NUR631 2023 January Discussions Latest (Full)

NUR631 Advanced Physiology and Pathophysiology

Week 1 Discussion

DQ1 Use information provided and the “Discussion Forum Sample” to answer the following questions.

Scenario

Mrs. D.S. is a 42-year-old Caucasian female who was admitted to the delivery unit with labor pains. She was accompanied by her 44-year-old husband. Mrs. S. had been in relatively good health before her pregnancy. However, while pregnant she was diagnosed with gestational diabetes. Furthermore, her dose of thyroid hormone had to be adjusted several times during the last two trimesters. At time of admission, Mrs. S.’s blood pressure was 129/68 and her pulse was 70. Fetal heart rate was 140 beats/minute. Four hours after admission, Mrs. S. delivered a 37-week, 8-pound, 1-ounce baby girl.

The delivery room physician and nurse immediately noticed that the baby had a rather small head with a flat occiput, a broad and flat nasal bridge, folds of skin in the corners of the eyes, an upward slant to the eyes, a protruding tongue, and short fingers. There also was an excess amount of skin on the back of her neck.

Questions

Answer the following questions:

These physical characteristics are highly suggestive of some type of chromosome abnormality. What is the most likely cause of this infant’s physical characteristics? Explain your answer.

The parents struggle to understand what happened to their baby. “We don’t smoke, drink, or take drugs, so why did this happen?” the mother asks. How do you explain this infant’s condition to the parents?

DQ2 Use the “Discussion Forum Sample” to answer two of the following questions.

What is the difference between epigenetics and genetics?

In nurse practitioner clinical practice, how would one apply the principles of epigenetics when determining the plan of care for a patient?

What is the difference between hyperplasia, dysplasia, and metaplasia in relation to epigenetic disorders?

 

NUR631 Advanced Physiology and Pathophysiology

Week 2 Discussion

DQ1 Complete all of the following for your discussion response.

Immunity is necessary to prevent infectious diseases from spreading. Differentiate between passive-acquired and active-acquired immunity. Provide two examples of each type of immunity.

Immunoglobulins are necessary to protect the human physiology from diseases and pathological disorders. Explain the role of IgA, IgG, IgE, IgD, and IgM.

Stress is a component that affects the normal regulations of human physiology. Neuroendocrine regulation is important in this abnormality. How does increased catecholamine and cortisol affect the immune system?

DQ2 Answer both of the following discussion questions for your discussion response using the “Discussion Forum Sample.”

Explain the differences between innate and adaptive immunity. Explain the differences between the primary and secondary line of defense. What factors interfere with these mechanisms? How are these levels of immunity affected in a child, an elderly person, or a person with a chronic disease?

Explain the complement system and the roles of macrophage, dendritic cells, mast cells, neutrophils, basophils, natural killer cells, T-cells (T-helper cells, cytotoxic T-cells, memory T-cells, and T-regulatory cells), and B-cells (antibodies and memory B-cells).

 

NUR631 Advanced Physiology and Pathophysiology

Week 3 Discussion

DQ1 Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Explain how acid-base physiology leads to the regulation of fluid balance and extra cellular pH.

What is the equation for the carbonic acid/bicarbonate buffering system? How do actions at the lungs and kidneys affect this equation and thus compensate for alterations in plasma pH levels?

How do changes in plasma osmolality affect the physiology of erythrocytes?

DQ2 Use information provided and the “Discussion Forum Sample” to answer the following questions.

Scenario

A 75-year-old man was admitted with shortness of breath and lower extremity edema. He has been unwell for about a week and had multiple bouts of diarrhea over the previous 5 days. He does not take any medications. He was hyperventilating and was very distressed when EMS arrived. Admission arterial blood gas is listed below. He was on high concentration oxygen by mask on arrival to the emergency department.

Chemistry Results

Na+ = 127

HCO3- 20

HCO- = 30meq/L 3

K+ = 5.2

BUN 50.5

Glucose 9.5 mmols/l

Cl- 79

Creatinine 0.38

Anion gap 33 mmols/l

Arterial Blood Gases

pH 7.58

pCO2 21 mmHg

pO2 154 mmHg

HCO3 19 mmol/l

Questions

Answer the following questions:

What is this patient’s acid-base disorder?

Discuss why you how you came to that conclusion.

Is the patient compensating?

