Response to Ryan Burris
First of all, I should admit an outstanding comprehensiveness of your post. The given case revolves around a patient suffering from the limb pain. Numerous diagnoses could be given on the basis of this symptom; however, you manage to make the right decision and suggest PAD as the primary cause of the pain. The actions you perform to justify your conclusion and offer clear evidence are appropriate and help to find the essential information related to the case.
When examining patients suffering from PAD, it is critical to consider their health history, the overall state of a person and his/her chronic diseases. All these elements are considered in the post which means that it provides the credible conclusion and the final diagnosis.
Furthermore, the usage of a duplex ultrasound to identify the problem and provide specific treatment is an excellent solution that helps to minimize the probability of error and promote the patients fast recovery. You also give essential recommendations related to her lifestyle and dietary habits. However, I should add that the woman has diabetes type II, thus the risk for complications increases significantly (Thriuvoipati, Kielhorn, & Armstrong, 2015). For this reason, it is crucial to monitor the state of the patients blood vessels (Rhee & Kim, 2015).
The clinical progression of PAD in patients suffering from diabetes is worse than in those who do not have the same health problem (Rhee & Kim, 2015). Additionally, the probability and frequency of amputation are much higher. Finally, mortality rates among patients suffering from both PAD and diabetes increase significantly (Thriuvoipati et al., 2015). In this regard, the patient should be educated about the complexity of her current situation and explained the critical need for the constant monitoring of her state.
Response to Natalya Arnold
The post is full of important facts related to the case. You provide a list of symptoms supported by an accurate description of the patients feelings and complaints. It is vital for diagnosing, as a specialist should possess relevant information to create the whole picture and prescribe a particular treatment. The suggested history of present illness contains exact details and peculiarities of the patients state of the health. Furthermore, you suggest a diagnosis that seems the most applicable to the case.
Coughing could signalize a number of health problems, and sinusitis is one of them. For this reason, the attempt to exclude other similar diseases like influenza and streptococcal infections is fundamental for the case. Your recommendation to use CT of sinuses to study the case and justify the final diagnosis is also appropriate. At the same time, a clinical blood analysis could also be useful as it detects an inflammatory process and provides a therapist with additional information that will help to prescribe the most effective treatment (Pynnonen et al., 2015). In case the situation remains unclear, sinus X-ray that could either confirm or refute a suspected case of sinusitis should be used (Pynnonen et al., 2015).
The combination of these tests will help to diagnose sinusitis and promote the patients recovery. Finally, if sinusitis is caused by virus infection, antibiotics should not be prescribed to the patient (Kennedy & Borish, 2013). As you mentioned, only pain relievers and decongestants can be used to treat sinusitis. Moreover, mucolytics could also be recommended to dissolve mucous and improve the state of the patient. Altogether, the post provides a comprehensive investigation of the case, and you suggest effective measures to diagnose and treat sinusitis.
References
Kennedy, J., & Borish, L. (2013). Chronic sinusitis pathophysiology: The role of allergy. American Journal of Rhinology and Allergy, 27(5), 367-371. Web.
Pynnonen, M., Lynn, S., Kern, H., Novis, S., Akkina, Keshavarazi, N., & Davis, M. (2015). Diagnosis and treatment of acute sinusitis in the primary care setting: A retrospective cohort. Laryngoscope, 125(10), 2266-2272. Web.
Rhee, S., & Kim, Y. (2015). Peripheral arterial disease in patients with type 2 diabetes mellitus. Diabetes & Metabolism Journal, 39(4), 283-290. Web.
Thriuvoipati, T., Kielhorn, C., & Armstrong, E. (2015). Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes. World Journal of Diabetes, 6(7), 961-969. Web.