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The patient has also been suffering from frequent fevers in the past two months. He has also suffered from frequent headaches but has always taken painkillers (Bloland & Williams, 2003, p. 58). On fevers, the patient has frequently visited a local health clinic that has never done any diagnosis but has given medication, which reduces the fever.
The patient has high temperature, and extreme sweating as well as visible chills on body.
Microscopy will be performed on the patient to establish the type of malaria parasite and the number of these parasites in his/her blood sample. The blood sample can be extracted through a finger stab and then made into thick and thin films, and examined severally using a 100x oil immersion objective after staining them with Romanovsky stain (Warrell, Cox, & Firth, 2005, p. 734). By observation, the species of plasmodium can be seen and the number of them established
Depending on the number of parasites and the type of parasites, the type of malaria can now be determined. Antimalarials with specific infectivity suppressive action such as derivatives of artemisinin and primaquine can be prescribed to reduce malaria transmission at all intensities. For falciparum malaria, which is very lethal, the patient should be referred to a larger facility for aggressive therapy as well as parenteral antimalarials or quinine derivative malaria drugs and supportive care (Bloland & Williams, 2003, p. 57).
1. What are the general symptoms and signs of malaria?
2. Why is it not possible nowadays to diagnose malaria with a set of signs and symptoms?The patient has been coughing for the last two weeks, lost 5 kilograms in weight, and whenever he coughs, very thick sputum in produced. Furthermore, the patient has been having chest pains, fever, sweating especially at night and loss of appetite (Harries, Maher, & Graham, 2004, p. 50). The sputum that is produced on coughing is not thick and is yellow in color (Warrell, Cox, & Firth, 2005, p. 560).
The patient has been experiencing fever for the past 3 months but takes medication, which reduces the fever.
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.
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The patient should submit three samples of sputum for microscopy analysis. The probability of finding the TB bacilli in the three samples is higher than with one or two samples. These samples should be taken in the morning as secretions build overnight in the human airways (Harries, Maher, & Graham, 2004, p. 51). For outpatients, they should provide an on-the-spot sample on day one then another two samples on day two-one early in the morning and
another on-the-spot. The samples are then examined for mycobacteria using the Ziel-Neelsen stain method and the TB Bacilli using the Fluorochrome stain method and a special fluorescence microscope. The number of Bacilli observed on each sample smear should then be recorded (Harries, Maher, & Graham, 2004, pp. 51-52). A smear-positive result shows presence of TB bacilli (having at least 10000 organisms in a milliliter of sputum) (WHO, 2008, p. 17). The result may be a smear-negative one, but if the patient is breathless, has continued haemoptysis or only one smear test was positive, then it may be necessary to do a Chest X-Ray to confirm the type of TB (Harries, Maher, & Graham, 2004, p. 55).
All TB types are treated with fixed-dose combinations (FDCs) of drugs to avoid prescription errors and ensure few tablets are ingested to encourage adherence to treatment. For a new case of pulmonary TB Rifampicin (R), Isoniazid (H), Pyrazinamide (Z), and Ethambutol (E) should be administered for two months followed by four months of Rifampicin and Isoniazid (WHO, 2008, p. 26). When the bacillary load is large, a four drug (HRZE) combination is used as the initial treatment. If the patients are HIV-negative and have a smear-negative, a three drug (RHZ) combination should be efficient. Supervised daily administration is recommended especially in the initial stage (WHO, 2008, p. 27). For pregnant mothers, a three drug combination of Isoniazid, Rifampicin, and Ethambutol are prescribed for the initial treatment.
The patients are then expected to stay in rooms that are well aerated when with other people to avoid spreading the disease until after two weeks of medication since it is airborne.What are the symptoms and signs that may force one to recommend a CXR for a TB patient?
2. What are the prominent symptoms and signs of pulmonary tuberculosis and what are the best diagnosis for pulmonary tuberculosis?The patient has been nauseating, vomiting, cramps, and pain in the stomach, and watery diarrhea some hours after eating lunch. Fevers started at night, with chills and headaches following there after (Griffith, Moore, & Yoder, 2006, p. 323).
The patient has always had a sensitive stomach and has trouble with his stomach
whenever he eats a mixture of foods.
The exhibits a high temperature (sign of fever), chills and diarrhea or even vomit (Williams & Wilkins, 2009, p. 944). Dehydration is also evident due to lots of body fluid loss through vomiting and diarrhea.
Bacteriological examination of vomitus, blood, stool smears, or fecal specimens is prescribed. This test aims at looking for antibodies present in the samples. This diagnosis should rule out other acute gastrointestinal disorders as well as causes of food poisoning (Williams, & Wilkins, 2009, p. 944). In most cases, the patients stool is examined for micro-organisms and culture. The vomit may be tested for enterotoxin of Staphylococcus aureus and observed under an electron microscope for rotaviruses. It is also necessary that some blood samples be taken for culture (Eley, 1996, p. 110).
Treatment for food poisoning is mostly supportive, and consists of bed rest and oral fluid replacement. Oral tetracycline is also prescribed (Williams & Wilkins, 2009, p. 944). In case of certain symptoms other than the normal food poisoning symptoms, antibiotics may be prescribed. Small amounts of clear fluids and complex carbohydrates are recommended. However, high sugar foods and fatty foods are to be avoided for a few days.
However, the patient should be warned against consuming improperly cooked food in future, ensure proper hygiene when preparing food and avoid drinking water or eating raw foods What are the major causes of food poisoning? 2. What are the key symptoms and signs of food poisoning and how is it treated?when travelling (Griffith, Moore, & Yoder, 2006, p. 323).
Bloland, P. B., & Williams, H. A., (2003). Malaria control during mass population movements and natural disasters. Washington, DC: The National Academies Press.
Warrell, D. A., Cox, T. M., & Firth, J. D. (2005). Oxford textbook of medicine, volume 1. New York, NY: Oxford University Press.
WHO. (2010). Guidelines for the treatment of malaria. Geneva: World Health Organization.Harries, A. D., Mather, D., & Graham, S. (2004). TB/HIV: A clinical manual. Geneva: World Health Organization.
Warrell, D. A., Cox, T. M., & Firth, J. D. (2005). Oxford textbook of medicine, volume 1. New York, NY: Oxford University Press.
WHO. (2008). Implementing the WHO stop TB strategy: A handbook for national TB control strategy. Geneva. World Health Organization.Eley, A. R. (1996). Microbial food poisoning. London, SE: Springer.
Griffith, H. W, Moore, S., & Yoder, K. (2006). Complete guide to symptoms, illness & surgery. New York, NY. Penguin Group Inc.
Williams, L., & Wilkins, L. (2009). Professional guide to diseases. Ambler, PA: Lippincott Williams & Wilkins.