What are the pathophysiological responses that the body is attempting to use to compensate?

 

NUR631 Advanced Physiology and Pathophysiology

Week 4 Discussion

DQ1 Answer both of the following discussion questions for your discussion response using the “Discussion Forum Sample.”

Anaemia of chronic disease is a common occurrence in elderly patients. What is the pathophysiological mechanism behind this disease process?

Virchow’s triad refers to states that can produce hypercoagulability. What are the three categories? Give an example for each and explain the pathophysiological changes seen.

DQ2 Answer both of the following discussion questions for your discussion response using the “Discussion Forum Sample.”

Discuss the epidemiology of thalassemia and share evidence-based practice guidelines necessary for chronic management.

 

NUR631 Advanced Physiology and Pathophysiology

Week 5 Discussion

DQ1 Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

As with all disorders, it is essential to determine the root cause of endocrine disorders. What are primary, secondary, and tertiary disorders? Compare the differences among primary, secondary, and tertiary forms of hyposecretion and hypersecretion.

The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable?

Explain how the circadian rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

DQ2 Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

What symptoms and exam findings would prompt you to perform a pituitary workup? What laboratory and neuroimaging studies would you order and why?

A 24-year-old postpartum patient presents with vague symptoms of fatigue, weight fluctuation, brittle nails, and a lump in her throat. From an endocrine standpoint, what are your potential diagnoses based on symptoms without knowing lab findings? Include the potential workup you would attempt.

What is the difference between diabetic ketoacidosis and hyperosmolar nonketotic syndrome? How do the treatment options differ as well as have similarities? What are the associated conditions that would cause either of the conditions?

 

NUR631 Advanced Physiology and Pathophysiology

Week 6 Discussion

DQ1 Select two of the following questions for your discussion response. Indicate which question you have chosen using the format displayed in the “Discussion Forum Sample.”

From a pathophysiological perspective, describe the disease mechanism of spinal trauma. Discuss complications associated with spinal trauma based upon time of injury.

What are some the recent discoveries surrounding the pathophysiology of Alzheimer’s disease, and how could these discoveries lead to new treatments? Include your resources in your response.

What are some of the leading theories that attempt to describe the pathophysiology underlying fibromyalgia? Which ones are best supported? Include your resources in your response.

Differentiate between Alzheimer’s disease, Parkinson’s disease, and vascular dementia.

DQ2 Use information provided and the “Discussion Forum Sample” to answer the following questions.

Scenario

J.R. presents to her PCP with a chief complaint of “pounding and throbbing” headache, and this is the fourth time this month she has experienced this type of headache. The patient is a 45-year-old Caucasian female who appears slightly overweight. She describes her headache at the right temple and having a pain score of 9/10. She denies any pain in the orbit or cheek. She denies lacrimation and rhinorrhea. She is sensitive to the lights in the clinic which make her feels nauseous and dizzy but has not vomited. She denies sensitivity to sound. Previous similar headaches have lasted about 6 hours, have not been responsive to any type of OTC medication, and do not appear to be associated with menses. In addition, she feels exhausted when the headaches finally subside and often fall into a long, deep sleep afterward. She has no known allergies, does not use alcohol or tobacco products, and denies the use of illegal drugs. She sleeps only about 5 hours every night and has rather poor eating habits. She eats “more chocolate than she should” and drinks three or four caffeinated soft drinks every day.

Blood Chemistry Panel

Na+ = 144 meq/L

K+ = 3.7 meq/L

Ca+2 = 8.5 mg/dL

Mg+2 = 0.9 mg/dL

PO4-3 = 2.7 mg/dL

Cl- = 110 meq/L

HCO- = 30meq/L 3

Questions

List four potential precipitating factors or contributing factors for migraines in this patient. Explain your answer.

Identify the single abnormal finding in the blood chemistry panel above and explain its possible association with the patient’s migraine headaches.

Identify five features of the patient’s headache that help exclude cluster headache as a potential diagnosis.

 

NUR631 Advanced Physiology and Pathophysiology

Week 7 Discussion

DQ1 Answer the following questions for your discussion response.  Use the format displayed in the “Discussion Forum Sample.”

Explain the neurotransmitter dysfunction in a patient with schizophrenia and bipolar disorders.

