Case Study 3 & 4 (10 Points) Due 06/29/2019Students 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 ObstructionCase Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.Late Assignment PolicyAssignments turned in late will have 1 point taken off for every day assignment is late, after 7 days assignment will get grade of 0. No exceptionsInflammatory Bowel DiseaseCase StudyThe 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.StudiesResultsHemoglobin (Hgb),8.6 g/dL (normal: >12 g/dL)Hematocrit (Hct),28% (normal: 31%-43%)Vitamin B12 level,68 pg/mL (normal: 100-700 pg/mL)Meckel scan,No evidence of Meckel diverticulumD-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 intestineDiagnostic AnalysisThe 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 B12. As a result, she has vitamin B12 deficiency anemia. She was placed on an aggressive immunosuppressive regimen, and her condition improved significantly. Unfortunately, 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 normal, as were her B12 levels. Her immunosuppressive drugs were discontinued, and she is doing well.Critical Thinking Questions1. 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 Ulcerative Colitis and Crohn’s Disease? (always on boards)4. What is prognosis for patients with IBD and what are the follow up recommendations for managing disease?
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