Chapter 6, Problem 184R

treatments for phobias

A call to the doctor’s office from an anxious mom reports that her 8-year-old son, Billy, arrives home from school with multiple small bruises (petechiae) and a few larger bruises (ecchymosis) on his arms, legs, and trunk. These bruises were not there when he left for school, and Billy denies being hit or falling. Mom states that he has no significant medical history, and that he is not on any medications. Billy is taken immediately to the emergency room. The mother becomes increasingly anxious as she notices new bruises appearing “in front of her eyes.” Billy also appears tense as he senses some urgency and notices some concern from medical personnel beginning the assessment.   Why does unexplained multiple bruising in a child or adult require prompt medical attention?   How might you understand the natural concern by medical personnel as to the source of the bruises on Billy’s body?   Early assessment of Billy’s vital signs and the child’s welfare indicate that Billy’s condition…

Clinical history: A suspicious envelope arrived for sorting at rural post office. The envelope was opened and found to contain white powder. Approximately two days later, the postal worker who handled the letter developed cutaneous boils, which were 1 to 5 cm in diameter with central necrosis and eschars. He and his wife also developed a mild nonproductive cough with fatigue, myalgia for 72 hours, followed by severe dyspnea, diaphoresis, and cyanosis.  Temperature of 39.5°C, pulse 105/min, respiration 25/min, and blood pressure 85/45mm Hg.  Crackles were heard at the lung bases. A chest xray shows a widened mediastinum and small pleural effusions. WBC count of 13,130/mm3, hemoglobin 13.7g/dL, hematocrit 41.2%, MCV 91 um3, and platelet count 244,000/mm3. Both died despite antibiotic therapy. Several cattle, horses, and sheep on the postal worker's farm also died. Photos include extremity photo and gram stain. What specimen was most likely collected for the grain stain? Does fact that…