Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions

Posted on November 15, 2022 |

Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions – Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment…

What You Will Learn hide

1 Paper details

1.1 To Prepare

1.2 The Lab Assignment

2 Solution

2.1 Comprehensive SOAP

2.1.1 SUBJECTIVE DATA:

2.1.2 Review of Systems:

2.1.3 OBJECTIVE DATA:

2.1.4 LAB/DIAGNOSTIC TESTS/EKG:

2.1.5 ASSESSMENT:

3 References

4 Health Care Systems Essay Examples

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Paper details

To Prepare

Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
Search the Walden Library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.

Your first assignment for this week is to be written in a SOAP Note format (NO NARRATIVES). There is a template/sample for you to follow posted in your announcements at the beginning of the semester. You will need to put in the missing information in the note (some may be made up ie meds, hx, parts of the ROS and PE).

Assignment 1:

The Lab Assignment

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week\’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

Solution

Comprehensive SOAP

Patient Initials: CJ Age: 53 Gender: Male
Image 2

SUBJECTIVE DATA:

Chief Complaint (CC): Generalized body rash and multiple joint pains

History of Present Illness (HPI): The patient CJ is a 53-year-old male. The patient presented at the clinic with complaint of a rash on his back. The rashes began a week ago and is progressing to the arms and thighs. CJ complains of discomfort in the affected areas. He also complains of pain in the knee joint and on both of the ankles which limits his movement. The patient has rates the pain at 4 out of 10 on the pain scale 0-10. The pain has a past medical history included asthma, hypertension and diabetes mellitus, and has not made any recent adjustments to his medications.

Medications:

Metformin 1 g bd
Gliclazide 160 mg bd
Amlodipine 10 mg daily
Albuterol Inhaler

Allergies: Has no known drug interactions, no seasonal or environmental allergies

Past Medical History (PMH):

Hypertension for four years
Diabetes Mellitus

Past Surgical History (PSH):

No surgical history
Sexual/Reproductive History: If applicable,
Heterosexual

Personal/Social History:

The patient is a nonsmoker. No blood tests. Occasional drinks on weekends and on occasions. Had some sunburn in the past

Immunization History:

Pneumovax-Unknown

Significant Family History: Family history of Hypertension, Obesity and diabetes

Lifestyle: Lives with family, wife and two children (19 years old and 16 years old).

Review of Systems:

General: + fatigue, rashes and joint pain for 7 days, itchiness and discomfort
CARDIOVASCULAR/PERIPHERAL VASCULAR: SOB, fatigue and chest pain, no weakness, no PND
GI: denies abdominal pain, nausea or vomiting, diarrhea, and constipation. No melena, no hemorrhoids
GU: No urinary symptoms and no dysplasia was found
MS: Joint pain and stiffness, weakness
Psych: Denies history of anxiety or depression, no suicidal or homicidal history
Neuro: Denies headaches or imbalance, dizziness, syncope, paralysis
HEME: rashes on back, thighs and right arm, itching,
Endo: No endocrine symptoms or hormone therapies
Allergic/ Immunologic: Has no known immune deficiencies

OBJECTIVE DATA:

Physical Exam:

Vital signs: Vital Signs: Temp 97.6; BP 119/85; RR 16; P 93; HT 5’11”; WT 189lbs
General: Awake, well-groomed and well-nourished. Denies fever, chills, fatigue, Nausea, and vomiting.
HEENT: No changes in vision or hearing. Has had no recent ear infections, drainage or pain. Patient does not have a history recent sinus infection. Denies loss of taste, no difficulty in chewing and no swallowing and tooth/ gum pain or bleeding.
Neck: Denies pain on neck
Chest/Lungs: SOB, chest pain
Heart/Peripheral Vascular: SOB, no murmur, gallops, heaves, or thrills.
Abdomen: Bowel sounds present in all four quadrants, No masses palpated. No lesions observed
Musculoskeletal: Joint pain, right knee, both ankles
Neurological: Alert and oriented to person, place, and time. CN II-X intact.
Skin: rashes on back, thighs and right arm, itching,

LAB/DIAGNOSTIC TESTS/EKG:

No diagnostic studies performed.
Clinical appearance is sufficient for distinctive diagnosis.

Differential Diagnosis:

Guttate Psoriasis (Confirmed). Characterized by multiple skin eruptions, less than 1cm in diameter, scaly tear drops (Shahid et al., 2013). May be present in patients with no preexisting psoriasis. Disease progression is mild, covers about 3% of the skin. The drop like lesions coupled with clinical examination to confirm diagnosis.
Plaque Psoriasis (Refuted) characterized by scaling and induration, scalp involvement, nail involvement, and a family history of psoriasis. Clinical diagnosis, and covers up to 80% of total body surface (Bélanger et al., 2016). Differentiated by the size of plaque, more common type of psoriasis.
Diabetic dermopathy (refuted). Begins as dull red scaly papules or plaques and later develop into bilateral asymmetrical circumscribed shallow pigmented scars and/or brownish macular lesions with a fine scale. Differentiated by size as in diabetic dermopathy the lesions usually are greater than 4 cm in size compared to lesions less than 1 cm in the patient (Ball et al., 2019).

ASSESSMENT:

• Guttate Psoriasis

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th Ed.). St. Louis, MO: Elsevier Mosby.
Bélanger, A., de Oliveira, C. P., Maheux, M., & Pouliot, R. (2016). Plaque psoriasis: understanding risk factors of this inflammatory skin pathology. Journal of Cosmetics, Dermatological Sciences and Applications, 6(02), 67features of varicella-zoster virus infection. Viruses, 10(11), 609.
Shahid, N., Bawany, M. Z., Rafiq, E., & Sodeman, T. (2013). Guttate psoriasis: a rare cause of diffuse rash. British Journal of Medical Practitioners, 6(4), 47-49.

Health Care Systems Essay Examples

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Drivers Of High Performance Healthcare Systems	NR 506 Week 5: Drivers of High Performance Healthcare Systems Select two drivers (for example quality, cost, and access) of high performance healthcare systems and apply it to your current work situation.
Ethics, Policy, And Health Care Delivery Systems	Describe current federal health care policies and standards that are designed to offer guidance to health organizations to ensure quality of care among vulnerable populations
A Comparison of Healthcare Systems	Comparison of Healthcare Systems in US.

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