Ordas i eckmann l talamini m baumgart dc sandborn wj

Ordas, I., Eckmann, L., Talamini, M., Baumgart, D.C., & Sandborn, W.J. (2012). Ulcerative
Colitis. The Lancet, 380 (9853), 1606-1619. doi: 10.1016/S0140-6736(12)60150-0
6/5/2016 3:23:48 PM Stella Adebusoye
Week 5 discussion 3
Dr Brown and Class,
Tammy is a 29 year old Caucasian female who presents to the emergency department with five day history of abdominal pain and watery diarrhea.
Denies past medical or surgical history and has no known drug allergies. She is a nonsmoker and only drinks alcohol socially. Tammy states some days
she can have up to 15 watery stools per day and most of the stools have a foul odor with pus and blood. She describes pain as continuous abdominal
cramping but the pain is milder than her menstrual cramps. Patient’s mother states she has had the same symptoms as Tammy, was diagnosed with
ulcerative colitis in her mid-thirties and has not had a flare up in over 10 years. Tammy also complains of weight loss, fatigue and loss of appetite.
Tammy stated she was not going to come in but her mom insisted because her eyes appeared yellow. Vital signs in triage are as follows: Temperature
101.0F, heart rate 110, respirations 20, blood pressure 90/68, and numeric pain score 6/10.
Patient was immediately placed in an emergency room and series of tests was ordered was ordered such as comprehensive metabolic panel, complete
blood count, liver function test and an abdominal ultrasound. Lab results: Sodium 155, potassium 2.9, chloride 111, hemoglobin 6.9, hematocrit 28.
Liver function test are as follows: bilirubin 4.8mg/dl, serum glutamic oxaloacetic transaminase (SGOT) – 102 U/L, serum glutamic pyruvate
transaminase (SGPT) – 130 U/L, serum alkaline phosphatase (SAP) – 400 U/L, Alb – 3.5g/dl, TP - 7.2 U/mL. Ultrasound of the abdomen tested
positive for intrahepatic biliary dilation and showed a mild dilation in common bile duct with multiple calculi. A gastrointestinal consult was ordered
and she was admitted to the hospital for three days with a diagnosis of ulcerative colitis with hepatic-biliary complications and common bile duct
(CBD) calculi causing obstructive jaundice for treatment, patient was given intravenous fluids for hydration, antipyretic for the fever, pain medication
and antibiotics for the infection. Sphincterotomy was performed to remove the gall bladder stones.
6/5/2016 3:29:18 PM Stella Adebusoye
reply to Stella Adebusoye
RE: Week 5 discussion 3
References
Bardia, A., Tiwari, S. K., G., S., Anjum, F., Habeeb, M. A., & Khan, A. A. (2011). Primary sclerosing cholangitis and Biliary cirrhosis associated
with Ulcerative colitis . Journal of Medical & Allied Sciences, 1( 2), 86-89.
McCance, K.,& Huether, S. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children, 7th Edition. [Vital Source Bookshelf
Online]. Retrieved from

6/5/2016 5:09:41 PM Nosimot Adepegba
Ulcerative Colitis
Dr. Brown and Class
Mrs. Kasey, 32 years old Jewish female is visiting your clinic with a major complain of frequent bloody watery diarrhea that contains pussy
mucus. She explained that this is accompanied by severe abdominal cramping pain. She stated that she has lost 4lbs in two days. She appears weak with
dry scaly skin. She informed you that she had a similar illness a year ago, was treated with antibiotics and was fine. Vital signs are; Temp 101.2, AP