Karen was likely to have been diagnosed with infectious mononucleosis caused by the Epstein - Barr virus (Medline, 2012). Her doctor suspected this disease because she displayed the classic symptoms of infectious mononucleosis. The first symptom was constant fatigue, also known as malaise (Medline, 2012). She also complained of a sore throat which indicated pharyngitis (Medline, 2012). When the physician examined her, it was found that she suffered from splenomegaly (enlarged spleen), and tender lymphadenopathy (swollen lymph nodes) (Medline, 2012) . In addition, Karen was seventeen years old, and infectious mononucleosis recorded high prevalence in her age group. These were all further indicators of infectious mononucleosis. The doctor confirmed this diagnosis by carrying out a heterophile antibody test, which was positive. Her WBC count and liver enzymes was high, which indicated presence of an infection.
The doctor first banned Karen from physical activity to reduce the risk of splenic rupture as she had splenomegaly. She was advised to have plenty of rest. Her treatment regimen was aimed at controlling the symptoms as the disease is self-limiting. It probably included administration of non-steroidal anti-inflammatory drugs (NSAIDS) like Ibuprofen to combat pain and fever (Medline, 2012). A corticosteroid for example Prednisone may be administered to reduce inflammation on the swollen glands. To treat her sore throat, Penicillin may be used if the doctor felt that it was necessary.
Karen was advised to go back to the doctor’s for re-examination before resuming strenuous activity like playing basketball. This is because the doctor would need to confirm that her spleen is no longer enlarged because resuming activity before it has healed would cause splenic trauma (Medline, 2012). Karen does not need to worry about getting this illness again because after symptomatic infection is over she will continue to carry the virus in her B lymphocytes for life. In later times, in case the virus is reactivated, she will be infectious but will not manifest any symptoms.
Bill’s doctor is likely to have diagnosed him as having osteoporosis. His history points to this disease first because of his age. He is seventy years old and osteoporosis is common in the elderly. He also does not consume dairy products, which means that his intake of calcium is limited. In addition, his lifestyle seems to have been quite sedentary for a long time, meaning that his bones have not benefitted from recommended exercise regimens. Medical examinations also revealed a compression fracture in L1 vertebrae; this occurred during his daily walk and caused him pain. A broken or fractured bone caused by normal daily functions is also highly indicative of osteoporosis (Department of Health, 2012). To confirm this diagnosis, the doctor carried out a Bone Mineral Density Test where his T-Score was -2.8; a T score of below -2.5 indicates osteoporosis (Department of Health, 2012). A T score compares the patient’s bone density with that of a fit young female, scores of -1 and above are normal (Department of Health, 2012). According to the Department of Health, (2012), the actual name of the test is known as a DEXA scan (Dual Energy X-ray Absorptiometry test) which determines bone density.
The doctor may have prescribed biphosphonates for Bill’s osteoporosis. They reduce the rate at which bones are dissolved, allowing them to become stronger over time. The doctor may also prescribe Teriparatide, a drug which amplifies the rate of bone formation and reduces risk of spinal fractures (Department of Health, 2012).The doctor may have recommended a nutritional supplement containing calcium and vitamin D3 (Department of Health, 2012). These act to increase the body’s intake of calcium which aids in bone strength.
References
Medline Plus, (2012). Infectious mononucleosis. Available at http://www.nlm.nih.gov/medlineplus/infectiousmononucleosis.html
Department of Health, (2012). All about Bone Mineral Density Tests. Available at http://www.health.ny.gov/diseases/conditions/osteoporosis/tests.htm
