case study

Thanks so much for making your appointment with me, Janessa!

I hope you are having a wonderful start to your Spring 😊 It is warm and humid here in North Carolina. The pups and I have been making the most of it and wandering through the different trails here in the area.

As a reminder, please note we only have a set amount of time for your review before we have to move on to our next appointments. However, during that time, we will be able to cover quite a bit! In addition to this, as a Walden student, you are permitted to have up to two writing appointments per week (and you can send an unlimited about of questions between appointments to our email address I will give you below 😊). This means that we can work on this, or other documents, later this week if you would like. You are also able to make appointments ahead of time to guarantee you have a slot booked! As per your review form, you would like this review to focus on:

Case Study Analysis

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According to the signs and symptoms presented by the 14-year-old female, the patient is suffering from immune thrombocytopenia purpura (ITP). Remember you will want to use your own ideas to frame your paragraphs and sections so that you can use your research to back your ideas and make your claim more successful. In starting with the research of others you lose the ability to gain the readers trust in your writing and research, and you also lose the ability to fully develop a clear and focused subject matter that works cohesively with your research.

ITP is a disorders that results in easy and excessive bruising and bleeding (Mayo Clinic, 2021). The bleeding is caused by unusual low levels of platelets, the cells that help in blood clotting. Children may contract ITP following a viral infection and can recover fully without any treatment interment. However, if a patient has severe bleeding, platelet count may be low and thus he or she might need medication intervention to boost their platelet count. A surgery may also be done to remove spleen. This is a good start, but I would like to see you build up your introduction a little further. There are a few things I think you could do that would help with this:

1. Work on revising your topic sentence for your introduction. You have good information here, but it does not make the reader fully aware of what this document is going to be about. Also, remember another name for a topic sentence is a “topic sentence” because it is meant to topic sentence the reader into the information that you are presenting. This helps people focus on what you are writing about and no accidentally speed-read or skim any information. When you have a strong topic sentence in each paragraph, especially your introduction, you will constantly re-topic sentence your reader

2. Work on fleshing out some of your ideas in your introduction. Right now, you have a good start but take it a little further and provide more of a background to your reader.

Work on revising your thesis statement. Remember, much like how your topic sentence sets the tone for your paragraph, your thesis statement sets the tone for your entire document. A strong thesis statement should be able to read, on its own, out of context, and the reader should know what the focus of the document is meant to me. If you have any questions as you continue to revise this document, please reach out to [email protected] and make your subject ATTN: Meghan K. Barnes, and I will be sure to respond personally.

The 14-year-old has presented significant signs associated with ITP. Remember all information that is not your own original thoughts needs a citation after each sentence. It seems like you have quite a bit of information here that needs citations but does not have any. This would be considered unintentional plagiarism but could be early correct, so don’t worry! Please remember this is still considered plagiarism and will need to be immediately corrected.

Her mother reported that she had an abnormal number of bruises and “funny looking red splotches” on her legs. The patient was also found to have low platelet count. Also, the patient’s gums were slightly bleeding after she bushed her teeth that morning (Mayo Clinic, 2021). These are major symptoms presented by patients suffering from ITP. Other symptoms associated with ITP include blood in urine or stools and unusual heavy menstrual flow. I would like to see you include 1-2 sentences of analysis here as well, to inform better your reader of the connections you are making here. Often, we will find that a reader may be coming to different conclusions than what we anticipated. Many times, this is caused because the writer has not created clear connections between their sources. The only way to be sure that the reader will see these sentence-level, paragraph-level, and essay-level connections are if you, as the writer, clearly make those connections for them.

ITP is an acquired thrombocytopenia caused by autoantibodies that destroy platelet antigens. Also, ITP can be as a result of an underlying conditions such as HIV infection, chronic lymphocytic leukemia, systemic lupus erythematous, or hepatitis, which cause low platelet count. On the other hand, thrombotic thrombocytopenic purpura (TTP) it is a rare blood disorder characterized by clotting in small blood vessels, thrombosis, causing a low platelet count. Medication interventions for ITP include steroids, immune globulin, and other drugs that boost platelet production such as romiplostim and eltrombopag, which help bone marrow produce more platelets. If ITP is severe, a doctor may recommend surgery to remove the spleen. Surgery eliminates the source of platelet destruction (Mayo Clinic, 2021). Remember you want to try to end on your own original thoughts when you are writing academic essays or documents. This not only allows the reader to better understand your presentation of your argument and your research, but it allows you to better synthesize your writing. Think of your original synthesis and writing as the mortar holding a brick wall together, and the sourced material as the bricks. Without the mortar holding the bricks together, they would not be able to form a wall. Much like that without your own argument and ideas connecting the sourced materials together and to your argument, the reader will not be able to build the wall (or their understanding) themselves.

