Factors That Influence Disease Essays: Diabetes, Digestive Disorders, Anemia, Respiratory Alterations, Anaphylactic Shock, Cardiovascular Disorders, Arthritis, Reproductive Systems, Urinary Tract Infections

Week 1 discussion

Factors That Influence Disease

In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.

To prepare:

Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.

Select a disorder from the following list:

Adrenal insufficiency (Addison’s disease)

Atherosclerosis

Cholelithiasis (gallstones)

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Colon cancer

Cystic fibrosis

Hemophilia

Nephrolithiasis (kidney stones)

Osteoporosis

Parkinson’s disease

Tuberculosis

Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.

Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.

By Day 3

Post a brief description of a patient scenario involving the disorder and the factor you selected. Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different disorders and factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

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Week 2 discussion

DQ1

Maladaptive Responses to Immune Disorders

Maladaptive responses to disorders are compensatory mechanisms that ultimately have adverse health effects for patients. For instance, a patient’s allergic reaction to peanuts might lead to anaphylactic shock, or a patient struggling with depression might develop a substance abuse problem. To properly diagnose and treat patients, advanced practice nurses must understand both the pathophysiology of disorders and potential maladaptive responses that some disorders cause.

Consider immune disorders such as HIV, psoriasis, inflammatory bowel disease, and systemic lupus E. What are resulting maladaptive responses for patients with these disorders?

To prepare:

Review Chapter 5 and Chapter 7 in the Huether and McCance text. Reflect on the concept of maladaptive responses to disorders.

Select two of the following immune disorders: HIV, psoriasis, inflammatory bowel disease, or systemic lupus E (SLE).

Identify the pathophysiology of each disorder you selected. Consider the compensatory mechanisms that the disorders trigger. Then compare the resulting maladaptive and physiological responses of the two disorders.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor might impact your selected immune disorders.

By Day 3

Post a brief description of the pathophysiology of your selected immune disorders. Explain how the maladaptive and physiological responses of the two disorders differ. Finally, explain how the factor you selected might impact the pathophysiology of each disorder.

Read a selection of your colleagues’ responses.

By Day 5

Respond to at least two of your colleagues on two different days who selected different immune disorders and/or factors than you, in the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the immune disorder your colleague selected.

Expand on your colleague’s posting by providing additional insights or contrasting perspectives based on readings and evidence.

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DQ2

Arthritis

While arthritis impacts nearly 50 million adults in the United States, it is not a disease that is limited to adulthood. Consider the case of Ashley Russell. At the age of 14 months, Ashley was diagnosed with juvenile rheumatoid arthritis. As a baby, her parents noticed that her knee was always swollen and that she often wanted to be carried instead of walking on her own (Cyr, 2012). After seeking medical care, Ashley’s underlying disorder was discovered. Arthritis in children is not uncommon. According to the CDC (2011), an estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition. Due to the prevalence of the disorder in both children and adults, you must understand the pathophysiology and symptoms of arthritis in order to properly diagnose and prescribe treatment.

To prepare:

Review Chapter 37 in the Huether and McCance text and Chapter 24 in the McPhee and Hammer text. Identify the pathophysiology of osteoarthritis and rheumatoid arthritis. Consider the similarities and differences of the disorders.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of and treatment for the disorders.

By Day 4

Post a description of the pathophysiology of osteoarthritis and rheumatoid arthritis, including the similarities and differences between the disorders. Then explain how the factors you selected might impact the pathophysiology of the disorders, as well as the diagnosis of treatment for the disorders.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different factors than you, in one or more of the following ways:

Offer alternative diagnoses and prescription of treatment options for osteoarthritis and rheumatoid arthritis.

Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives.

References:

Centers for Disease Control and Prevention. (2011). Arthritis-related statistics. Retrieved from http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm

Cyr, J. (2012). 7-year-old from Aroostook County chosen as youth ambassador for Bangor Arthritis Walk. Bangor Daily News. Retrieved from http://bangordailynews.com/2012/05/10/health/7-year-old-from-aroostook-county-chosen-as-youth-ambassador-for-bangor-arthritis-walk/

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Week 3 discussion

Pain

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.

To prepare:

Review this week’s media presentation on the neurological system, as well as Chapter 13 in the Huether and McCance text.

Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

By Day 3

Post a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them. Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different factors than you, in the following ways:

Share insights on how your colleague’s factors impact the pathophysiology of pain.

Suggest alternative diagnoses and treatment options for acute, chronic, and referred pain.

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Week 4 discussion

Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

To prepare:

Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 23 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.

Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.

Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected.

By Day 3

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different alterations and factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the cardiovascular alteration your colleague selected.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Reference:

National Heart Lung and Blood Institute. (2011). What is coronary heart disease? Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/cad/

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Week 5 discussion

DQ1

Cardiovascular Disorders

At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.

Consider the following scenario:

A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.

To prepare:

Review the scenario provided, as well as Chapter 24 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.

Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.

By Day 3

Post a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.

Read a selection of your colleagues’ responses.

By Day 5

Respond to at least two of your colleagues who selected a different factor than you, in one of the following ways:

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Share insights based on your own experience and additional research.

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DQ2

Anaphylactic Shock

The treatment of anaphylactic shock varies depending on a patient’s physiological response to the alteration. Immediate medical intervention and emergency room visits are vital for some patients, while others can be treated through basic outpatient care.

Consider the January 2012 report of a 6-year-old girl who went to her school nurse complaining of hives and shortness of breath. Since the school did not have any medication under her name to use for treatment and was not equipped to handle her condition, she was sent to an emergency room where she was pronounced dead. This situation has raised numerous questions about the progression of allergic reactions, how to treat students with severe allergies, how to treat students who develop allergic reactions for the first time, and the availability of epinephrine in schools. If you were the nurse at the girl’s school, how would you have handled the situation? How do you know when it is appropriate to treat patients yourself and when to refer them to emergency care?

To prepare:

Review “Anaphylactic Shock” in Chapter 23 of the Huether and McCance text, “Distributive Shock” in Chapter 10 of the McPhee and Hammer text, and the Jacobsen and Gratton article in the Learning Resources.

Identify the multisystem physiologic progression that occurs in anaphylactic shock. Think about how these multisystem events can occur in a very short period of time.

Consider when you should refer patients to emergency care versus treating as an outpatient.

Select two patient factors different from the one you selected in this week’s first Discussion: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the process of anaphylactic shock.

By Day 4

Post an explanation of the physiological progression that occurs in anaphylactic shock. Then, describe the circumstances under which you would refer patients for emergency care versus treating as an outpatient. Finally, explain how the patient factors you selected might impact the process of anaphylactic shock.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues who selected at least one different factor than you in one of the following ways:

Share insights on how the factor your colleague selected impacts the pathophysiology of anaphylactic shock.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

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Reference:

Moisse, K. (2012). Death of allergic student raises questions about school’s responsibility. Retrieved from http://abcnews.go.com/Health/AllergiesFood/year-virginia-girl-dies-allergic-reaction-school/story?id=15295949#.T7qD0sWPRBk

Week 6 discussion

Respiratory Alterations

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’s underlying illness can be challenging, it is essential because even basic symptoms such as persistent coughing can be a sign of a more severe disorder. Advanced practice nurses must be able to differentiate between moderate and severe respiratory disorders, as well as properly diagnose and prescribe treatment for their patients. For this reason, you must have an understanding of the pathophysiology of respiratory disorders.

Consider the following three scenarios:

Scenario 1:

Ms. Teel brings in her 7-month-old infant for evaluation. She is afraid that the baby might have respiratory syncytial virus (RSV) because she seems to be coughing a lot, and Ms. Teel heard that RSV is a common condition for infants. A detailed patient history reveals that the infant has been coughing consistently for several months. It’s never seemed all that bad. Ms. Teel thought it was just a normal thing, but then she read about RSV. Closer evaluation indicates that the infant coughs mostly at night; and, in fact, most nights the baby coughs to some extent. Additionally, Ms. Teel confirms that the infant seems to cough more when she cries. Physical examination reveals an apparently healthy age- and weight-appropriate, 7-month-old infant with breath sounds that are clear to auscultation. The infant’s medical history is significant only for eczema that was actually quite bad a few months back. Otherwise, the only remarkable history is an allergic reaction to amoxicillin that she experienced 3 months ago when she had an ear infection.

