Question

Discuss the underlying pathophysiology of the following patient. Describe the alterations in health and treatment modalities. Please respond thoughtfully and respectfully

Mrs. Sullivan is a 54 year old female patient that is being admitted to your medical floor from the emergency room. Mrs. Sullivan has a history of Crohn’s disease and is having a major flare up of this disease. She reports that she is having approximately 20 loose bloody stool per day. She came to the emergency room with dizziness and the sudden confusion. She was brought in by her adult son. She is having moderate abdominal pain that is intermittent. She has been incontinent of a small amount of tea colored urine that is foul smelling.

Labwork:

WBC: 20.1

RBC: 10.2

Hb: 6.5

Pt: 214

BUN: 34

Cr: 2.5

Vital signs:

BP: 78/40

P: 220

R:16

T:101.5

Answer 1

Crohn's disease is a chronic inflammatory disease of intestine.This women has Crohn's entero_colitis and ileo_ coitis, where inflammation is small intestine and colon occurs which gives typical symptoms of bloody diarrhoea and abdominal pain.

The cause is unknown may be because of mycobacterium>leads to small , shallow,crater like ulceration (aphthous ulcer)>>scarring and stiffness of bowel>>bowel narrow>>Obstruction of food,gas, fluid to pass in to colon>>symptoms like and pain, bloody diarrhoea, nausea, vomitting, alterations in blood values.

He laboratory results predict that she has severe infection

WBC is increased ,fever

She has severe anaemia because her HB is decreased because of bloody diarrhoea

She has a low BP due to fluid loss and to combat it the pulse have increased.She is simultaneously experiencing dizziness

These all resulted in affecting the kidney with its function, because when there is low HB,low BP,the kidney cannot do it's function resulting in increased creatinine levels,BUN levels are elevated.This a significant significant glomerulonephritis where tea colour urine occurs.

Treatment modalities generally includes topical antibiotics,immunology modulant and corticosteroid are given very cautiously because it can worsen the renal function.Mild inflammatory drugs are administered.

A IV therapy and TPN(Total Parenteral Nutrition) can ideally help her to regain her lost minerals etc.,

Urine output has to be closely monitored.

A low fibrre diet Can be given but initially liquid diet is preferred.

If nothing has helped surgery is the choice of treatment but there are also chances of recurrence.