Open the attached case study. Using the free internet, do some research on the patient's signs and symptoms. Using this information, choose a plausible diagnosis, then construct and complete and concise answer to each stated question.
Why do I bruise so easily?
Patient History
Marenisha Smith is a 24 year old female with a long medical history. The patient suffers severe bruising from minor trauma, has progressively worsening arthritis of both knees, and had a sister die at age four from an intracranial hemorrhage after falling from the bed. In addition, the patient’s maternal grandfather died at age 27 of a bleeding complication following a gastric bypass. During childhood, Marenisha’s mother was told that she had a ‘blood disease’ and would need to be under a doctor’s care for life.
The patient has sought care today as she is experiencing fever, swollen cervical lymph nodes, muscle ache and a severe sore throat. The primary care physician has diagnosed Marenisha with ‘flu’.
Patient Signs and Symptoms
Test
|
Patient Result
|
Normal Values
|
Platelet
|
280,000 / mm3 of blood
|
150,000 - 350,000 / mm3 of blood
|
Bleeding time
|
6 minutes
|
3.5-19.5 minutes
|
Prothrombin time (PT)
|
11 seconds
|
10-12 seconds
|
Partial thromboplastin time (PTT)
|
58 seconds
|
20-30 seconds
|
Fibrin split products
|
22 ug/ml
|
8-40 ug/ml
|
Hematocrit
|
39% RBC
|
38% - 44%
|
Neutrophil
|
61.5%
|
60%-70%
|
Lymphocyte
|
27.9%
|
20%-30%
|
Monocyte
|
7.8%
|
6%-8%
|
Eosinophil
|
2%
|
1%-3%
|
Basophil
|
0.8%
|
|
Questions: Using the patient’s signs/symptoms and sound logic, provide a complete and concise answer to each question stated below.
1. What is your primary diagnosis for this patient? In other words, while she may have the flu her patient history and test results indicate an underlying condition. Why does the patient bleed so easily? What is significant her family history?
2. Why is the PTT elevated? Why isn't the PT elevated? In your answer, be sure to explain exactly what is assessed by these tests.
3. The bleeding time was normal. What general types of disorders are ruled out by the normal value of this test?
4. What treatments are available for patients with this condition?
The answers to each of the assigned questions including the full citations of at least three sources will be submitted via the SafeAssign link on the Blackboard for grading on or before the posted due date