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HPI: E. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief.
She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago.
She applied lotrimin AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills.
PMH: Diabetes Mellitus, type 2. Surgeries: None Allergies: Augmentin Medication: Metformin mg PO BID. Vaccination History: Immunization is up to date and she received her flu shot this year. Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.
Family history: Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN. ROS: Constitutional: Negative for fever. Negative for chills. Respiratory: No Shortness of breath. No Orthopnea Cardiovascular: Regular rhythm.
Skin: Right great toe swollen, itchy, painful and discolored. Psychiatric: No anxiety. No depression. Gums no redness. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement, case study writing help online. LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds, case study writing help online. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. ABDOMEN: No abdominal distention. No organomegaly. Normal contour; No palpable masses.
GU exam deferred. No Kyphosis. SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. No pus. No neuro deficit. PSYCH: Normal affect. Labs: Hgb A: Primary Diagnosis: Proximal subungual onychomycosis Differential Diagnosis: Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis Special Lab: Fungal culture confirms fungal infection. Treatment: terbinafine mg daily x 12 weeks or Itraconazole mg daily x 12 weeks For follow up and baseline therapy the labs ordered were: liver blood test and blood count to determine the ALT and the AST levels Please address the following:.
Specify when to refer the patient after therapy and why? Provide rationale. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis? Provide patient education. Keep in mind the past medical history of this patient. Delivering a high-quality product at a reasonable price is not enough anymore. This describes us perfectly. Make sure that this guarantee is totally transparent. Each paper is case study writing help online from scratch, according to your instructions.
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Buy Case Study Writing Help Online To raise students' awareness of business practices, professors often assign case studies. A case study paper requires you to investigate the problem given and come up with a possible solution based on your findings Chief complaint: “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”. HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and Buy a Case Study Online — Forget about a Deadline. And we're not joking. You can request a custom assignment with the urgency starting from 6 hours — even at night. You may think it's unbelievable. But our professional team can make your dreams come true and provide you with expert case study writing help 24 hours a day
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