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James; 54 y/o male. Presenting symptoms: psoriasis; skin is red and…
James; 54 y/o male. Presenting symptoms: psoriasis; skin is red and inflamed; racing anxious thoughts, poor sleep onset; joint pain and swelling.
Bodily systems
Immune system. impacted by overstimulation / dysregulation of the nervous sx. Immunity may have been poor in childhood.
Integumentary system. Current state of the skin suggests poor immune function and genetic predisposition. Skin condition is dry, irritated, inflamed, itchy on elbows, shin and scalp.
Musculoskeletal system. Swelling and pain at areas of previous bone injuries and knees (mostly in morning). Could suggest arthritis (rheumatoid or psoriatic) pathophysiology and immune system involvement.
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Predisposing: Father & brother has psoriasis suggesting genetic link. Father also has arthritis which may explain joint pain / swelling. Asthma as a child suggesting weakened immune system and susceptibility.
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Exciting: Sweating / physical movement worsens the psoriasis. Stress: racing anxious thoughts leading to poor sleep hygiene thus impacting upon nervous sx and immunity.
Sustaining: poor immune function i.e. asthma, glandular fever, infections. Anxiety/racing thoughts: the nervous system is overstimulated thus impacting upon immune function leading to issues w/ integumentary system.
Dietary habits: high caffeine consumption, high carbohydrate consumption and low healthy fatty acids (essential for skin health) and low amounts of fruit and vegetables. He is drinking beer to alleviate anxiety and stress yet could contribute to his liver inflammation thus his mental health state due to connections of liver and central nervous system.
Sport injuries: in left scapula, radius broken bones leading to arthritis susceptibility.
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lab tests: liver enzyme issues (AST elevated), ALT elevated showing hepatic damage/inflammation.
Lactate dehydrogenase is significantly elevated indicating tissue damage to an organ; possibly the liver if AST & ALT are high.
ESRate is high indicating inflammation, possible inflam cond. May be due to arthritis as father has arthritis.
Treatment Aims
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Assist w/ the production of GABA to ease anxiety and racing thoughts to assist w/ sleep. anxiolytic actions/
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Nervous system. Racing thoughts, poor sleep onset, general stress
Digestive System.
impacted by use of NSAID'S (GIT blood clot); chronic use of glucocorticoids (immunosupression). Current diet is high in carbohydrates/ some minor GIT disruptions.
Organ: Liver. Enzymes are elevated; indicates inflammation. Poor functioning of liver may contribute to digestive issues.
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