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Women’s and Men’s Health, Infections, and Hematologic Disorders

Scenario 3: 67-year-old female presents with chief complaint of shortness of breath, fatigue, weakness, unintentional weight loss, and mild numbness in her feet. She states she feels unsteady when she walks. PMH includes hypothyroidism well controlled on Synthroid 100 mcg/day. No hx of HTN or CHF.
Vital signs: Temp 98.7 F, pulse 118, Respirations 22, BP 108/64, PaO2 95% on room air.
Physical exam revealed pale, anxious female appearing older than stated years.
HEENT- pale conjunctiva of eyes and pale palate. Tongue beefy red and slightly swollen with loss of normal rugae. Turbinates pale but no swelling. Thyroid palpable but no nodules felt. No lymph nodes palpated.
Cardiac-regular rate and rhythm with soft II/VI systolic murmur. Respiratory- lungs clear with no adventitious breath sounds. Abdomen-soft, non-tender with positive bowel sounds. Liver edge palpated two finger breadths below right costal margin. Lab data- hgb, hct, reticulocyte count, serum B12 levels low, mean corpuscle volume, plasma iron, and ferritin levels high, folate, TIBC are normal.

In your Case Study Analysis related to the scenario provided, explain the following as it applies to the scenario you were provided (not all may apply to each scenario):
• The factors that affect fertility (STDs).
• Why inflammatory markers rise in STD/PID.
• Why prostatitis and infection happens. Also explain the causes of systemic reaction.
• Why a patient would need a splenectomy after a diagnosis of ITP.
• Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Sample Solution

rthermore, Vittola argues war is necessary, not only for defensive purposes, ‘since it is lawful to resist force with force,’ but also to fight against the unjust, an offensive war, nations which are not punished for acting unjustly towards its own people or have unjustly taken land from the home nation (Begby et al (2006b), Page 310&313); to “teach its enemies a lesson,” but mainly to achieve the aim of war. This validates Aristotle’s argument: ‘there must be war for the sake of peace (Aristotle (1996), Page 187). However, Frowe argues “self-defence” has a plurality of descriptions, seen in Chapter 1, showing that self-defence cannot always justify one’s actions. Even more problematic, is the case of self-defence in war, where two conflicting views are established: The Collectivists, a whole new theory and the Individualists, the continuation of the domestic theory of self-defence (Frowe (2011), Page 9& 29-34). More importantly, Frowe refutes Vittola’s view on vengeance because firstly it empowers the punisher’s authority, but also today’s world prevents this action between countries through legal bodies like the UN, since we have modernised into a relatively peaceful society (Frowe (2011), Page 80-1). Most importantly, Frowe further refutes Vittola through his claim that ‘right intention cannot be used as an excuse to wage war in response to anticipated wrong,’ suggesting we cannot just harm another just because they have done something unjust. Other factors need to be considered, for example, Proportionality. Thirdly, Vittola argues that war should be avoided (Begby et al (2006b), Page 332) and that we should proceed circumstances diplomatically. This is supported by the “last resort” stance in Frowe, where war should not be permitted unless all measures to seek diplomacy fails (Frowe (2011), Page 62). This means war shouldn’t be declared until one party has no choice but to declare war, in order to protect its territory and rights, the aim of war. However, we can also argue that the war can never be the last resort, given there is always a way to try to avoid it, like sanctions or appeasement, showing Vittola’s theory is flawed
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