Scenario 2:

Kevin is a 6-year-old boy who is brought in for evaluation by his parents. The parents are concerned that he has a really deep cough that he just can’t seem to get over. The history reveals that he was in his usual state of good health until approximately 1 week ago when he developed a profound cough. His parents say that it is deep and sounds like he is barking. He coughs so hard that sometimes he actually vomits. The cough is productive for mucus, but there is no blood in it. Kevin has had a low-grade temperature but nothing really high. His parents do not have a thermometer and don’t know for sure how high it got. His past medical history is negative. He has never had childhood asthma or RSV. His mother says that they moved around a lot in his first 2 years and she is not sure that his immunizations are up to date. She does not have a current vaccination record.

Scenario 3:

Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Maria has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

To prepare:

Review the three scenarios, as well as Chapter 26 and Chapter 27 in the Huether and McCance text.

Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described.

Identify the pathophysiology of the alteration that you associated with the cough.

Select two of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the disorder.

By Day 3

Post a description of the disorder and underlying respiratory alteration associated with the type of cough in your selected scenario. Then, explain the pathophysiology of the respiratory alteration. Finally, explain how the factors you selected might impact the disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected a different scenario than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the disorder your colleague identified.

Ask a probing question regarding the disorder that your colleague identified.

Suggest an alternative disorder for the scenario your colleague selected.

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Week 7 discussion

Anemia

In clinical settings, advanced practice nurses often encounter patients with blood disorders such as anemia. Consider the case of a 17-year-old girl who is rushed to the emergency room after suddenly fainting. The girl’s mother reports that her daughter has had difficulty concentrating for the past week, frequently becomes dizzy, and has not been eating normally due to digestion problems. The mother also informs the nurse that their family has a history of anemia. With the family history of anemia, it appears that this is the likely diagnosis. However, in order to properly diagnose and treat the patient, not only must her symptoms and family history be considered, but also factors such as gender, ethnicity, age, and behavior. This poses the question: How do patient factors impact the incidence and prevalence of different types of anemia?

To prepare:

Review Chapter 20 in the Huether and McCance text. Reflect on the pathophysiological mechanisms of iron deficiency anemia.

Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected.

Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected.

Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders.

By Day 3

Post an explanation of the pathophysiological mechanisms of iron deficiency anemia and the anemia you selected. Compare these two types of anemia, as well as their potential causes. Finally, explain how genetics, gender, ethnicity, age, and behavior might impact the anemic disorders you selected.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different types of anemia than you, in the following ways:

Share insights on how the anemia you selected is similar to or different from the one your colleague selected.

Discuss how genetic, gender, ethnic, age, and behavioral factors impact the diagnosis and prescription of treatment for anemic patients.

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Week 8 discussion

Digestive Disorders

Many patient symptoms can be tied to multiple disorders, which may lead to misdiagnoses. For instance, consider two digestive disorders of the gastrointestinal tract—inflammatory bowel disease and irritable bowel syndrome. These two disorders are commonly confused because they present similar symptoms. As an advanced practice nurse, you must know the differences to properly diagnose and treat the disorders. How does the pathophysiology of inflammatory bowel disease compare to the pathophysiology of irritable bowel syndrome? How do treatments for the two disorders compare?

To prepare:

Review Chapter 34 in the Huether and McCance text and Chapter 13 in the McPhee and Hammer text.

Identify the pathophysiological mechanisms of inflammatory bowel disease and irritable bowel syndrome. Think about similarities and differences between the disorders.

Consider common treatments for inflammatory bowel disease and irritable bowel syndrome. Reflect on whether treatments for one disorder would work for the other disorder.

Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factor you selected might impact the pathophysiology of and treatments for each disorder.

By Day 3

Post an explanation of the pathophysiological mechanisms of inflammatory bowel disorder and irritable bowel syndrome, including similarities and differences. Then describe common treatments, addressing whether treatments for one disorder would work for the other disorder. Finally, explain how the patient factor you selected might impact the pathophysiology of and treatments for each disorder.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different treatments and factors than you, in the following ways:

Offer alternative common treatments for the disorders.