Questions

1. The factors that affect fertility (STDs).

If left untreated, STDs can cause infertility. For instance, gonorrhea and chlamydia, if left untreated, may spread to fallopian tubes or the uterus and cause pelvic inflammatory disease (PID), which can result in inflammation, blockage and scarring of reproductive organs such as the uterus and fallopian tubes (Low & Broutet, 2017). Comment by Meghan K. Barnes: Note that the acronym uses all capital letters, and there are no periods between the letters. To use an abbreviation, write out the term or phrase on first use, followed by the abbreviation in parentheses. See these examples: The patient had been diagnosed with traumatic brain injury (TBI) in March of the previous year. Walden students need to know how to cite information using the American Psychological Association (APA) guidelines.

2. Why inflammatory markers rise in STD/PID.

Gonorrhea and chlamydia in acute PID is linked with increased level of inflammatory markers such as ESR, CA-125 and CRP. A high level of CRP in the blood is an inflammation marker and it is caused by a number of conditions such as STDs. As a reader I am not quite sure if I do not understand the presentation of these materials because I do not have enough of a basis of understanding to, or if they may be presented in a confusing way. I think it would be best to have your Professor or chair review this to make sure that the clarity is where you would like it to be.

3. Why prostatitis and infection happens. Also explain the causes of systemic reaction.

Prostatitis is inflammation of the prostate gland and can be as a result of an infection as well as other causes. Prostatitis is often caused by common strains of bacteria. The infection may start when a bacteria in the urine leaks to the prostate gland. Infections are caused by bacteria. An infection occurs when viruses, bacteria or other microbes enter the body and start to multiply. Vagina is prone to infection, which are as a result of bacteria found in the vagina, yeast or bacteria contracted through sexual contact. This is a section I would love to see you revise. Right now, you have some strong ideas, but some of them are not presented fully or cohesively. Reading your work out loud will help you with revising this section and making sure that each sentence works on its own as well as work with the rest of the section.

Systemic reaction occurs when inflammation spread from one body other organ systems in the body. It can be as a result of allergies, infections or toxins.

4. Why a patient would need a splenectomy after a diagnosis of ITP?

After the diagnosis of ITP, splenectomy is the medical intervention used to remove spleen from the body which result in low platelet count. In people with ITP, the immune system treats platelets as foreigners and destroys them. The spleen is responsible for the removal of the damaged platelets and therefore removal of spleen helps keep more platelets in the body. Splenectomy involves a surgical process to remove the spleen (Mayo Clinic, 2021).

5. Anemia and the different kinds of anemia (i.e., micro and macrocytic).

Anemia is a condition where a person lacks enough health red blood cells to carry enough oxygen to the body tissues. Anemia makes a person feel tired and weak. Different types of anemia include sickle cell anemia, vitamin deficiency anemia, thalassemia, iron deficiency anemia, and aplastic anemia. Anemia is classified into two broad categories, microcytic and macrocytic. In microcytic anemia, the red blood cells are smaller than normal while in macrocytic anemia, red blood cells are larger than normal. The difference helps doctors to identify the cause of anemia (Stauder, Valent & Theurl, 2018). Expand this a bit further to make this a more concrete statement. Can you give the reader the firm How & Why of this within this sentence? This would make your conclusive statement not only stronger—but provide the reader with the exact take-away you want them to have upon completing reading this document.

References Comment by Meghan K. Barnes:

Low, N., & Broutet, N. J. (2017). Sexually transmitted infections—Research priorities for new challenges. Use the links to the right to finish this reference entry. I am not sure if this is a website or a journal article.

Mayo Clinic. (2021). Immune thrombocytopenia (ITP). Sentence case and italics here https://www.mayoclinic.org/diseases- conditions/idiopathic-thrombocytopenic-purpura/diagnosis-treatment/drc-20352330

Stauder, R., Valent, P., & Theurl, I. (2018). Anemia at older age: Eetiologies, clinical implications, and management. Blood, 131(5), 505-514. <-= Your DOI is missing here

APA 7

Scholarly Writing

Paragraph Formatting/Overall Structure