Module 7 Case Studies

Sample Answer

Integumentary Function

1. Name the most common triggers for psoriasis and explain the different clinical types.

Psoriasis can be triggered by systemic factors including infections, such as severe streptococcal throat, Candida, and upper respiratory tract infection, and hormonal changes during puberty and menopause (Raharja et al., 2021). It is also triggered by stress, obesity, drugs like lithium, beta-blocking agents, indomethacin, and antimalarials, and the presence of other diseases.
The clinical types of psoriasis include Psoriasis vulgaris, Exfoliative psoriasis, and Palmoplantar pustulosis (PPP).

Psoriasis vulgaris is the most common type of psoriasis and presents with thick, erythamatous papules or plaques covered by silvery white scales. Exfoliative psoriasis is an explosively eruptive and inflammatory form of psoriasis with generalized erythema and scaling (Raharja et al., 2021). PPP causes pustules on the palms of the hands and soles of the feet.

2. There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.

Various topical agents used to treat psoriasis include topical steroids, topical tar, Salicylic acid, Emollients, and anthralin preparations. Ultraviolet (UV) light is a physical agent commonly used as a topical treatment in many skin conditions, including psoriasis. The most appropriate approach to treat the patient’s psoriasis relapse is topical corticosteroid therapy with Betamethasone -0.1% cream due to its anti-inflammatory actions (Raharja et al., 2021). When applied to psoriatic lesions, corticosteroids suppress cell division.

Non-pharmacological options and recommendations include daily sun exposure, topical moisturizers, sea bathing, and relaxation. The patient will be recommended to apply moisturizers, such as petrolatum jelly (Raharja et al., 2021). Daily application of moisturizing cream to the affected area is a successful adjunct to psoriasis treatment.

3. A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?

Medication review and reconciliation is a process whereby a complete list of a patient’s previously prescribed drugs are recorded and then evaluated with respect to concomitantly prescribed drugs and current medical conditions (Talebi et al., 2018). It is crucial to know the medications the patient is taking to reduce the number of prescribed drugs and decrease the risk of drug interactions.

4. What others manifestation could present a patient with Psoriasis?

Other manifestations in psoriasis include pruritus, afebrile, dystrophic nails, and debilitating arthritis with pain, stiffness, throbbing, swelling, or tenderness of the joints (Raharja et al., 2021).

References

• Raharja, A., Mahil, S. K., & Barker, J. N. (2021). Psoriasis a brief overview. Clinical Medicine, 21(3), 170. doi 10.7861/clinmed.2021-0257
• Talebi, M. M., Sefidani Forough, A., Riazi Esfahani, P., Eskandari, R., Haghgoo, R., & Fahimi, F. (2018). Medication Interaction and Physicians’ Compliance Assessment through Medication Reconciliation Forms in a University Affiliated Hospital. Iranian journal of pharmaceutical research IJPR, 17(Suppl), 159–167.

Sensory Function

1. Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.

Conjunctivitis is the identified eye diagnosis for C.J. Conjunctivitis is an inflammation or infection of the conjunctiva. Clinical manifestations of conjunctivitis include blood vessel dilation, irritation, lacrimation, yellow-discharge, and mild edema (Azari & Arabi, 2020). This is the likely diagnosis based on the patient’s pertinent findings of yellowish discharge and bilateral conjunctival erythema.

2. With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

The patient’s conjunctivitis is likely to be bacterial. Bacterial conjunctivitis typically has purulent discharge and “pink eye”. The eye discharge is watery at first and becomes thicker, with shreds of mucus (Azari & Arabi, 2020). The patient has conjunctival erythema which fits the “pink eye” description and crusty and yellowish discharge indicating it is purulent.

3. Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.

The best drug therapy for Bacterial Conjunctivitis is topical antibiotics to eliminate the infection (Yeu & Hauswirth, 2020). Trimethoprim with polymyxin B eye drops 3 times a day for 7-10 days will be recommended.

References

• Azari, A. A., & Arabi, A. (2020). Conjunctivitis A Systematic Review. Journal of ophthalmic & vision research, 15(3), 372–395. https //doi.org/10.18502/jovr.v15i3.7456
• Yeu, E., & Hauswirth, S. (2020). A Review of the Differential Diagnosis of Acute Infectious Conjunctivitis Implications for Treatment and Management. Clinical ophthalmology (Auckland, N.Z.), 14, 805–813. https //doi.org/10.2147/OPTH.S236571