Share insight on how the factor you selected impacts the treatment of alterations of digestive function.

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Week 9 discussion

Diabetes

According to the American Diabetes Association (2011), 25.8 million children and adults have been diagnosed with diabetes in the United States. Approximately 2 million more are diagnosed every year, with another 79 million people considered to be in a pre-diabetes state. These millions of people are at risk of several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. Since diabetes has a major impact on the health of millions of people around the world, it is essential for nurses to understand the pathophysiology and associated alterations of this disorder. In this Discussion, you compare two types of diabetes—diabetes mellitus and diabetes insipidus.

To prepare for this Discussion:

Review Chapter 18 in the Huether and McCance text and Chapter 18 in the McPhee and Hammer text. Identify the pathophysiology of diabetes mellitus and diabetes insipidus. Consider the similarities and differences between resulting alterations of hormonal regulation.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Think about how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

By Day 3

Post an explanation of the pathophysiology of diabetes mellitus and diabetes insipidus. Describe the differences and similarities between resulting alterations of hormonal regulation. Then explain how the factors you selected might impact the diagnosis and prescription of treatment for these two types of diabetes.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the pathophysiology of diabetes mellitus and diabetes insipidus.

Offer alternative diagnoses and prescription of treatment options for diabetes mellitus and diabetes insipidus.

Validate an idea with your own experience and additional research.

Reference:

American Diabetes Association. (2011). Diabetes statistics. Retrieved from http://www.diabetes.org/diabetes-basics/diabetes-statistics/

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Week 10 discussion

Urinary Tract Infections

Urinary tract infections (UTIs) are caused by bacteria—most often Escherichia coli. However, certain viruses, fungi, and parasites can also lead to infection. The infection can affect the lower and upper urinary tract, including the urethra, prostate (in males), bladder, ureter, and kidney. Due to the progression of the disease and human anatomy, symptoms present differently among the sexes as well as among age groups. It is important to understand how these factors, as well as others, impact the pathophysiology of UTIs. Advanced practice nurses must have this foundation in order to properly diagnose patients.

To prepare:

Review Chapter 29 in the Huether and McCance text. Identify the pathophysiology of lower and upper urinary tract infections. Consider the similarities and differences between the two types of infections.

Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

By Day 3

Post a description of the pathophysiology of lower and upper urinary tract infections, including their similarities and differences. Then explain how the factors you selected might impact the pathophysiology of the infections, as well as the diagnosis of and treatment for the infections.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected at least one different factor than you, in one or more of the following ways:

Offer alternative diagnoses and prescription of treatment options for urinary tract infections.

Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives.

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Week 11 discussion

Disorders of the Reproductive Systems

While the male and female reproductive systems are unique to each sex, they share a common function—reproduction. Disorders of this system range from delayed development to structural and functional abnormalities. Since many reproductive disorders not only result in physiological consequences but also psychological consequences such as embarrassment, guilt, or profound disappointment, patients are often hesitant to seek treatment. Advanced practice nurses need to educate patients on disorders and help relieve associated stigmas. During patient evaluations, patients must feel comfortable answering questions so that you, as a key health care provider, will be able to diagnose and recommend treatment options. As you begin this Discussion, consider reproductive disorders that you would commonly see in the clinical setting.

To prepare for this Discussion:

Review Chapter 22 and Chapter 23 in the McPhee and Hammer text, as well as Chapter 32 in the Huether and McCance text.

Select two disorders of the male and/or female reproductive systems that interest you. Consider the similarities and differences between the disorders.

Select one of the following factors: genetics, ethnicity, age, or behavior. Think about how the factor you selected might impact the diagnosis of and treatment for the reproductive disorders.

By Day 3

Post a description of the two reproductive disorders you selected, including their similarities and differences. Then explain how the factor you selected might impact the diagnosis of treatment for the reproductive disorders.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different disorders or factors than you, in one or more of the following ways:

Share insights on how the factor you selected impacts the pathophysiology of the disorder your colleague selected.

Offer alternative diagnoses and prescription of treatment options for the disorder your colleague selected.

Validate an idea with your own experience and additional research.

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