Case study 2
Nameof the Student:
WhenRichard’s outer skin was damaged, the fish bite at the base of hisfinger nail gave a direct path for microorganism. After washing, noantibacterial treatment was given, he was only Band Aided for oneday. That is the reason the infection spread and furthermore, theinflammation response was initiated when Richard was bitten by thefish.
Afish tooth in the wound lead to infection because, Richard was notaware that a tooth from the northern pike was left in the wound. Thetooth was full of germs, thus infection was certain, and even if thetooth had been removed the infection would still occur because theinflammation response was initiated after the bit.
Thered streaks on Richard’s arm indicated that the infection had begunto spread. In Richard’s case, the red streaking in the skin couldmean that the bacteria had spread into the lymphatic channels,causing lymphangitis.
Whatdid the pus mean in the wound? What is pus? According to Gould, B.E. (2011). Pus is purulent exudates that consist of collection ofinterstitial fluid formed in the inflamed area. The pus meant therewas a bacterial infection.
TheIV antibiotics were used instead of oral antibiotics because the redstreaking noticed in the skin could have meant that the bacteria hadspread into the lymphatic channels, causing lymphangitis he was puton IV antibacterial drug, a possible broad spectrum drug, in order toprovide an instant dose and achieve an adequate blood level toeffectively treat the infection.
Richardnot allowed to return to work until the infection was gone becausedue to nature of his job, he would be exposed to microorganism yetthe infection had not cleared.
Whatrisk factors did Mary have for breast cancer? What risk factors werenot given in the case study, but might have been present?
Familyhistory is an important risk factor for breast cancer, Mary’smaternal aunty had breast cancer due to inherited genetic mutation.This is a risk factor that Mary had. Other risk factor not given inthe study which could have been present are Physicalinactivityphysical exercise appears to protect against breast cancer in bothpremenopausal and postmenopausal women. Smoking,both passive and active tobacco smoking have been associated with anincreased risk of breast cancer. Exposure to ionizing radiation ofthe chest at a young age, possibly for treatment.
Marychoose to have a healthy breast removed to minimize the risk of arecurrence of cancer in the opposite breast, she chose to have bothbreasts removed. Women below fifty who have double mastectomy haveless chance of cancer recurrences in future.
Ductalcarcinoma in situ is a condition in which abnormal cells are found inthe lining of breast ducts. These cells have not spread outside theduct to the surrounding breast tissue. This type of breast tumorwhich does not necessarily led to breast cancer, however since it isnot easy to tell which case of this type of tumor will becomecancerous, it is important to have it treated
Thestaging of the cancer indicates the level at which the cancerouscells have spread, the ductal carcinoma in situ in Mary’s leftbreast is sometimes called Stage 0 breast cancer.
Estrogenreceptor (ER) positive. Thistype of breast cancer is sensitive to estrogen. Helps the doctor tellthe treatment to apply in such a case, tamoxifen is given.
Radiationtherapy lowers the chance that DCIS will come back or develop intobreast cancer.  Thedrug tamoxifen is an anti oestrogen which stops effects of estrogenin the tissue. Tamoxifen would decreases the risk of a breast cancerdeveloping in the opposite breast.
Gould,B. E. (2011). Path physiology for the Health Professions, 4thEdition. Saunders Learning, printed in United States.