Mary is a 35 years old electrical engineer who presents to the office for evaluation of a rash on her face that has been present for 1 week. She denies new soaps, detergents, lotions, environmental exposures, medications, and foods. The rash is across her face and the bridge of her nose. She states that she first noticed it after spending a week hiking and camping in the Appalachians. The lesions itch and are painful. She has not tried anything to make it better, but she has noticed that going outdoors makes it worse. She denies any spread of the rash to other areas. She has never had this rash before.
She has noticed some increased fatigue, fever, and weight loss. She denies headache, sore throat, ear pain, nasal or sinus congestion, chest pain, shortness of breath, cough, abdominal pain, and pain with urination, constipation, or diarrhea. She does have mouth soreness. She has noticed some increased muscle aches and pains, which are worse in the hand and wrist. She denies early morning joint stiffness or difficulty with being able to move in the morning. She denies temperature intolerance, polyuria, polydipsia, or polyphagia.
She had a tonsillectomy at age 9 for chronic strep throat infections. She has been healthy as an adult. She has never had children. She has never been hospitalized for any reason.
Her family history is significant for a mother with rheumatoid arthritis. Her father is healthy.
She does not smoke; she drinks a glass of wine nearly every night with her dinner; she denies illicit drug use. She completed a master’s degree in engineering. She has lived with her boyfriend for the past 5 years.
Patient is an alert young woman, sitting comfortably on the examination table. BP 112/66 mm Hg; HR 62 BPM and regular; respiratory rate 12 breaths/min; temperature 100.3°F. Several erythematous plaques scattered over the cheeks and the bridge of nose, sparing the nasolabial folds. Normocephalic, atraumatic. Sclera white, conjunctivae clear; pupils constrict from 4 mm to 2 mm and equal, round, and reactive to light and accommodation. Oropharynx moist with erythema in the posterior pharyngeal wall; no exudates; shallow ulcers in the buccal mucosa bilaterally. Neck supple without cervical lymphadenopathy or thyromegaly. Full range of motion; no swelling or deformity; muscles with normal bulk and tone. Get The Best Essay Writing Service Online with HelpHub
Why Work with Us
Top Quality and Well-Researched Papers
We always make sure that writers follow all your instructions precisely. You can choose your academic level: high school, college/university or professional, and we will assign a writer who has a respective degree.
Professional and Experienced Academic Writers
We have a team of professional writers with experience in academic and business writing. Many are native speakers and able to perform any task for which you need help.
Free Unlimited Revisions
If you think we missed something, send your order for a free revision. You have 10 days to submit the order for review after you have received the final document. You can do this yourself after logging into your personal account or by contacting our support.
Prompt Delivery and 100% Money-Back-Guarantee
All papers are always delivered on time. In case we need more time to master your paper, we may contact you regarding the deadline extension. In case you cannot provide us with more time, a 100% refund is guaranteed.
Original & Confidential
We use several writing tools checks to ensure that all documents you receive are free from plagiarism. Our editors carefully review all quotations in the text. We also promise maximum confidentiality in all of our services.
24/7 Customer Support
Our support agents are available 24 hours a day 7 days a week and committed to providing you with the best customer experience. Get in touch whenever you need any assistance.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
No need to work on your paper at night. Sleep tight, we will cover your back. We offer all kinds of writing services.
No matter what kind of academic paper you need and how urgent you need it, you are welcome to choose your academic level and the type of your paper at an affordable price. We take care of all your paper needs and give a 24/7 customer care support system.
Admission Essays & Business Writing Help
An admission essay is an essay or other written statement by a candidate, often a potential student enrolling in a college, university, or graduate school. You can be rest assurred that through our service we will write the best admission essay for you.
Our academic writers and editors make the necessary changes to your paper so that it is polished. We also format your document by correctly quoting the sources and creating reference lists in the formats APA, Harvard, MLA, Chicago / Turabian.
If you think your paper could be improved, you can request a review. In this case, your paper will be checked by the writer or assigned to an editor. You can use this option as many times as you see fit. This is free because we want you to be completely satisfied with the service offered.