The assignment
Respond to your colleagues’ posts on and explain how you might think differently about the types of tests you might recommend and explain why. Use your Learning Resources and/or evidence from the literature to support your position. Sources within 5 years.
Colleague’s Post
Patient Information:
38-year-old female EG
S.
CC: The case study presents a 38 years old female called Elaine Goodwin. She visited the healthcare clinic to discuss contraceptive options since she is not interested in having more children with her new partner.
HPI: Clinical health information history indicates that the patient had IBS, migraines, exercise-induced asthma. She had tonsil when she was a child. Elaine takes drug allergies and vitamins but never used alcohol, tobacco, and recreational drugs. Her grandmother and her grandfather have a history of dementia and COPD, respectively. Her mother has a health history of fibromyalgia and osteopenia while her father is still alive with skin cancer conditions. According to the clinical breast exam, Elaine Goodwin shows some changes in the fibrocystic (Lockwood, 2019).
Location: breast
Onset: 1 week ago
Character: fibrocystic changes bilaterally, without masses, dimpling or discharge
Associated signs and symptoms: firm, smooth, parous, without CMT
Timing: after having new partner
Exacerbating/relieving factors: ibuprofen (Motrin IB and Advil).
Severity: 6/10 pain scale
Current Medications: Ibuprofen as needed for pain
Allergies: She has no known drug allergies and takes only vitamin C.
PMHx: Surgical history is remarkable only for tonsils as a child.
Hospitalizations were only for childbirth
Soc & Substance Hx: Her social history is negative for alcohol, tobacco, and recreational drugs.
Fam Hx: Her grandmother and her grandfather have a history of dementia and COPD, respectively. Her mother has a health history of fibromyalgia and osteopenia while her father is still alive with skin cancer conditions. Her sisters and brother have not reported medical problems.
Surgical Hx: Surgical history is remarkable only for tonsils as a child
Mental Hx: Denies any mental condition.
Violence Hx: Denies any risk of personal safety
Reproductive Hx: Birth control method (Oral contraceptives)
ROS:
GENERAL: No fever, body weakness, and signs of weight loss.
HEENT: WNL
SKIN: No itching or rashes
CARDIOVASCULAR: WNL
RESPIRATORY: No cough of shortness of breath.
GASTROINTESTINAL: No diarrheas nausea and anorexia. No abdominal pain
GENITOURINARY: Normal urination.
NEUROLOGICAL: No tingling in the extremities, headache, numbness, ataxia, paralysis, syncope, and dizziness.
MUSCULOSKELETAL: No stiffness, joint pains, back pain or muscle pain.
HEMATOLOGIC: No bruising, bleeding and anemia.
LYMPHATICS: No splenectomy history or enlarged nodes.
PSYCHIATRIC: No history of depression or anxiety.
ENDOCRINOLOGIC: No reports heat intolerance or excess cold or heat. No polyuria or polydipsia.
REPRODUCTIVE: Not pregnant and sexually active.
ALLERGIES: History of asthma
O.
Physical exam:
Height 5’ 7” Weight 148 (BMI 23.1), BP 118/72 P 68
HEENT: hypoglycemia (low blood sugar
Neck: supple without adenopathy
Lungs/CV: No shortness of breath
Breast: soft, fibrocystic changes bilaterally, without masses, dimpling or discharge
Abd: soft, +BS, no tenderness
VVBSU: except 1st degree cystocele
Cervix: firm, smooth, parous, without CMT
Uterus: RV, mobile, non-tender, approximately 10 cm,
Adnexa: without masses or tenderness
Diagnostic results:
Methacholine test: The patient needs to take the Methacholine challenges test to asthma in the body. The test has low sensitivity screening that detects the contraction of muscles. Patient test gluten intolerance (celiac disease) with IBS with diarrhea.
Osmotic challenge test: The osmotic challenge test is yet another sensitive and specific diagnosis approaches that can help Elaine Goodwin. The first diagnosis test protocol is 3 minutes at 30% MVV, the second protocol is 3 minutes 60% MVV, and the third protocol is 3 minutes 90% MVV.
Mammogram screening test: A mammogram or ultrasound screening test is recommended to test breast cancer. According to the clinical breast exam, Elaine Goodwin shows some changes in the fibrocystic (Lockwood, 2019).
A.
Differential Diagnoses
Asthma: Elaine Goodwin is most likely to suffer from asthma, according to the methacholine challenges test. The patient recorded signs of inflammation in the Lung. There was problem with breathing.
Breast cancer: There was some changes in fibrocystic. The abnormality was detected in the screening process on the breast. The ultrasound assessment of breast produces uncommon images structure deep down the body.
Cystocele – The patient has first degree cystocele. This requires reconstruction of surgery for the normal position and interior repair. This condition worsens with increased bowel movements.
P.
The management of gynecology health-related issues includes the following approach. First, the patient needs to manage the level of blood pressure with medications, exercise, and diet. This can help in reducing high blood pressure. The measure of the BMI 23.1 is within the recommended level according to overweight concern. The breast examination for the patient shows some fibrocystic changes. This condition can be treated with nonsteroidal anti-inflammatory drugs (American Cancer Society, 2020). The patient needs to take pain relievers such as acetaminophen and other drugs like ibuprofen (Motrin IB and Advil). Oral contraceptives are also recommended since they lower the fibrocystic breast changes.
Questions
When was the most recent primary care visit, and what was the issue?
Do you have a history of STIs in your lifetime?
When was the most recent cervical cytology results normally with the abnormal Pap history?
Do you have past or current experience of gynecological issues?
Do you have a fertility plan? If yes, which birth control methods are using current?
Do you have a history of postmenopausal bleeding and current hormonal therapy?
At what age did you experience the last menses?