Case Study 3 & 4 (10 Points) Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same
Inflammatory Bowel Disease Case Stud y The patient is an 11 -year -old girl who has been complaining of intermittent right lower quadrant pain and diarrhea for the past year. She is small for her age. Her physical examination indicates some mild right lower quadrant tenderness and fullness. Studies Results Hemoglobin (Hgb) , 8.6 g/dL (normal: >12 g/dL) Hematocrit (Hct) , 28% (normal: 31% -43%) Vitamin B 12 level, 68 pg/mL (normal: 100 -700 pg/mL) Meckel scan, No evidence of Meckel diverticulum D-Xylose absorption, 60 min: 8 mg/dL (normal: >15 -20 mg/dL) 120 min: 6 mg/dL (normal: >20 mg/dL) Lactose tolerance, No change in glucose level (normal: >20 mg/dL rise in glucose) Small bowel series, Constriction of multiple segments of the small intestine Diagnostic Analysis The child's small bowel series is compatible with Crohn disease of the small intestine. Intestinal absorption is diminished , as indicated by the abnormal D-xylose and lactose tolerance tests. Absorption is so bad that she cannot absorb vitamin B 12. As a result, she has vitamin B 12 deficiency anemia. She was placed on an aggressive immunosuppressive regimen, and her condition improved significantly. Unfortuna tely, 2 years later she experienced unremitting obstructive symptoms and required surgery. One year after surgery, her gastrointestinal function was normal , and her anemia had resolved. Her growth status matched her age group. Her absorption tests were nor mal, as were her B 12 levels. Her immunosuppressive drugs were discontinued, and she is doing well. Critical Thinking Questions 1. Why was this patient placed on immunosuppressive therapy? 2. Why was the Meckel scan ordered for this patient? 3. What are the clinical differences and treatment options for Ulcerati ve Col itis and Crohn ’s Disease? (alwa ys on boards) 4. What is prognosis for patie nts with IBD and what are the follow up recommendations for managing disease ?