Mr. Ahmadi, an out-of-shape 45-year-old man, was advised by his physician to lose weight and to exercise on a regular basis. He followed his diet faithfully and began to jog daily. One day, while on his morning jog, he heard a snapping sound that was immediately followed by a severe pain in his right lower calf. When his leg was examined, a gap was seen between his swollen upper calf region and his heel. He was unable to plantar flex that ankle.

Local anesthetics block voltage-gated Na+ channels. General anesthetics are thought to activate chemically Cl- gated channels, thereby rendering the nervous system quiescent while surgery is performed.

• What specific process do anesthetics impair, and how does this interfere with nerve impulse transmission? 

• Discuss and described the pathophysiology and symptomology/clinical manifestations of Hyperandrogenism.
• Discuss three differential diagnoses for AUB with ICD 10 numbers for each.
• Discuss patient education.
• Develop the management plan (pharmacological and nonpharmacological).