Case StudyMr. T is a 21-year-old man who is brought to the ER by his mother after he began talking about “aliens” who were trying to steal his soul. Mr. T reports that aliens left messages for him by arranging sticks outside his home and sometimes send thoughts into his mind.

On assessment, he is guarded and often stops talking while in the middle of expressing a thought. Mr. T appears anxious and frequently scans the room for aliens, which he thinks may have followed him to the hospital. He denies any plan to harm himself but admits that the aliens  sometimes want him to throw himself in front of a car, “as this will change the systems that belong under us.”

The patient’s mother reports that he began expressing these ideas a few months ago, but that they have become more severe in the last few weeks. She reports that during the past year, he has become isolated from his peers, frequently talks to himself, and has stopped going to community college. He has also spent most of his time reading science fiction books and creating devices that will prevent aliens from hurting him. She reports that she is concerned because the patient’s father, who left while the patient was a child, exhibited similar symptoms many years ago and has spent most of his life in a psychiatric hospital.

Questions:Remember to answer these questions from your textbooks and clinical guidelines to create your evidence-based treatment plan. At all times, explain your answers. 

Summarize the clinical case including the significant subjective and objective data.

Generate a primary and two differential diagnoses. Use the DSM5 to support the assessment. Include the DSM5 and ICD 10 codes.

Discuss a pharmacological treatment would you prescribe? Use the clinical guidelines to support the rationale for this treatment.

Discuss non-pharmacological treatment would you prescribe?  Use the clinical guidelines to support the rationale for this treatment.

Describe a health promotion intervention that would be appropriate for this patient.

Submission Instructions:

Your initial post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 

All replies must be constructive and use literature where possible.

Integumentary Function:

K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

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

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.

Included in question 2

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?

1. What others manifestation could present a patient with Psoriasis?
2. Sensory Function:
   C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.
3. Case Study Questions
4. 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.
5. 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.

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.

Integumentary Function: 

K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

1. Name the most common triggers for psoriasis and explain the different clinical types.
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.
3. Included in question 2
4. 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?
5. What others manifestation could present a patient with Psoriasis?

Sensory Function:
C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.

Case Study Questions

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.
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.
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.

PEMT 303

Video Review & Reflection Assignment

Video 1:

Video 2:

Video 3:

For this assignment, you are to view the above videos regarding instruction in APE. You are to respond to the following questions/prompts regarding your reflection on the information provided in the videos and drawing on what you are learning in this course and any/all of your other PE teacher preparation courses. You can also reference your own APE lesson plan you develop for this course and your rationale for your selection of instructional activities and assessments.

Complete the questions/prompts below and submit your completed assignment to the designated Dropbox by the posted deadline. Email me any questions needed for clarification of assignment requirements.

1. Briefly describe 2 instructional practices or techniques used in any of the videos that you believe are the most effective and why. Were there any that surprised you and why?

2. Briefly describe 1 or 2 techniques or practices that you believe would be ineffective or difficult to implement in the schools you are working in or plan to work in as you begin your teaching career and why.

3. Briefly describe 2 instructional practices/techniques that you would opt to use or believe would be easiest for you to implement in your own teaching now and why.

4. Briefly describe 2 instructional practices/techniques or environment that you believe are too uncomfortable for you to implement and why.

5. Considering both the videos and all the information we have covered this semester in our course, briefly 1 or 2 disabilities that you believe you are most comfortable with and why. Has that changed from the beginning of this course? Why or why not?

6. Considering both the videos and all the information we have covered this semester in our course and the entirety of your experience thus far, briefly describe one aspect of APE that was not covered in enough detail for you to increase your comfort level of working with students with special needs. In other words, what would you have liked to learn about APE that was not covered in enough detail. Be honest and constructive in your response. It is important to have the confidence to share this information (constructively) so we can always make the course for the next class.

How death has been defined has changed over time, the materials in the course discuss.  Please imagine yourself as part of the new USF Brain Death Committee charged to reevaluate Brain Death.  The committee has been convened to reassess the standard of definition for death originally developed by the Harvard Criteria and develop a new policy that defines Brain Death or reaffirms the current standard definition. Your post is the position that would you bring to the committee’s discussion before the group votes. 

Brain Death

The USF Brain Death Committee has three policy approaches under consideration: 

1. Will you retain the current standard?
2. Will you change the definition and Eliminate Brain Death?
3. Will you change the definition so that Death equals “loss of higher consciousness”?

You will want to review the Harvard Criteria, all the readings for Determining Death, Organ Donation, and Withdrawal of Treatment and Consent as you consider which approach you will adopt as your position for your statement to the Committee.

Discussion Post

The discussion post has two key parts, the choice of the policy approach from the three above that informs your position and then a section that clearly identifies the ethical principle prioritized in your position.

Section 1:

Please clearly choose one of the following questions as you formulate your position.

1. Will you retain the current standard?

• Would you make any modifications to the standard in practice? If so, what are they are and why?

1. Will youchange the definition and Eliminate Brain Death?

• How would you change the definition and why? 

1. Will youchange the definition so that Death equals “loss of higher consciousness”?

• What would a change in the definition mean to patients in a Persistent Vegetative State (PVS) and newborns with anencephaly?

Section 2:

When discussing the ethical issue, please consider the impact with respect to the following principles. Please choose 1 ethical issue to address; you do not need to address all provided below. 

• Beneficence: Is your obligation to one patient, or is your obligation to society?
• Nonmaleficence: Would one patient be harmed, or would society be harmed?
• Allocation and justice: What impact would your policy have on organ transplantation or on medical care costs and availability of scare resources?
• Autonomy: What would patients want?  How would they want to live, die, and be declared dead?
• Trust and transparency: Patients should trust in the medical profession and believe in the honesty of clinical judgments.  How does your policy impact trust and transparency?