How would you recognize symptoms and severity of suicide? What would you do if you have a patient reporting suicidal ideation? How would you handle this and what type of resources would you provide?  From a legal perspective, what are you obligated to do as a provider?

DQ2 Answer two of the following discussion questions for your discussion response using the “Discussion Forum Sample.”

Many argue that using alcohol, marijuana, or other seemingly “minor” drugs acts as a gateway to stronger, more lethal drugs and addictions. Do you believe there is support for this claim? Support your position from a neurobiology point of view.

From your role as a provider, explain how pain and addiction are a multidimensional public health problem.

Since addicted persons need more and more prescription painkillers or opiates to get the feeling of being “high” or staying “well,” what are some consequences they may face?

 

 

 

 

 

NUR631 Advanced Physiology and Pathophysiology

Week 8 Discussion

DQ1 Answer all of the following questions for your discussion response. Use the format displayed in the “Discussion Forum Sample.”

Describe coronary artery disease. How does it develop? What is the pathophysiological basis of how the various risk factors can lead to this disorder?

Numerous hormones have an impact on cardiac function. List two to three of these hormones and address how they affect the heart or the cardiovascular system.

Diet and lifestyle play an important role in cardiovascular health. What is the impact of a poor diet and lifestyle on the cardiovascular system?

DQ2 Select three of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Scenario

C.H. presented to your office with the complaint of a “racing heartbeat.” She is an overweight, 66-year-old African American female, who has been experiencing increasing shortness of breath during the past 4 months and marked swelling of the ankles and feet during the past 3 weeks. She feels very weak and tired most of the time and has recently been waking up in the middle of the night with severe breathing problems. She has been sleeping with several pillows to keep herself propped up. Five years ago, she suffered a transmural (i.e., through the entire thickness of the ventricular wall) anterior wall (i.e., left ventricle) myocardial infarction. She received two-vessel coronary artery bypass surgery 4.5 years ago for obstructions in the left anterior descending and left circumflex coronary arteries. Her family history is positive for atherosclerosis as her father died from a heart attack and her mother had several CVAs. She had been a three-pack-per-day smoker for 30 years but quit smoking after her heart attack. She uses alcohol infrequently. She has a 9-year history of hypercholesterolemia. She is allergic to nuts, shellfish, strawberries, and hydralazine. Her medical history also includes diagnoses of osteoarthritis and gout. Her current medications include celecoxib, allopurinol, atorvastatin, and daily aspirin and clopidogrel.

Questions

Based on the limited amount of information provided above, do you suspect that this patient has developed heart failure based on the most recent guidelines? Explain your answer.

What are the most common causes of congestive heart failure (CHF) in an adult? Given the information in this case, which causes seems to be the most likely?

 

NUR631 Advanced Physiology and Pathophysiology

Week 9 Discussion

DQ1 Topic 9 DQ 1

Mar 2-4, 2023

Select two of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Scenario

Mr. K.P. is a 71-year-old male, who presents to your office with a 3-day history of more than 103F with chills. The patient reports, “I don’t feel well, and I think that I may have the flu.” He also complains of “some painful bumps on my fingers and toes that came on last night.” He denies IVDA. When asked about recent medical or dental procedures, he responds: “I had an infected tooth removed about 2 weeks ago.” He does not recall receiving any antibiotics either prior to or after the procedure.

PMH:

Asthma since childhood

Rheumatic fever as a child x 2 with mitral valve replacement 2 years ago

HTN x 20 years

DM type 2, x 9 years

COPD x 4 years

H/O tobacco abuse

Alcoholic liver disease

Urinalysis: The urine was pale yellow, clear, and negative for proteinuria and hematuria. A urine toxicology screen was also negative.

ECG: Normal

Transthoracic ECHO: A 3-cm vegetation on the aortic valve was observed. No signs of ventricular hypertrophy or dilation were seen.

Blood Cultures: 3 of 3 sets (+) for Streptococcus viridans (collection times 1030 Tuesday, 1230 Tuesday, 1345 Tuesday)

 Laboratory Blood Test Results

Na 135 meq/L

K 3.7 meq/L

Cl 100 meq/L

HCO3 22 meq/L

BUN 17 mg/dL

Cr 1.0 mg/dL

Glu, random 145 mg/dL

Hb 14.1 g/dL

Hct 40%

Plt 213,000/mm3

WBC 19,500/mm3

Neutros 80%

Bands 7%

Lymphs 12%

Monos 1%

Alb 4.0 g/dL

ESR 30 mm/hr

Ca 8.9 mg/dL

Questions

Which type of infective endocarditis is suggested by the patient’s clinical manifestations—acute or subacute? Explain your answer.

