Miwa, S., Nakayama, E., Noguchi, S., Kimura, Y., Tomihara, K., Tachinami, H., Imaue, S., Nakamori, K., Fujiwara, K., Suzuki, K., Yasuda, T., & Miwa, S. (2017). Conventional osteosarcoma of the mandible successfully treated with radical surgery and adjuvant chemotherapy after responding poorly to neoadjuvant chemotherapy: a case report. Journal of Medical Case Reports, 11, 1–6. https://doi-org.lopes.idm.oclc.org/10.1186/s13256-017-1386-0

 

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