Use clinical terminologies to explain the physicalcharacteristics featured in the graphic. Formulate adifferential diagnosis of three to five possible conditions for theskin graphic that you chose. Determine which is mostlikely to be the correct diagnosis and explain your reasoning usingat least three different references, one reference from currentevidence-based literature from your search and two differentreferences from this week’s Learning.
Ms. Jones presents today for a physical examination and withreport of a scrape to the ball of her right foot. She reports thatshe obtained the scrape 1 week ago when she tripped going down thestairs and scraped her bare foot on the edge of the step. Shereports bleeding at the time of injury, and shares that she hasbeen washing the wound with soap and water twice daily (morning andnight), and that she has been using Neosporin prior to keeping itbandaged. She added that she sometimes uses peroxide and thenrinses the area when it is irritated. She reports that the scrapeis not healing on its own, “is not looking well”, and is causingher pain. Her current pain level is a 7/10, and she describes thepain as “throbbing” and “sharp” when weight is applied. She reportsthat her entire right foot feels some pain, but the pain is theworst at the center/ball of her foot. She added that the pain alsoradiates up her ankle. She has not been able to walk due to thispain. She has been taking Tramadol 100 mg three times daily forpain, but feels that this only alleviates the pain for a few hours.She reports that the area has been red and swollen with noted pus,heat, and increased pain over the last 2 days ago. She denies notedodor.
Medications Tramadol 50 mg tablets. Taking 2 tablets (100 mgTotal) 3 times daily for pain. Proventil Inhaler 90 mg 2- 3 puffs2-3 times per week for asthma symptoms. Advil 200 mg tablets.Taking 3 tablets (600 mg Total) up to 3 times daily for menstrualcramps. o Patient self-discontinued Metformin and birth controlpill use 3 years ago. o She denies use of any other vitamins,supplements, or additional OTC medications.
Medical History Type 2 Diabetes: Diagnoses at age 24. Has aglucometer, but does not currently monitor her blood glucose due tofeeling it is a hassle. Not currently taking prescribed medication.Was taking Metformin when first diagnosed but discontinued takingthis 3 years ago due to not liking it. Does not follow a specificdiabetic diet. Tries to make healthy choices. Avoids excesscarbohydrate and sugar intake (drinks diet versus regular soda).Does not monitor her salt intake. She reports increased appetite,thirst, and water intake. Reports unintentional weight loss of 10lbs. over the last month. She also reports more frequent urination. Asthma: Diagnosed as a child at age 2. Reports chest & throattightness, wheezing, and feels that she can’t take in enough airinto her lungs during attacks. Reports dust, cats, and exercise(such as running up the stairs) make breathing worse. Reportsshowering helps with symptoms when exposed to cats. She reportsthat her asthma attacks are rare, and that the last attack resultedin hospitalization when her inhaler was not working at age 16.Reports using a prescribed Proventil Inhaler 90 mg 2- 3 puffs 2-3times per week as needed for asthma symptoms.