Which three of the illnesses in this patient’s medical history may be contributing to the onset of infective endocarditis and why are these diseases considered risk factors? Explain each of the factors.

What are the six diagnostic modified Duke University criteria that favor a diagnosis of infective endocarditis in this patient? Explain your answer.

Explain the pathophysiology of proteinuria and hematuria in a patient with infective endocarditis.

Identify four elevated laboratory test results that are consistent with a diagnosis of bacterial endocarditis. And explain the pathophysiology of the elevated values.

DQ2 Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

Explain the underlying pathophysiology associated with hypertensive conditions. What are the associated pathological complications?

Detail a common congenital defect associated with the cardiovascular system of a pediatric patient.

 

NUR631 Advanced Physiology and Pathophysiology

Week 10 Discussion

DQ1 Answer both of the following discussion questions for your discussion response using the “Discussion Forum Sample.”

Explain the differences between irritable bowel syndrome and inflammatory bowel disease.

Gastric cancers require meticulous management. Choose a gastrointestinal cancer that is primary-sourced in an organ of the gastrointestinal system and discuss the epidemiological characteristics and pathological ramifications of the condition.

DQ2 Answer all of the questions below using the “Discussion Forum Sample” for your discussion response.

Scenario

A.O. is a 28-year-old woman who presents to your clinic with complaints of rectal bleeding and weakness. Five days ago, she noticed bright red blood in her stools. Furthermore, she reports that her daily bowel movements have increased to five or six with significant diarrhea. She has been weak for approximately 3 days. She has not traveled outside of the city, been hospitalized, or received antibiotics recently.

A proctosigmoidoscopy was conducted 3 days after the patient’s discharge from the acute care clinic. A significant pseudopolyps formation could be seen. Biopsies of the colon revealed erosions of the mucosa and ulcerations into the submucosa with mixed acute (i.e., neutrophils) and chronic (lymphocytes and macrophages) inflammatory cells. No dysplastic cells suggesting the development of colon carcinoma were seen. No multinucleated giant cells suggesting Crohn’s disease were seen. Inflammation and ulceration were limited to the rectum and sigmoid colon only. Crypts of Lieberku?hn were intensely inflamed. Marked hemorrhaging of capillaries in the mucosa was also observed.

 Laboratory Blood Test Results

Na+ = 143 meq/L

BUN = 20 mg/dL

Plt = 315,000/mm3

AST = 33 IU/L

K+ = 3.2 meq/L

Cr = 1.1 mg/dL

PO4-3 = 4.0 mg/dL

ESR = 24 mm/hr

ALT = 41 IU/L

Cl- = 108 meq/L

Hb = 10.8 g/dL

CRP = 1.5 mg/dL

T bilirubin = 0.9 mg/dL

Alb = 3.1 g/dL

HCO+3 = 18 meq/L

Hct = 36%

Ca+2 = 8.9 mg/dL

PT = 11.3 sec

Glu, fasting = 132 mg/dL

WBC = 9,400/mm3

Questions

What is the relevance of the last sentence in the first paragraph of the scenario provided above: “She has not traveled outside of the city, been hospitalized, or received antibiotics recently”? Explain your answer in detail.

What is the diagnosis? Explain your answer. Why and how did you come up with this diagnosis?

Identify eight abnormal laboratory blood test values and provide a brief pathophysiological explanation for each of them.

 

NUR631 Advanced Physiology and Pathophysiology

Week 11 Discussion

DQ1 Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

Explain the differences between restrictive and obstructive respiratory disorders. Choose one disorder for each and explain the pathophysiological changes seen and alterations in pulmonary function tests that aid diagnosis.

Explain the manifestations of congenital pulmonary disorders seen in children.

DQ2 Select two of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Discuss the differences between respiratory acidosis and respiratory alkalosis. Provide a case study or presentation associated with respiratory acidosis or respiratory alkalosis.

Clinicians have developed an appreciation for obstructive sleep apnea. Explain the pathophysiological problems a patient could experience associated with obstructive sleep apnea (OSA).

