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You are a gastroenterologist and assessing a 2-year-old child rushed to the clinic. Upon assessment, the patient is irritated but weak and pale. The skin is dry and the area around the eyes is sunken. According to the mother, the patient has been vomiting for a day and
the stool is clear and watery. Based on your understanding of digestive structures, how will you explain the appearance of the symptoms?
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- In the clinical setting, one often uses a differential diagnosis. This proccess differentiates between possible diagnoses bases on the person’s symptoms. Here you will demonstrate your knowledge of the gastrointestinal system to either confirm or reject potential diagnosis. A 50-year old, slightly obese individual presents to your clinic with the following symptoms: severe abdominal pain, especially in the left side. However the patient also complains the pain radiates to the right side. They have nausea and have been vomiting for the past several days. Upon examination, you find abdominal tenderness and constipation. The patient is of Asian descent, has been a smoker for the past 20 years, reports frequent alcohol use (>7drinks/week) and takes aspirin on a daily basis (nonsteroidal anti-inflammatory drug). Will age, weight, lifestyle and ethnicity play a role in your diagnosis? Based on the patient’s symptoms, the list of differential diagnoses is extensive as follows: Acute…“A 48-year-old male complains of abdominal discomfort after meals, especially, high fat meals. At those times he also has aching in his right shoulder and back. An ultrasound of the upper abdomen revealed cholelithiasis. A consult with a gastroenterologist determined that cholelithotripsy was considered but it was decided that a laparoscopic cholecystectomy would be the first procedure attempted. If complications were encountered then an open cholecystectomy would be performed. Significant medical history: patient had a coronary angiography performed at age 46 following suspected MI (myocardial infarction). -Give definitions for the BELOW medical terms taken from the Medical Record:” ultrasound - cholelithiasis - gastroenterologist - cholelithotripsy - laparoscopic cholecystectomy - open cholecystectomy - coronary angiography - MI (myocardial infarction) -Mrs. Gina Ryan, a 52-year-old court stenographer, was admitted to the nursing unit from her physician's office. She had a gnawing pain on. her right side radiating to her back for 3 days. she now describes her pain as "excruciating after eating or drinking". In the past 48 hours she has been vomiting about 2 to 3 hours after she eats. she has not had anything to eat or drink for the past 12 hours. Mrs. Ryan stated that she had not been successful in adhering to the weight reduction diet that had been prescribed by her physician and that she had rapidly lost, then regained, weight several times in the past year and a half. She stated, "My life is just too busy - I work late hours in the court system and had to buy my meals put a lot". She indicated that in addition to her work, she and her husband share the responsibility for raising their two teenage daughters. Admission physical examination revealed BP-130/80, PR-102, RR-24, Temp-37.3, height - 5'7", weight - 122kg, skin warm, no…
- An overweight 45-year-old female patient is seen by the primary care physician. She complains of a severe colicky pain in her right upper quadrant about 2 hours after meals but is otherwise healthy. After a history and physical, the physician diagnosis the patient with cholelithiasis.1. Describe the condition and causes of cholelithiasis.2. What are three possible treatments for this condition?3. How would a patient’s diet affect this conditionA 56-year-old male patient with a personal history of colonic polyps presents to the outpatient surgery department for a colonoscopy to rule out colon cancer. The patient has been experiencing rectal bleeding for approximately six weeks and has lost a significant amount of weight. A colonoscopy to the terminal ileum is performed. Just beyond the rectal vault, two polyps are found and excised by hot biopsy forceps. Further up into the sigmoid colon, a lesion was biopsied. The pathology report confirms a diagnosis of colon cancer in the lesion found and the polyps were found to be villous adenoma. What are the two CPT codes?All of the following regions / structures demonstrate simple columnar cells (microvilli) with goblet cells EXCEPT for the? 1. middle of the esophagus 2. distal end of the esophagus 3. stomach 4. duodenum 5. jejunum 6. ileum Choose from the following: (A) 1 and 2 (B) 1, 2, and 3 (C) only 3 (D) 4 and 5 (E) 5 and 6
- Intrinsic Factor is a protein that plays a role in how the body absorbs Vitamin - This protein is secreted by the cells which are found in the gastric mucosa. A 75 year old male who recently had surgery on the ileum presents with a beefy red tongue. He reports feeling extremely fatigued and numbness and tingling in the hands. The doctor orders a peripheral blood smear. Based on your knowledge of this chapter, he is most likely to be diagnosed with and is ordered to receive supplementary Vitamin by intramuscular injection.The patient turned to the doctor with complaints of general weakness, sleep disturbances. Objective: the skin is yellow. In the blood: increased amount of direct bilirubin, bile acids. Acholic feces. What state is characterized by these changes? Justify the answer.The Digestive System Mr. McArthur is hospitalized with pancreatitis and cholecystitis. Neither his gallbladder nor his pancreas is functioning normally at this time. The client is placed on an NPO (nothing by mouth) diet order, given intravenous fluids and pain medication. The nurse is aware that the pancreas has two functions: one being endocrine, secretion of hormones to assist with glucose control, and the other being exocrine, aiding the digestive system. Mr. McArthur is scheduled for gallbladder removal in the morning to treat the cholecystitis. 1. The client asks what his gallbladder does. What is the nurse’s best response? 2. The client also asks how the pancreas works to help with digestion. What will the nurse tell him
- TYPICAL STRUCTURE OF THE ALIMENTARY TUBE 1. Match each layer of the alimentary tube with the proper descriptive statements. Use each letter once. Two answer lines will bave three correct letters, and two will have two correct letters. A. Includes the epitchelial tissue that lines the organ B. Above the diaphragm; made of fibrous connective tissue C. Made of areolar connective tissue D. Secretes mucus and digestive enzymes E. Made of two layers (typically) of smooth muscle E Contains lymph nodules to destroy pathogens G. Contains Meissner's plexus, enteric nerves that regulate secretions of the mucosa 1) Mucosa 2) Submucosa 3) External muscle layer 4) Serosa H. Contains Auerbach's plexus, enteric nerves that regulate peristalsis I. Below the diaphragm; is the mesentery J. Provides mechanical digestion and peristalsisA 56-year-old man who is an alcoholic presents with a 2-week history of mid-abdominal pain. He also describes clay-colored stools, mild icterus, nausea, vomiting, and a 10-lb weight loss. Laboratory results in the picture QUESTION: Explain the significance of the patient's laboratory test results.A nurse is scheduling tests for a patient who has been experiencing epigastric pain. The physician ordered the fol-lowing tests: (a) barium enema, (b) fecal occult blood test, (c) endoscopic studies, and (d) upper gastrointestinal series.Which is the correct order in which the tests would normallybe performed?a. c, b, d, ab. d, c, a, bc. a, b, d, cd. b, a, d, c