Biology 1180 5% of Finale Grade

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CASE STUDY It was a beautiful fall day in October. Anita, a 20 year old second year college student, went to the athletic medicine facility complaining of diffuse myalgia centered in her midback. She was a competitive athlete, and represented her college in tennis at the Intercollegiate Championship games. The nurse recorded the following information on her chart, prior to the physician’s examination. Height: 160.5 cm Mass: 59.4 kg Temperature: 36.7 0C Respirations: 13 per minute Blood Pressure: 118/76 mm Hg During her conversation with the doctor regarding her past medical history, Anita said that she had developed severe eczema about 5 years ago and mononucleosis the previous year. From April of the current year, she found that she felt fatigued quite often, frequently experienced diarrhea, myalgia and arthralgia. Her family doctor had referred her to an allergist who found negative reactions to a multitude of substances. Because her symptoms were so severe, more specific testing was done 2 months later. An enzyme-linked immunosorbent assay showed positive reactions to gluten, spelt, albumin, lactose, barley and rye. She also disclosed that her symptoms first started in August of the previous year when she first began living on campus at college. Sometimes, the gastrointestinal distress was accompanied by back spasms, inability to “pay attention in class’ and general feelings of malaise. Prior to starting college, she avoided dairy products because she thought that she was lactose intolerant. Sometimes, she developed a painful rash on her back that consisted of reddened papules without drainage. To the doctor, Anita’s outward physical appearance seemed normal and he was happy to learn that despite her health problems, Anita continued to train and play tennis competitively. The differential diagnosis included irritable bowel syndrome, Crohn disease, lupus

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