Multiple conditions lead to pulmonary embolus. Articulate the development and associated conditions during pregnancy which lead to pulmonary embolus.

 

NUR631 Advanced Physiology and Pathophysiology

Week 12 Discussion

DQ1 Select two of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Explain the concept of azotemia (including prerenal, renal, and postrenal), causes, and diagnostic measures used to identify each.

Identify and discuss the pathophysiology underlying one pediatric urological disorder.

Spinal cord injuries carry a high risk of neurogenic bladder and reflex incontinence. Explain the mechanisms responsible for these disorders.

DQ2 Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

A patient presents with flank pain. You suspect renal calculi. What is the pathophysiological reason for development of renal calculi and associated treatment considerations to rid renal stones and prevent future development of others?

Explain the common conditions associated with proteinuria and hematuria. Discuss the rationale for potential complications.

 

NUR631 Advanced Physiology and Pathophysiology

Week 13 Discussion

DQ1 Answer all of the following questions for your discussion response. Use the format displayed in the “Discussion Forum Sample.”

A 28-year-old woman was admitted to the general internal medicine service with a 3-day history of malaise and cough that progressed to include myalgia, generalized weakness, and dark-colored urine. Three days before admission, she had an abrupt onset of a dry nonproductive cough, malaise, and anorexia that resulted in a prolonged period of fasting. On the second day of the illness, she awoke with diffuse muscle pain and progressive weakness, culminating in an inability to walk. She subsequently noted dark urine and presented to the emergency department, leading to this admission. She had no recent trauma, exercise, rash, joint pain, or foreign travel. She was taking a multivitamin supplement but no prescription medication.

At presentation, she was mildly distressed but oriented. Her vital signs were within normal limits, apart from mild tachycardia (heart rate, 104 beats/min). Physical examination revealed grade 3/5 limb muscle strength, although testing was associated with obvious discomfort. Muscle bulk and tone, tendon reflexes, and sensation were normal. Notably, there was no rash, and cardiorespiratory examination yielded unremarkable findings. Initial chest radiography revealed a left lower lobe infiltrate most consistent with pneumonia. Urinalysis was strongly positive for hemoglobin. Initial laboratory analysis (reference ranges provided parenthetically) revealed that her creatine kinase (CK) level was markedly elevated at 118,342 U/L (38-176 U/L).

What is the most appropriate next step to confirm the diagnosis of rhabdomyolysis in this patient? Provide an explanation for your answer.

What is the most likely etiology of this patient’s recurrent rhabdomyolysis?

Rhabdomyolysis is a rapid breakdown of muscle. Detail the pathophysiology behind rhabdomyolysis.

What are the possible complications of rhabdomyolysis?

Which medications may cause rhabdomyolysis?

DQ2 Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

Both osteoarthritis and rheumatoid arthritis present with several of the same manifestations, such as joint pain and stiffness. How do the two disorders differ?

A child born with osteogenesis imperfecta is at risk for pathological fractures. Explain the pathophysiology of this disorder and the associated risk factors.

 

 

 

NUR631 Advanced Physiology and Pathophysiology

Week 14 Discussion

DQ1 Answer all of the questions below using the “Discussion Forum Sample” for your discussion response.

History

R.S. is a 38-year-old white male who presents to his PCP after his wife noticed a suspicious looking, dark brown mole in his scalp while giving him a haircut. He was referred to your clinic. He has a history of lipoma over the left ribcage, surgically removed 10 years ago with no recurrence. He reports an episode of major depression with suicidal tendencies 8 years ago, treated successfully with an antidepressant and psychotherapy for 10 weeks with no recurrence.

Review of Systems (ROS)

No changes in vision, smell, or hearing.

No headaches, cough, fever, chills, night sweats, nausea, or vomiting.

No changes in bowel or bladder habits.

No fatigue or weakness.

SKIN

Fair complexion with multiple scattered nevi on the back.

Negative for rashes and other lesions.

Warm to the touch and slightly diaphoretic.

Normal distribution of body hair.

HEENT

7-mm nodule on the scalp above the right ear, dome-shaped, symmetric, dark brown in color, no variations.

PERRLA.

EOMI.

Funduscopic WNL.

Normal sclera.

TMs intact.

Mucous membranes moist.

Throat without lesions, edema, exudates, or erythema.

Poor dentition, several fractured teeth.

