A 52-year-old woman presented to a gastroenterologist with a 3-month history of progressive left lower quadrant...

A 52-year-old woman presented to a gastroenterologist with a 3-month history of progressive left lower quadrant abdominal pain, weight loss, and fatigue. In the last few days she had noted bloody stool. A colonoscopic examination with biopsy revealed an obstructing adenocarcinoma of the sigmoid colon. The patient underwent a partial colectomy and colostomy placement. Past medical history was noteworthy for ulcerative colitis, which was diagnosed when the patient was 24 years old but which had not required extensive medical care. The patient's previous clinical encounters had been limited to preventive visits to her gynecologist, who had never discussed her ulcerative colitis and had not recommended periodic colonoscopy or sigmoidoscopy.

1) What are the patient's risk factors and

(2 What are the gaps in healthcare/risk assessment

APA citation

Expert Solution

ulcertive colitis is long term illness of the colon characterized by a period of remission and a period of excerabation, mainly affect colon and rectum. it leads carcioma of colon. an individual ith ulcerative colitis develops carcionoma 2% after 10 years, 8% after 20 years and 18% after 30 years.

adenocarcioma of sigmoid colon is a cancer that occurs in the lining of mucous producing glands of large intestine. Risk factors of adenocarcioma are familyhistory of cancer, history of inflammatory bowel disease for 10yeras, has history of villous adenoma. it occurs in age between 40-50, increases with age and life style factors include smoking, alcohol, obesity, higher consumption of red meat.

1.This 52 year old women has had history of ulcerative colitis for the last 30 years and age is another risk factor for her. adenocarcinoma increases with age

2. The gaps occurs for her in order to find her disease, are instruction regarding follow up and advise to visit gastroenterologist to check for colonoscopy and sigmoidscopy as she has history of ulcerative colitis for more than 30years. she should be educated regarding stool occult blood test and fecal immunochemical test yearly and a double contrast enema every years,colonoscopy every 10 years

even though causes of adenocarcinom is unknown, risk factors to be kept in mind and educate to visit and review medical condition.. thereby chances of disease can be reduced to maximum.

Nightingale answered 2 years ago

A 55 year old woman presented to her family with a 3 day history of burning...

A 55 year old woman presented to her family with a 3 day history of burning and pain over her left forearm. The symptoms were rather abrupt in onset, and she had not experienced anything like this before. Over the previous 2 days, several vesicles had developed in a band like distribution on her arm, and new ones were erupting daily. On the day she went to see her family doctor, the lesions had started turning purplish. At no time...

A 54-year-old woman presented with a 1-month history of intermittent, burning epigastric abdominal pain that was...

A 54-year-old woman presented with a 1-month history of intermittent, burning epigastric abdominal pain that was moderately severe in intensity. Her pain radiated toward her back in a band-like fashion. She also noted nausea and vomited once, with the vomit consisting of food particles. The patient denied having signs and symptoms of melena, hematochezia, or hematemesis. Her medical history was significant for peptic ulcer disease, and the patient had had multiple endoscopies in the past 6 years. It was learned...

A 36-year-old woman presents to the emergency room with a history of right upper quadrant pain,...

A 36-year-old woman presents to the emergency room with a history of right upper quadrant pain, shaking chills and jaundice. This pain came on suddenly 6 hours earlier and has been progressing. She took her temperature at home and it was 102 F. She vomited once at the onset of pain. She has had intermittent episodes of epigastric and right upper quadrant pain after eating, for the past 6 months. The pain always abated after 30-60 minutes. Her BP is...

M.E. is a 66 year old woman who has a 2-year history of progressive forgetfulness. After...

M.E. is a 66 year old woman who has a 2-year history of progressive forgetfulness. After a neurological evaluation, M.E. was diagnosed as having Alzheimer Disease (AD). She is no longer able to care for herself, has become increasingly depressed and paranoid, and recently started a fire in the kitchen. Her husband and children have come to the Alzheimer unit at your extended care facility to seek information about AD and discuss the possibility of placement for M.E. You assure...

A 21-year-old woman presented to the emergency department of an urban hospital with a history of...

A 21-year-old woman presented to the emergency department of an urban hospital with a history of systemic lupus. Her complaint was dehydration, dizziness, and feeling faint. The woman also had a recent history of being dehydrated, complicated by renal involvement from lupus and having to receive bolus fluids. She was on multiple medications, including steroids and methotrexate. An intravenous (IV) line was started, and blood was drawn for labs. The emergency department physician returned to report that the lab values...

A 45-year-old woman presents with a history of progressive weakness, fatigue, weight loss, nausea and increased...

A 45-year-old woman presents with a history of progressive weakness, fatigue, weight loss, nausea and increased skin pigmentation (especially of creases, pressure areas and nipples). Her blood pressure is 120/78 mmHg when supine and 105/52 mmHg when standing. LAboratory findings reveal serum sodium of 120 mEq/L (normal is 135 - 145 mEq/L); potassium level of 5.9 mEq/L (normal is 3.5 to 5 mEq/L); and low plasma cortisol and high ACTH levels. A. What diagnosis would this woman's clinical features and...

Monica Williams is a 32-year-old woman who presents with a 3-month history of nervousness, tremor, palpitations,...

Monica Williams is a 32-year-old woman who presents with a 3-month history of nervousness, tremor, palpitations, increased sweating, and discomfort with heat. She has lost 20 pounds over the last 3-months, despite a voracious appetite. Monica also complained of muscle weakness and fatigue with exercise at a level to which she was ordinarily accustomed. Physical exam revealed a heart rate of 110 beats/minute, respirations at 20/minute, and a blood pressure of 150/60. Her skin was warm and moist, her speech...

Match left hypochondriac region epigastric region right inguinal region right upper quadrant left lower quadrant A....

Match left hypochondriac region epigastric region right inguinal region right upper quadrant left lower quadrant A. position of the stomach B. Where you can find the esophagus C. where is localized the appendix D. patient reflects pain in this area due to the accumulation of stones in the kidney E. woman diagnosed with ovarian cyst exhibits pain in this area

A 43-year-old woman presented to her family physician with a two-year history of fatigue, diarrhea, and...

A 43-year-old woman presented to her family physician with a two-year history of fatigue, diarrhea, and constant dull abdominal discomfort. Stools were described as normal in frequency and intermittently loose in consistency. The patient, a marine biologist with an extensive travel history, noticed that her symptoms began after a busy year of fieldwork in Iceland, Denmark, and the Arctic, during which she began regularly consuming raw sushi and sashimi. Serum vitamin B12 was 157 pmol/ L, compared to a level...

Brenda, a 74-year-old woman with a history of rheumatic fever while in her twenties, presented to...

Brenda, a 74-year-old woman with a history of rheumatic fever while in her twenties, presented to her physician with complaints of increasing shortness of breath ("dyspnea") upon exertion. She also noted that the typical swelling she's had in her ankles for years has started to get worse over the past two months, making it especially difficult to get her shoes on toward the end of the day. In the past week, she's had a decreased appetite, some nausea and vomiting,...

Question