Topic 1: Case Study
Case Study Posting Requirements
- Make sure all of the topics in the case study have been addressed.
- Cite at least three sources; journal articles, textbooks or evidenced-based websites to support the content.
- All sources must be within five years.
- Do not use .com, Wikipedia, or up-to-date, etc., for your sources.
Case Study 1
Structure and Function of the Gastrointestinal System
Amy is a small, but active, eight-year-old. When Amy was approaching two, her mother took her to a pediatrician because Amy was “failing to thrive.” She was small for her age and got tired easily. She was having difficulty with her meals, often developing colicky pain, abdominal distension, and diarrhea after eating. After a series of tests, Amy was diagnosed with celiac disease, a condition involving an abnormal immune response in the small intestine to foods containing the protein gluten. Her mother reminds Amy that in order for her to grow healthy and strong, it is important for her to eat her “special” food that is made at home, or has the words “gluten free” on the package.
- What anatomical features of the small intestine lend it to the digestion and absorption of fats, carbohydrates, and proteins?
- Sometimes individuals with celiac disease experience steatorrhea (fatty stools) after eating foods containing gluten. What are the chemical components that normally digest fats in the small intestine, and how are the fats absorbed?
- Celiac disease involves an inflammatory response in the small intestine. How do inflammatory conditions affect small intestine motility?
Case Study 2
Disorders of Gastrointestinal Function
Marcee is a 52-year-old woman who worked at a reception desk at a company head office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.
- Review Marcee’s diet. What factors in her dietary choices might contribute to the development of colorectal cancer?
- Colorectal cancer often arises from adenomatous polyps. What are the development and histological features of these polyps?
- Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the “pseudopolyps” seen in this disease different from the polyps discussed above?
- Why is a fecal occult blood test used as one of the screening tools for colorectal cancer? Explain the procedure for administering the test.
Case Study 3
Disorders of Hepatobiliary and Exocrine Pancreas Function
Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep.
- Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematological disorders?
- What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition?
- Acute pancreatitis is sometimes seen in the alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?
- Why are women more predisposed to alcoholic liver disease than men?
Case Study 4
Alterations in Nutritional Status
Frank is a 52-year-old male who began to feel unwell four months ago. His appetite declined, and he could not taste food as well as he used to. When he lost a considerable amount of weight and became weak as a result, he visited his doctor. The examination revealed Frank had adenocarcinoma of the pancreas, and surgery was immediately ordered. During his hospitalization, Fred was slow to gain weight and his muscles were wasted. In order to build up his strength for chemotherapy, his wife tried to tempt him with freshly baked cookies and sweets she brought from home.
- In severe protein–calorie malnutrition, what is a potential complication of rapid enteral re-feeding? What effects does protein–calorie malnutrition have on the gastrointestinal system?
- What might Frank’s nitrogen balance be? Why would he have this type of nitrogen balance?
- Frank’s nurses encourage him to eat the potatoes and dinner rolls that come with his meals. Why are they encouraging Frank to complete the carbohydrates on his plate?
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