NUA 5950 Case Study 1 Questions With Answers Graded A+ Assured Success; Rockhurst University

Case 1 Context A 15-year-old male patient is brought to the clinic by his mother, complaining of a rash that started on his abdomen about 3-4 days ago. He states that it started out just as a single spot on his abdomen, and then a few days later, he noticed another spot under his left underarm. He states that the rash does itch but is not painful. The current time of the year is spring, and he has no known environmental, food, or medication allergies. Case 1 Questions 1. Describe the rash/lesion(s) specifically for this case (based on the picture above) as you would in the physical exam (PE) section of the chart (objective findings only). For this case, you only need to provide the information that you can see (or estimate) from this picture alone. It is OKAY for the purpose of this case to estimate the size and location as you describe your findings. For ANY information that you believe is necessary for the focused physical exam of this suspected condition that you cannot perform (because it is a picture), such as the palpation of the lesion, please describe that component of the exam in as much detail as possible (as if you were explaining to someone how you would perform a focused physical exam if this were a "real" patient). Be specific and use medical terms, not layman's terms or generalizations. HINT: Use the textbook and focus on the section titled "Components of the physical exam." • Physical Exam Findings (based on the interpretation of the picture): Patient presents with a well-defined ring-shaped plaque with a raised silver scaly border to the right abdomen measuring approximately 8cm x 8cm in size. Another well-defined ring-shaped plaque with a raised silver scaly border is noted superior to the previous plaque on the right abdomen. Area measures approximately 3cm x 2cm. There is also an area measuring approximately 12cm x 8cm to the left axillae. This is not well defined like the other areas, but it does have a silver plaque appearance (Wolff, 2017). • Physical Exam Techniques that I believe are necessary but cannot be performed on the picture: First I would observe for drainage. Secondly, I would palpate the areas for tenderness, pain, and/or fluctuations. This would also allow me to check for induration. I would also make sure to palpate lymph notes that are proximal to the areas (Rhoads & Petersen, 2025). 2. What questions, as part of the subjective assessment, will you ask the patient that will assist you with the differential diagnosis and treatment of the patient's problem (see the examples in Module 1 for appropriate questions)? • HPI (Rhoads & Petersen, 2025): 1. When did you first notice the rash to your abdomen and axillae? (Onset) 2. Other than your current rashes, do you have any other rashes? (Location) 3. How long have you had both rashes? (Duration) 4. Are the rashes painful or itchy? (Characteristic) 5. Does anything make the rashes worse? (Aggravating factors) 6. Does anything make the rashes better? (Relieving factors) 7. Is there a certain time of day when the rash is worse? Have you been around with any animals? (Timing) 8. On a scale of 0 to 10, with 0 being no discomfort and 10 being the most discomfort you have ever experienced, how would you rate your discomfort? (Severity) • ROS (Focused on the problem) (Rhoads & Petersen, 2025): 1. General/Constitutional: Have you had a fever? Have you had chills? Have you noticed a change in weight? Do you have any fatigue? 2. Neurological: Have you had a headache? Have you had any numbness, tingling, or dizziness? 3. EENT: Does your throat hurt? Have you had any sinus drainage? 4. Cardiovascular: Have you had any chest pain or swelling in your arms or legs? 5. Respiratory: Have you had a cough? Shortness of breath? 6. Gastrointestinal: Have you had nausea, vomiting or diarrhea? Abdominal pain? 7. Integumentary: Have you noticed any other rashes? Have you noticed any hair loss? Have you had excessive moisture or dryness? 8. Psychiatric: Have you been under stress? Have you been anxious or depressed? • History (Rhoads & Petersen, 2025): 1. Past Medical History: Do you have any medical conditions that you have been diagnosed with? Have you ever had a skin problem in the past? 2. Past Surgical History: Have you ever had surgery? Have you ever had biopsy on your skin before? 3. Social History: Do you use smoking tobacco or smokeless tobacco? 4. Do you play sports?