Biopsy

An excisional biopsy of the mole showed cells consistent with that of nodular melanoma. Tumor thickness was 3.8 mm. Cervical nodes were enlarged and measured 2.3 and 2.7 cm. A CT scan of the thorax was negative. With the exception of questionable shadows in the liver, the abdominal CT scan was also negative. A CT scan of the brain was clearly positive for 3 lesions.

Laboratory Blood Test Results

Na = 142 meq/L

Cr = 0.6 mg/dL

WBC = 7,200/mm3

AST = 115 IU/L

K = 4.5 meq/L

RBC = 5.3 million/mm3

ALT = 145 IU/L

Hct = 43%

Glu, fasting = 103 mg/dL

Mg = 2.7 mg/dL

HCO3 = 31 meq/L

Cl = 103 meq/L

Bilirubin, total = 1.7 mg/dL

PO4 = 4.4 mg/dL

Ca = 10.3 mg/dL

BUN = 14 mg/dL

Alb = 3.5 g/dL

Alk phos = 278 IU/L

Plt = 239,000/mm3

Hb = 16.3 g/dL

Questions

Why is the lack of clinical manifestations in the ROS above significant?

Based on this rather limited information provided under History, ROS, SKIN, and HEENT above, which subtype of melanoma is most likely?

Are any of the laboratory blood test results above abnormal and, if so, what is suggested by the abnormality?

What is the current probability that this patient will be alive in 10 years?

DQ2 Answer both of the following questions for your discussion response using the “Discussion Forum Sample.”

What is the pathological process in the development and presentation of eczema versus psoriasis?

Discuss the pathological process and presentation of atopic dermatitis and its relationship to asthma and allergies.

 

NUR631 Advanced Physiology and Pathophysiology

Week 15 Discussion

DQ1 Select two of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Review the hypothalamus, pituitary, and ovarian axis, and explain the pathophysiology of PCOS. Explain the role of hormones in the development of this disorder. How does PCOS contribute to infertility?

Explain the role of genetics and oncogenes in the development of reproductive cancers. In addition, examine if genetically linked reproductive cancers are only seen in women or are they also in men?

Jones, a 60-year-old male, was seen for his yearly physical. Upon review of his lab results, a high PSA level was seen. Having heard about the PSA test and correlation to prostate cancer, he is worried about a diagnosis of cancer. What would you tell Mr. Jones in your discussion about the lab results?

DQ2 Select two of the following questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

Explain the pathophysiological development of breast cancer. Detail the varying types and oncogenic influences for each type.

Menopause comes at different ages for women. What are the changes causing menopause and what are the changes experienced after menopause?

Testicular cancer is common in younger men. Upon examination, you discover a hard nodule of the right testes. What are the oncogenic influences associated with testicular cancer?

 

NUR631 Advanced Physiology and Pathophysiology

Week 16 Discussion

DQ1 Discuss the etiology, presentation, transmission, and management of a sexually transmitted infection using the “Discussion Forum Sample.”

DQ2 Based on the following information, create a list of three differential diagnoses and explain why you would include them on your list. Use the format displayed in the “Discussion Forum Sample.”

History

C.R., a 34-year-old man, came to your clinic with an episode of chest pain. He has a previous history of occasional stabbing chest pain for 2 years. The current pain had come on 4 hours earlier at 8 p.m. and has been persistent since then. It is central in position, with some radiation to both sides of the chest. It is not associated with shortness of breath or palpitations. The pain is relieved by sitting up and leaning forward. Two Tylenol tablets taken earlier at 9 p.m. did not make any difference to the pain.

The previous chest pain had been occasional, lasting a second or two at a time and with no particular precipitating factors. It has usually been on the left side of the chest although the position has varied.

Two weeks previously he had mild to moderate symptoms of COVID-19 which lasted 14 days. This consisted of a sore throat, low-grade fever, loss of taste and smell, and a cough. His wife and two children were ill at the same time with similar symptoms but have been well since then. He has a history of migraines. In the family history, his father had a myocardial infarction at the age of 51 years and was found to have a marginally high cholesterol level. His mother and two sisters, aged 36 and 38 years, are well. After his father’s infarct, he had his lipids measured; the cholesterol was 5.1 mmol/L (desirable range < 5.5 mmol/L). He is a nonsmoker who drinks two 12-packs of b

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