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Question: chapter 4 gastrointestinal disorders case study 46 case study 46...

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chapter 4 Gastrointestinal Disorders Case Study 46 Case Study 46 46lass/Group Date Group Members apply to this case study Your responses should be brief and to the point. When askecd o provide several answers, ist them in order of clearly If your response is not legible, It wil be marked as 7 and you will need to or wite Scenario P.M, a 24- year-eld house painter, has been tooill to work for the past 3 days. When he arrives at your out ouatient dinic, he seems an alert but acutely ill young man of average build, with a deep tan over exposed areas of skin. He reports headaches, severe myalgia, a low-grade fever, cough, anorexia, and nausea and vomiting NM, especially after eating any fatty food. P.M. describes vague abdeminal pain that started about the same time as the other problems. His past medical history (PMH) reveals he has no health prob- lems, s a nonsmoker, and drinks a Yew beers each evening to relax. Vital signs (VS) are 128/84, 88, 26 100.6 F; awake, alert, and oriented (AAO) in his muscles; very slight scleral jaundice present; heart tones clear and without adventitious bowel sounds clear ou note moderate hepatomegaly measured at the midelavicular line; liver edge is easily palpated and tender to palpati P.M. Is manifesting the key signs of hepatitis. Lab work is sent for identification of his precise problem. Results are No 140 mmoV/L, K 3.9 mmol/L, Cl 102 mmol/L, co, 26 mmol/L, BUN 10 mg/dl, creatinine 1.0 mg/dil, platelets 86 thou/cmm, direct bilirubin 1.6 mg/dl, total billiubin 2.3 mg/dl, albumin 3.8 g/dl, total protein 6.2 g/dl, alanine aminotransferase (ALT) 66 units/L aspartate aminotransferase AST) 52 units/L, lactate dehydrogenase (LDH),205 units/L, alkaline phosphatase 176 units/L PT 12 sec, 3; moves all extremities well(MAEW) except for aching pain throughout abdomen and pelvis; abdomen soft and palpable without distinct masses. on. P.M. mentions that his urine has been getting darker over the past 2 days. INR 1.06, PTT 32 sec. Urine urobilinogen is 1.6 IU/L, albuminuria 160 mg/dl, positive for bilirubinuria, positive for anti-HAV (hepatitis A virus) IgM 1. Which key diagnostic tests will determine exactly what type of hepatitis is present? est, done Soc e Presence a or specf НА Ai 2. A CBC, BMP, LFT, and PT/PTT were drawn. Which of the lab values listed above specifically indicates liver disease?
asp PART ONE Medical-Surgical Cases 3. List three drugs that can cause increased ALT levels. 4. Considering that the basic pathology of hepatitis involves inflammation, degeneration, and regeneration of the hepatocyte, what type of diet will you strongly encourage P.M. to follow? 5. Differentiate between hepatitis A, B, and C on the basis of the mode of transmission and prevenion.
chapter 4 Gastrolntéstinal Disorders Case Study 46 6. Name three major activities that can be done in a community to prevent the spread of hepatitis (all types). 7. In P.M.s case, the IgM class andi-HAV antibody is positive. This result indicates that P.M. is infected with hepastis A and is in the acute or early convalescent period of the disease. Is this disease contagious? What precaution would you take? 8. Pruritus is usualy associated with jaundice. What will you do to ease this problem for Р.М.?
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