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SOLVED! A 58-year-old obese white male presents to ED

Scenario 3: A 58-year-old obese white male presents to ED with chief complaint of fever chills pain and swelling in the right great toe

To prepare:

Scenario 3: A 58-year-old obese white male presents to ED with chief complaint of fever chills pain and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl.

Assignment (1- to 2-page case study analysis)

In your Case Study Analysis related to the scenario provided, explain the following:

  • Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
  • Any racial/ethnic variables that may impact physiological functioning.
  • How these processes interact to affect the patient.

Grading Rubric:

Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:Explain both the neurological and musculoskeletal pathophysiologic processes of why the patient presents these symptoms.–

Excellent28 (28%) – 30 (30%)

Good25 (25%) – 27 (27%)

Fair23 (23%) – 24 (24%)

Poor0 (0%) – 22 (22%)

Explain how the highlighted processes interact to affect the patient.–

Excellent28 (28%) – 30 (30%)

Good25 (25%) – 27 (27%)

Fair23 (23%) – 24 (24%)

Poor0 (0%) – 22 (22%)

Explain any racial/ethnic variables that may impact physiological functioning.–

Excellent23 (23%) – 25 (25%)

Good20 (20%) – 22 (22%)

Fair18 (18%) – 19 (19%)

Poor0 (0%) – 17 (17%)

Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.–

Excellent5 (5%) – 5 (5%)

Good4 (4%) – 4 (4%)

Fair3.5 (3.5%) – 3.5 (3.5%)

Poor0 (0%) – 3 (3%)

Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation–

Excellent5 (5%) – 5 (5%)

Good4 (4%) – 4 (4%)

Fair3.5 (3.5%) – 3.5 (3.5%)

Poor0 (0%) – 3 (3%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.–

Excellent5 (5%) – 5 (5%)

Good4 (4%) – 4 (4%)

Fair3 (3%) – 3 (3%)

Poor0 (0%) – 3 (3%)

Total Points: 100

EXPERT ANSWER AND EXPLANATION

Case Study Analysis

Analysis of Processes Related to Musculoskeletal and Neurological Disorders

A 58-year-old overweight man presents to the ER with symptoms of musculoskeletal degradation. Besides the fever and chills, he has a painful swelling on the right toe which is confirmed after assessment. Musculoskeletal and neurological disorders result when the nerves, ligaments, discs, blood vessels, and tendons become impaired (Rueangsirarak et al., 2018). The fact that the patient has a history of hypertension and diabetes could also be reason for the occurrence of this degradation of the musculoskeletal system. Breakage of MTD as a result of the deficiency of the necessary nourishment could also play a larger role in the pain, and the associated fatigue brought the musculoskeletal disorder.

Racial and Ethnic Variables that may Impact Physiological Functioning

While people of any race can get musculoskeletal and neurologic disorders, blacks are more susceptible because of their different environmental factors. One of these factors is the absence of active physical activity compared to Hispanics and whites (Stryjecki, Alyass, & Meyre, 2018). Also, blacks are more susceptible to junk diets compared to other races. This lifestyle difference between the races is what increases the presence of more cases of being overweight among blacks.

Impact of Patient Characteristics on Altered Physiology and Disorders

The fact that the patient is obese means that he may not be well positioned to recover from the condition. (Nuckolls et al., 2020). Patients with Musculoskeletal disorders have problems carrying their own weight, and hence being obese makes the situation worse. The therapists of the patient may have to engage them in weight management procedures that would allow them to control the condition with much ease.

References

Nuckolls, G. H., Kinnett, K., Dayanidhi, S., Domenighetti, A. A., Duong, T., Hathout, Y., & McNally, E. M. (2020). Conference Report On Contractures In Musculoskeletal And Neurological Conditions. Muscle & Nerve61(6), 740-744. https://doi.org/10.1002/mus.26845

Stryjecki, C., Alyass, A., & Meyre, D. (2018). Ethnic and Population Differences in the Genetic Predisposition to Human Obesity. Obesity Reviews19(1), 62-80. Doi: 10.1111/obr.12604. Epub 2017 Oct 10.

Rueangsirarak, W., Zhang, J., Aslam, N., Ho, E. S., & Shum, H. P. (2018). Automatic Musculoskeletal and Neurological Disorder Diagnosis with Relative Joint Displacement from Human Gait. IEEE Transactions on Neural Systems and Rehabilitation Engineering26(12), 2387-2396. Doi: 10.1109/TNSRE.2018.2880871.

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