Review the case below and answer the questions. Each answer needs to be a minimum of 250 words in grammatically correct sentences. Please see the rubric below for grading details.
A 40 year old man, resident of the United States, presents to an emergency room with a 5-day history of fever, chills, nausea, vomiting, and myalgias. He returned 2 weeks ago from a 16-day visit to Zambia.
Question 1: What chemoprophylaxis regimen (if any) should be recommended for travel to Zambia? (more than one might apply)
Question 2: Based on the observed time intervals, could the symptoms experienced by the patient be due to malaria?
Some days later, the patient was seen at another clinic, where on a routine CBC malaria parasites were seen. He was then referred to a hospital, where he presents to the emergency room, at 4 am, with continuing fever, nausea, vomiting, and myalgias. On physical examination, the patient is febrile (102°F), tachycardic. jaundiced and pale. He is well oriented but slow in answering questions. A thin blood smear obtained while in the emergency room is read as Plasmodium, species not determined. Other laboratory findings include: hematocrit 33% , creatinine 3.6 mg/dL, and total bilirubin 11.0 mg/dL. The urine is dark, with a measured output of 40 mL/6 hours.
Question 3: What would be the best next step in the clinical management of this case?
The patient is admitted to the medical intensive care unit and treated with oral quinine and doxycycline. Later that day, the blood smear is reviewed by more experienced personnel for speciation.
An autopsy was performed, but after a delay of 8 days. The gross findings show a slight swelling of the cerebral gyri, with consequent narrowing of the sulci; some blood vessels are engorged, with scattered petechial hemorrhage. The hematoxylin-eosin section of the brain shows autolysis, some pyknotic nuclei, and scattered pigment felt to be malarial in origin. The pigment and pinpoint hemorrhages are felt to be pre-mortem.
4. What is the life cycle of the pathogen which causes malaria and what cell/cells does it attack in humans?
5. Show a blood smear and name the cells shown of infected cells.- Hint: go to the CDC website for information.
Rubric:
Writing Assignment Rubric
Criteria
Below Expectations
0 Points
Proficient
10 points
Exemplary
20 points
Reasoning and Analysis
Weak reasons and/or irrelevant or confusing reasons given that don’t support the answers; incomplete answers.
Reasons support answers with some / an important reason(s) overlooked; general examination and assessment.
Clear and accurate answers; insightful, specific.
Focus on Topic
Some of the documentation relates to the assigned topic; misuses or uses limited course vocabulary.
The answers are not as detailed and/or concise as needed; and/ or use limited course vocabulary.
Answers address the questions clearly and fully, showing higher level analysis and synthesis of concepts and uses course vocabulary.
Accuracy of
Facts and Citations
No direct quotes or “work consulted” used or referred to in the paper. Incorrect facts and / or citations.
All facts are accurate and relate back to the answer, yet there was a disproportionate amount of opinion based statements then facts. Provided 2-5 citations throughout paper using the text, interview and or other related documentation.
All facts are accurate and relate back to the answer. Provided 2-5 citations throughout paper using the text, interview and or other related documentation.
References
No works cited.
Works cited is not formatted in the correct APA style.
Works cited is formatted in the correct APA style.
Mechanics/
Organization
Numerous errors, paper hard to read; questions are not stated before answers; format details are not adhered to.
Enough errors to distract the reader; organization problems; questions not stated before answers; and / or format difficult to navigate.
Use of correct grammar, spelling, and punctuation; well organized; one idea follows another in a logical sequence with clear transitions; questions stated before answers; format easy to navigate.
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