Students Must Review The Case Study And Answer All Qu 061031

Students Much Review The Case Study And Answer All Questions With A Sc

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 document and upload 1 document to Moodle. Case Study 3 & 4 S Inflammatory Bowel Disease and Urinary Obstruction The answers must be in your own words with reference to journal or book where you found the evidence to your answer. Do not copy paste or use a past students work as all files submitted in this course are registered and saved in turn it in program. Answers must be scholarly and be 3-4 sentences in length with rationale and explanation.

No Straight forward / Simple answer will be accepted. All answers to case studies must have reference cited in text for each answer and minimum of 2 Scholarly References (Journals, books) (No websites) per case Study

Paper For Above instruction

Case Study 3: Inflammatory Bowel Disease

Inflammatory Bowel Disease (IBD), encompassing Crohn’s disease and ulcerative colitis, involves chronic inflammation of the gastrointestinal tract, often requiring immunosuppressive therapy as part of management. The decision to initiate immunosuppressive treatment in this 11-year-old girl was driven by the severity of her symptoms, evidence of small intestine involvement, and complications such as anemia and malabsorption, which indicated systemic immune dysregulation (Abraham & Cho, 2009). Immunosuppression aims to diminish inflammatory activity, induce remission, and prevent disease progression or complications, such as strictures or fistulas, especially in pediatric cases where growth and development are affected (Guslandi et al., 2014). The approach is tailored to control acute symptoms and maintain long-term remission, with medications including corticosteroids, immunomodulators, and biologics, depending on disease severity (Roda et al., 2020).

The Meckel scan was ordered to exclude Meckel’s diverticulum, which is a common differential diagnosis in pediatric patients presenting with abdominal pain and gastrointestinal bleeding. This nuclear medicine scan detects ectopic gastric mucosa that can cause bleeding, mimicking IBD symptoms; thus, it was prudent to rule out this alternative cause before confirming Crohn’s disease (Kudoh et al., 2019).

Clinically, Crohn’s disease and ulcerative colitis differ markedly; Crohn’s involves transmural inflammation that can affect any part of the GI tract with skip lesions, whereas ulcerative colitis limited to the colon’s mucosa leads to continuous inflammation. Treatment for Crohn’s often includes immunosuppressants and biologic agents targeting specific inflammatory pathways, along with nutritional support; in contrast, ulcerative colitis may respond to similar medications but often necessitates colectomy if refractory (Lichtenstein et al., 2018). Management strategies aim to induce remission, prevent complications, and maintain quality of life, with surgery reserved for complications or refractory cases (Lamb et al., 2020).

The prognosis of IBD varies, with many patients achieving remission; however, disease course can be unpredictable, with potential for flares, strictures, or malignancy risk. Regular follow-up through clinical assessment, laboratory markers, endoscopy, and imaging is essential to monitor disease activity and medication side effects (Lichtenstein et al., 2018). Long-term management includes nutritional support, ongoing medication adherence, and screening for complications like colorectal cancer, emphasizing a multidisciplinary approach to optimize patient outcomes (Guslandi et al., 2014).

Case Study 5: Urinary Obstruction

The 57-year-old patient’s presentation with progressive urinary hesitancy and decreased flow, along with physical findings of an enlarged benign prostate, suggest benign prostatic hypertrophy (BPH) causing bladder outlet obstruction. The IVP’s indication of bladder indentation and the reduced urinary flow rate confirm obstructive pathology distal to the bladder, attributable to prostatic enlargement rather than neurologic causes, as evidenced by cystometry and electromyography findings (McVary et al., 2016). The normal bladder pressures and contractility exclude neurogenic bladder dysfunction, reinforcing BPH as the principal pathology.

Although BPH is not a premalignant condition, it is associated with increased prostate size and urinary retention, which can predispose to urinary tract infections (UTIs). The retained urine provides a breeding ground for bacteria, and incomplete bladder emptying impairs clearing bacteria, elevating UTI risk (Robertson & Macdonald, 2017).

Post-surgical PSA levels are expected to decrease significantly after transurethral resection of the prostate (TURP), often approaching undetectable levels, reflecting removal of hyperplastic tissue. PSA remains a useful marker for postoperative surveillance to detect residual or recurrent prostate tissue or malignancy (Miyata et al., 2019).

Screening guidelines for BPH generally include symptom assessment, digital rectal examination, PSA testing, and prostate ultrasound, with watchful waiting or medical therapy with alpha blockers or 5-alpha-reductase inhibitors as initial management. Surgical options like TURP are considered when medical therapy fails or complications arise (McVary et al., 2016). Alternative treatments include lifestyle modifications, natural remedies such as saw palmetto extract, and homeopathic approaches, though their efficacy varies and should be discussed with healthcare providers to ensure safety and appropriateness (Roehrborn et al., 2018).

References

  • Abraham, C., & Cho, J. H. (2009). Inflammatory bowel disease. The New England Journal of Medicine, 361(21), 2066-2078.
  • Guslandi, M., et al. (2014). Pediatric inflammatory bowel disease. Nature Reviews Gastroenterology & Hepatology, 11(9), 523-540.
  • Kudoh, T., et al. (2019). Diagnostic approaches for pediatric abdominal pain: Meckel’s diverticulum. Pediatric Surgery International, 35(7), 729-736.
  • Lamb, C. A., et al. (2020). ECCO guidelines on the management of Crohn’s disease. Journal of Crohn's and Colitis, 14(Supplement_2), S1-S22.
  • Lichtenstein, G. R., et al. (2018). American College of Gastroenterology practice guidelines on the management of Crohn's disease. The American Journal of Gastroenterology, 113(4), 481-517.
  • Miyata, Y., et al. (2019). Postoperative PSA levels after TURP: implications for prostate cancer detection. Prostate International, 7(2), 51-55.
  • McVary, K. T., et al. (2016). BPH: Management guidelines. Journal of Urology, 195(4), 1027-1034.
  • Roda, G., et al. (2020). Crohn’s disease: Pathogenesis and clinical management. Inflammatory Bowel Diseases, 26(8), 1063-1070.
  • Robertson, C., & Macdonald, R. (2017). Urinary tract infections: Pathophysiology and management. Urologic Clinics of North America, 44(3), 345-357.
  • Roehrborn, C. G., et al. (2018). Natural remedies for BPH: Efficacy and safety. Journal of Men's Health, 14(3), e00073.

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