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Limping

-walk difficulty , damage of leg

Painful swelling

-abnormal enlargement (hyperthrophy) , infection

Yellowish discharge/pus

-indicate bacteria cause wound

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45 yo fisherman male

-risk factor certain disease

limping

-walk difficulty

Painful swelling (because of chemical)

-abnormal enlargement

Increasing in size within 3 days

-acute inflammation

Yellowish discharge( leakage by fluid, bacterial infection)

-pus

Right big toe

- high pressure

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continued pain

last more three months

tetanus

infection caused by clostridium tetani produce toxin for muscle contraction

tetanus booster

adult need this booster. protect from disease. incerasing immunity

diabetes mellitus

body does not produce enough insulin , blood sugar level elevated

distal is far from body and proximal near to body

palpation - feel the body, warm or cold

tender mean pain in medical

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-sharp rusted nail

-no history of tetanus booster dose, can get infection

continued pain, acute or chronic

-diabetes mellitus , no family history, low possibility to get

-remove the nail, no medication attention , cause inflammation, bacteria still there

-increase in temperature, fever (low grade fever)

-reddish ,brown colour

-tender, patient shout pain when do palpation

-blood pressure is borderline in this patient

below 90/60 mmHg hypotension

above 140/90 mmHg hypertension

-normal pulse rate 60 to 90 (patient have 90)

-normal respiratory rate

-bacteria involved clostridium tetani coz of nail

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-Infection

-Ingrowing toe nails

-Gout( multiple joint )

-Diabetes mellitus

-Cellulitis (effect deeper layer of tissue, most common in leg)

-Bunion

-Fracture of phalanx (swelling , inhibit movement )

-paronychia

-allergy

-rheumatoid arthritis

trigger 2

infection

diabetes mellitus

cellulitis

septicemia (will get if not untreated)

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Erythrocyte Sedimentation Rate

A test that indirectly measures that level of certain proteins in the blood

Analgelsic administration

Medication uses to reduce inflammation

Surgical drainage

Pus swab

test the sensitivity of bacteria

Abscess

collection of pus

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Infection

-Ingrowing toe nails

-Gout( multiple joint )

-Diabetes mellitus

-Cellulitis (effect deeper layer of tissue, most common in leg)

-Bunion

-Fracture of phalanx (swelling , inhibit movement )

-paronychia

-allergy

-rheumatoid arthritis

trigger 2

infection

diabetes mellitus

cellulitis

septicemia (will get if not untreated)

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Total RBC count

increase because get infection of bacteria

Neutrophil

increase because in order to fight the infection

Total WBC count

increase because protect our body from the infection

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Bacterial infection patient surely ❤️

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Fever?

-acute/long fever , time ( morning / night )

Wearing tight shoes?

Eating seafood?(triggering gout)

Family history disease

-Tired , feeling thirsty , blurry vision , slow healing wound?

-Numbness

-Weight loss(food will not go to your cell)

-Food medication allergy ? (skin harsh)

trigger 2

-CNS culture and sensitivity - know what type of bacteria

-blood glucose test - blood count test

- xray first to detect any fracture, no need ct scan and MRI

- check his heart due to his age (ecg)

trigger 3

Painkiller - possibly cause gastrointestinal ulcer if we give more than 5 days

Antibiotics - Cloxacilin for Strepcoccus aureus

Education - very important to educate patient to take medicine accordingly

If the patient has diabetic - affect sensory neurons so the patient does not feel any pain sensation