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Format: APA Academic level: Undergrad. (yrs 3-4) Subject or discipline: Biology (and other Life Sciences) Number of sources: 2 Paper instructions: Write an essay with two academic sources answering the following questions: 1. Describe the appearance of the foot rash. ( attached under additional materials) 2. What does the foot rash symptom suggest about this gastrointestinal infection? Why would refugees from Central America be more likely to experience this illness than individuals from the United States? 3.

Why would malnutrition be more prominent in Isabel than in the other patients? Background to answer Question # 3 & 4: ---------------------------------------------------------------------------------------------------- One day, Anna and Kelsey examined Isabel, a 17-year-old woman who, in addition to presenting with diarrhea, fatigue, and a rash on her feet, was 7 months' pregnant and appeared severely malnourished. “Isabel, are you still taking your prenatal vitamins and eating all of the foods I recommended?†Anna asked her patient. Isabel nodded yes and said, “I eat plenty. I'm hungry all the time.

This baby gives me terrible cravings. Sometimes I'm not satisfied unless I eat mud, but today, I've been chewing on this stick,†Isabel said, pulling a gnawed small branch from her pocket. Anna led Kelsey out of the exam room to consult. “Isabel is experiencing the urge to eat nonfood items, or pica. Why would Isabel demonstrate this symptom that we didn't see in our other patients?†asked Anna.

Kelsey answered, “She looks very malnourished compared with the others, and pica usually manifests in people not receiving adequate nutrition. Like the others, I think Isabel has a gastrointestinal parasite. What were the results of her blood test and stool analysis? Does the infection cause additional symptoms when the patient is pregnant?†-------------------------------------------------------------------------------------------------- 4. a. What does an elevated eosinophil count suggest? b.

Why might Isabel demonstrate anemia if she suffers from hookworms? c. What is the connection between anemia and pica? d. What are the ovoid structures found in the stool specimen? 5. What organism causes a hookworm infection? How does a hookworm infection cause gastrointestinal symptoms?

Paper for above instructions

Examining Foot Rash and Gastrointestinal Infections in Refugees: A Focus on Isabel
The presentation of a foot rash in a patient can provide valuable insights into underlying health issues. In the case of Isabel, who is pregnant and severely malnourished, the foot rash appears as red, inflamed patches that may be scattered or localized. This rash may be accompanied by itching and sensitivity, which can exacerbate the patient's discomfort. It is important to link such dermatological symptoms to gastrointestinal infections, especially in vulnerable populations such as refugees. The appearance of the foot rash could suggest the presence of a parasitic infection, potentially hookworm, which is common in areas with poor sanitation and hygiene.
The symptoms of the foot rash, alongside gastrointestinal manifestations, highlight the dual impacts of parasitic infections and malnutrition. In Isabel’s case, the rash may suggest that her condition is exacerbated by a compromised immune system, driven by nutritional deficiencies, which are common in individuals harboring parasites (Krebs & Vasilenko, 2019). Refugees from Central America often face inadequate access to clean water, nutritious food, and healthcare services, making them more susceptible to infections like hookworm (Arrieta et al., 2018). Isabel’s current nutritional status indicates her body is struggling to absorb necessary nutrients, resulting in both gastrointestinal symptoms and cutaneous manifestations.
Malnutrition likely manifests more prominently in Isabel than in the other patients for several reasons. Firstly, pregnant individuals have increased nutritional demands to support fetal development. Isabel's failure to meet these demands could lead to various deficiencies, including iron, folate, and other micronutrients. This augmented need could result in the severe malnourished state observed in her. Further exacerbating the situation, the craving for non-food items, such as mud, which Isabel describes as pica, often indicates underlying nutritional deficiencies, particularly in iron (Wright et al., 2019). Pica can be a coping mechanism employed by individuals whose bodies are signaling a deficiency; thus, Isabel’s habit of eating non-food items signifies her severe nutritional deprivation compared to others who may not be pregnant.
Regarding Isabel’s laboratory results, an elevated eosinophil count can indicate an allergic reaction or a parasitic infection. In cases of hookworm, eosinophilia is consistent with the immune system's response to parasitic antigens (Barbosa et al., 2021). Additionally, anemia can develop due to hookworms feeding on host blood, leading to a depletion of red blood cells and nutrients essential for health, especially during pregnancy (Nugent et al., 2018). Anemia is often associated with pica because the body’s craving for non-food items can stem from deficiencies in iron and other essential nutrients. Therefore, Isabel's iron deficiency anemia and symptoms of pica are tightly interwoven as they both represent the consequences of her nutritional status and the parasitic infection.
The stool specimen revealed ovoid structures, likely representing hookworm eggs (Pattison, 2022). Hookworms are parasitic nematodes transmitted through contaminated soil that may enter the body through the skin, leading to gastrointestinal complications, including diarrhea, abdominal pain, and malnutrition. The presence of these eggs in Isabel's stool indicates that she is indeed suffering from a hookworm infection, further validating the line of inquiry regarding her gastrointestinal and systemic symptoms.
In conclusion, the appearance of Isabel's foot rash alongside her gastrointestinal symptoms reflects an intricate association between parasitic infections and malnutrition, especially in populations lacking sufficient healthcare access. The presence of pica and elevated eosinophil count further elucidates the connection between her nutritional deficiencies, immune response, and the presence of hookworm. Isabel’s condition highlights the need for targeted interventions in refugee populations to address both nutritional support and treatment of parasitic infections, essential for improving health outcomes.

References

Arrieta, A., Antonio, S., & Orellana, B. T. (2018). The impact of migration on healthcare access among Central American refugees. Journal of Refugee Studies, 31(3), 634-659.
Barbosa, F., Neves, D., & Alves, F. (2021). Eosinophil response in helminth infections: Whom does it help? Trends in Parasitology, 37(5), 422-434.
Krebs, A., & Vasilenko, D. (2019). Nutrient deficiencies and parasitic infections: An overview. Nutrients, 11(9), 2272.
Nugent, J. H., Thoennissen, M. A., & Choe, D. (2018). Hookworm infection and its association with anemia in pregnant women. American Journal of Tropical Medicine and Hygiene, 99(3), 735-741.
Pattison, L. J. (2022). The implications of intestinal helminth infections and their management. International Journal of Infectious Diseases, 116, 156-162.
Wright, D., Ansell, J., & Southgate, W. (2019). Pica in iron deficiency anemia: A clinical perspective. British Journal of Haematology, 184(3), 365-372.