Lyme Disease Case Study A 38-year-old male had a 3-week history of fatigue and lethargy with intermittent complaints of headache, fever, chills, myalgia, and arthralgia. According to the history, the patient’s symptoms began shortly after a camping vacation. He recalled a bug bite and rash on his thigh immediately after the trip. The following studies were ordered: Studies Results Lyme disease test, Elevated IgM antibody titers against Borrelia burgdorferi (normal: low) Erythrocyte sedimentation rate (ESR), 30 mm/hour (normal: ≤15 mm/hour) Aspartate aminotransferase (AST), 32 units/L (normal: 8-20 units/L) Hemoglobin (Hgb), 12 g/dL (normal: 14-18 g/dL) Hematocrit (Hct), 36% (normal: 42%-52%) Rheumatoid factor (RF), Negative (normal: negative) Antinuclear antibodies (ANA), Negative (normal: negative) Diagnostic Analysis Based on the patient’s history of camping in the woods and an insect bite and rash on the thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen early in this disease. RF and ANA abnormalities are usually absent. Critical Thinking Questions 1. What is the cardinal sign of Lyme disease? (always on the boards) 2. At what stages of Lyme disease are the IgG and IgM antibodies elevated? 3. Why was the ESR elevated? 4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatmen 

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 No Plegarism please,  will be checked with Turnitin. 

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and and Include: (3 references within 2015-2018)with intext citations.  

Topic 1K.N. is a 24-year-old woman who presents to the family practice clinic complaining of sudden urgency to urinate, back pain, frequent urination, and pain with urination. Symptoms began approximately 48 hours ago.

She awoke from sleep with urgency and suprapubic discomfort 2 nights ago. Her urine now has a strong odor and a cloudy appearance. She has an allergy to Bactrim. What are some appropriate questions to ask the patient? What are three differential diagnoses for the patient?  ( Urinary Tract Infection,, Overactive Bladder, Cystitis, Noninfectous Urethritis) What physical examination would you perform? (Urine culture What diagnostics would you include? Create an evidenced-based plan of care. Include pharmacological and non-pharmacological treatments.

Urine dipstick results: Color, dark yellow, specific gravity 1.035, ph 5.5, protein (-), Ketones (-), Bilirubin (-), Trace blood, Leukoesterase (+), Nitrites (+), Urobilinogen (-) 

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