Assignment: Crohn’s Disease Case Study

Assignment: Crohn’s Disease Case Study

Assignment  Crohn’s Disease Case Study

Case Overview

The case study is of a female patient 18-years of age with complaints of recurrent abdominal pain for two weeks. She also has a history of cramping, low-grade fever, loss of appetite, diarrhea, and Crohn’s disease. The patient admits to smoking in the last two years, half a packet per day but denies substance or alcohol use.

Differential Diagnosis

Chron’s Disease Flares. Flares are a recurrence of Crohn’s disease (CD) symptoms for individuals with a history of CD. It causes inflammation in the gastrointestinal (GI) tract resulting in nausea, abdominal cramps, diarrhea, rashes, rectal pain, and joint pain (Ko, Abraham & Shih, 2018). During an episode of flares, there is an increase in body temperature due to inflammatory mediators’ production. Possible causes of flares are NSAIDs, smoking, stress, and disruptions in medications (Panés & Rimola, 2017). The presence of CD flares is a probable diagnosis based on positive symptoms of cramping, diarrhea, low-grade fever, loss of appetite, as well as a history of CD and smoking.

Giardiasis: It is a diarrheal disease that presents with symptoms of diarrhea, flatulence, abdominal cramps, nausea, vomiting, low-grade fever, loss of appetite and weight loss (Tontini et al., 2015). In the present case, this is a possible diagnosis based on the positive symptoms of diarrhea, abdominal cramps, loss of appetite, and low-grade fever.

Amebic colitis: Amebic colitis develops gradually and with diarrhea as a typical symptom. Other clinical symptoms include abdominal cramping, rectal bleeding, loss of appetite, weight loss, and fever, which last for 1-2 weeks (Tontini et al., 2015). Amebic colitis is a probable diagnosis based on the patient’s history of diarrhea, abdominal pain for two weeks, low-grade fever, and loss of appetite.

Important Focused Physical Exam Findings

Abdominal masses: A discrete mass or abdominal fullness, especially in the right lower quadrant, indicates an involvement of the ileum (Panés & Rimola, 2017). A patient having an inflamed bowel may have a palpable mass which results from thickening of the colon.

Abdominal tenderness: Diffuse localized pain on palpation is a clinical sign of GI inflammation (Ko, Abraham, & Shih, 2018). Tenderness in the left lower quadrant mostly results from inflammation in the sigmoid colon.

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Rectal examination findings:  Positive examination findings of rectal fistulae, ulcers, skin tags, abscesses, and scars are indicative

of CD (Panés & Rimola, 2017). A digital rectal examination would be helpful to assess the sphincter tone and detecting abnormalities in the mucosa of the rectum.

Diagnostic Tests

In the present case, Barium contrast radiology will be useful in detecting and staging the inflammation process as well as identifying

lesions in the small bowel that indicate a CD diagnosis (Ko, Abraham & Shih, 2018). Further, inflammatory markers test will also play a fundamental role. This test will include assessing the level of C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR). They will be useful in making a diagnosis and predicting the development of CD (Loddo & Romano, 2015). CD presents with elevated levels of CRP and ESR due to GI inflammation. Lastly, a stool culture test will also be conducted.  Stool samples will be tested to identify if there are ova, parasites, occult blood, white blood cells, pathogens, and Clostridium difficile toxins.

Treatment Plan

Medications: Metronidazole 500 mg PO TDS for 5 days; it acts as a

Oral Prednisone 40mg/day for 7 days; to decrease inflammation.

Imodium 2 mg Qday for 2 days; to relieve diarrhea.

Delzicol 800 mg PO TDS; for long term maintenance and prevention of remissions.

Health Education: I will recommend the patient to quit smoking since it triggers CD flares and is a causative factor of major respiratory and chronic conditions (Loddo & Romano, 2015). Besides, I will advise the patient to avoid NSAIDs and spicy foods since they cause flares. I will further advise the patient to prevent stress by adopting coping mechanisms since stress causes remission of flares.

Follow-up: The patient will be scheduled for a monthly follow-up for evaluation of progress and re-evaluation of treatment.

An 18 year old white female presents to your clinic today with a 2 week history of intermittent abdominal pain. She also is positive for periodic cramping and diarrhea as well as low grade fever. She also notes reduced appetite. She notes that She admits smoking ½ PPD for the last 2 years. Denies any illegal drug or alcohol use. Does note a positive history of Crohn\’s Disease. Based on the information provided answer the following questions:
What are the top 3 differentials you would consider with the presumptive final diagnosis listed first?
What focused physical exam findings would be beneficial to know?
What diagnostic testing needs completed if any to confirm diagnosis?
Using evidence based treatment guidelines note a treatment plan.

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Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource