Assignment 5: Aspirin and NSAIDS
Assignment 5: Aspirin and NSAIDS
Tom, a 26-year-old runner, came into the office today complaining
of constant pain in the right ankle. While running his usual route,
he accidentally stepped on a branch lying in his path, twisting his
ankle inward. He denies hearing a “pop.” He was able to walk, or
limp, the remaining ¼ mile back to his home, where he
immediately elevated and iced the ankle for 30 minutes. He took
two acetaminophen 325 mg, showered and dressed for work, and
drove to his place of employment. He continued to experience
significant pain in the ankle, worse when walking. His foot became
swollen. Since his job in a sporting goods store requires that he be
on his feet most of the day, he was unable to continue his normal
workday, and made a same-day appointment to be seen. He has
no chronic diseases, takes no medication, and denies recent use
of NSAIDs, as aspirin and ibuprofen cause him to have gastritis. He
sprained the ankle last year, but was able to manage that injury at
home.
Assessment
A 26-year-old, otherwise healthy male presents limping into the
examination room, holding his right shoe in his hand. He grimaces
with partial weight-bearing of the affected foot. He has local
ecchymosis and 1+ edema over the anterolateral ligaments of the
right ankle. Capillary refill, pulses, and sensation of the foot and
toes are intact. There is no lateral or anterior instability of the joint
or tendons. X-ray of the ankle and foot are negative for fracture or
dislocation. He has a grade I lateral ankle sprain.

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