Scenario 1: Peptic Ulcer
4 points 15 A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies NI8N, weight loss or obvious bleeding. She admits to frequent belching with bloating. PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthritis, Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain Family Hx-non contributary IZiVs har’egS:IPZ:it: ntre:rattl’ofaell”adadrnill; trsVIZII:m” wklitirdurigkT1177atews=aesa day, an 6a-7Lcups of coffaee per day. She denies illicit druguse, vapingaor unprotected sexual encounters. Breath test in the office revealed + unease. The healthcare provider suspects the client has peptic ulcer disease.
Questions: Explain what contributed to the development from this patient, history of PUD?
QUESTION 2
Scenario 1: Peptic Ulcer A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. TO pain has been persistent for two weeks. The pain described as burning, non-radiating and worse after meals. Denies NW, weight loss or obvious bleeding. She admits to frequent belching with bloating. PMH: seasonal allergies with Chronic Sinusitis, positive for osteoarthrilis, Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn pain Family Hx-non contributary Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters. Breath test in the office revealed + urease. The healthcare provider suspects the client has peptic ulcer disease.
Question: What is the pathophysiology of PUD/ formation of peptic ulcers?
QUESTION 3
Scenario 2: Gastroesophageal Reflux Disease (GERD) A 44-year-old morbidly obese fernale comes to the clinic complaining of ‘burning i my chest an ba ft‘rie2nt:Vteirs’yr”.1nYptno’rr,LiitTrntsaYclidPtTtrZ:WvhIche:gedsgitilt eTaasrts4bO Et::11:ta;e1: rslieLhrasdaw a raVttrasar; w”de2r pfilr STee ssa7ss tswYarstasdgceO:ghrig;:tt InZhItt.:tti=shhaesigeYetr7?ncttivenrigrgdw’iltahs her sleep. Sheltdheniesipalpitations, shortness of breath, or nausea.
PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg(m2) FH:non contributory Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prn SH: 20 PPY of smoking, ETOH rarely, denies vaping Diagnoses: Gastroesophageal reflux disease (GERD).
Question: If the client asks what causes GERD how would you explain this as a provider?
QUESTION 4 4 points
Scenario 3: Upper GI Bleed A 64-year-old male presents the clinic with complaints of passing dark, tar, stools. He stated the first epise occurreas wee, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper I bleed which won’t be confirmed until further endoscopic procedures are performed.
Question: What are the variables here that contribute to an upper GI bleed?
QUESTION 5
Scenario 4: Diverticulitis tti5c1′ :rt.:Its:X=1’1T r:I=Igntrs:VeadY trIZ s’llielpailsteMo=c7 !bar:We:1. re ..pvi IsZes today was accompanied by nausea, sweating, and weakness. She states she has had sorne LLO pain for several weeks but described it as “coming and going”. She says she has had a fever and abdominal cramps that have worsened this morning. Diagnosis is lower GI bleed secondary to diverticulitis.
Question: What can cause diverticulitis in the lower GI tract?
