A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon. Case Analysis Essay
RUbric
Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:
Explain why you think the patient presented the symptoms described.
Points Range:28 (28.00%) – 30 (30.00%)
The response accurately and thoroughly describes the patient symptoms.
The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.
Points Range:25 (25.00%) – 27 (27.00%)
The response describes the patient symptoms.
The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.
Points Range:23 (23.00%) – 24 (24.00%)
The response describes the patient symptoms in a manner that is vague or inaccurate.
The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.
Points Range:0 (0.00%) – 22 (22.00%)
The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.
The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.
Identify the genes that may be associated with the development of the disease.
Points Range:23 (23.00%) – 25 (25.00%)
The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.
Points Range:20 (20.00%) – 22 (22.00%)
The response includes an accurate analysis of the genes that may be associated with the development of the disease.
Points Range:18 (18.00%) – 19 (19.00%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.
Points Range:0 (0.00%) – 17 (17.00%)
The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.
Explain the process of immunosuppression and the effect it has on body systems.
Points Range:28 (28.00%) – 30 (30.00%)
The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.
Points Range:25 (25.00%) – 27 (27.00%)
The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.
Points Range:23 (23.00%) – 24 (24.00%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
Points Range:0 (0.00%) – 17 (17.00%)
The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
Points Range:5 (5.00%) – 5 (5.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
Points Range:4 (4.00%) – 4 (4.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.
Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
Points Range:3 (3.00%) – 3 (3.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.
Purpose, introduction, and conclusion of the assignment are vague or off topic.
Points Range:0 (0.00%) – 2 (2.00%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.
No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English Writing Standards:
Correct grammar, mechanics, and proper punctuation
Points Range:5 (5.00%) – 5 (5.00%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range:4 (4.00%) – 4 (4.00%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
Points Range:3 (3.00%) – 3 (3.00%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
Points Range:0 (0.00%) – 2 (2.00%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference l Case Analysis Essay
Case Analysis
Inflammatory bowel diseases are extremely debilitating and chronic to the patients they affect. This is especially true if the patient is an elderly person with other pre-existing comorbidities. Diverticulitis is one of these inflammatory bowel diseases that commonly affect the elderly. It is characterized by bowel lesions that appear like sacs that project from the bowel wall. These are easily inflamed with subsequent abdominal pain, fever, and constipation amongst other symptoms. Overweight and obesity as conditions are known to worsen the progression and manifestation of diverticulitis (Hammer & McPhee, 2018). The patient in this case is a 65 year-old obese African American male presenting with a fever of 101°F, constipation, and left lower quadrant (LLQ) abdominal pain. He has a long history of chronic diverticulitis. The purpose of this paper is to explain his symptoms, explain immunosuppression, and the possible genetic role in his condition.
ORDER NOW A PLAGIARISM-FREE PAPER HERE
Reasons for the Symptom Presentation of the Patient
Diverticulitis causes changes in the composition of gut normal flora. This destabilizes the environment of the intestines and other inflammatory factors take advantage to cause widespread inflammation and infection. As peristaltic movements increase to clear the inflammation and infection, the diverticula or pouches are stretched together with their innervation causing tremendous painful abdominal cramps (Strate & Morris, 2019). This is the source of the abdominal pains. Of course the inflammation is what causes the fever that the patient experiences. When diverticulitis is of long-standing, there is gradual impaction of fecal matter in the diverticula and the overall effect after sometime is intestinal obstruction.
This is what results to a feeling of constipation as the patient spends a number of days without emptying their bowel. Actually, this also makes the abdominal pain and the fever worse by increasing peristaltic movements and aiding colonization of the diverticula by pathogenic microbiota. When it reaches the stage of constipation due to possible intestinal obstruction, it is imperative that the patient gets relived by laxatives or enema as it may turn out to be a surgical emergency. The colorectal cancer is the result of obesity (lifestyle), chronic diverticulitis, constipation, and genetic factors. Case Analysis Essay
Genetic Factors in Diverticulitis
The gene whose polymorphisms cause diverticulitis is the LAMB4 gene (Coble et al., 2017). The gene is a laminin gene and they are known to have a role to play in the development and function of the innervation framework of the gut nervous system. In a situation that represents a lack of or low levels of the LAMB4 protein, there will be colonic dysmotility resulting in stasis. This is exactly what happens in diverticulitis. According to Coble et al. (2017), the innervation architecture in the gut and its form will also be affected causing both pain and paralysis.
Immunosuppression and Its Impact
The process of immunosuppression is caused by a situation in which the body’s defences are overwhelmed and destroyed. This process can be deliberate of voluntary through the use of medications as in cases where the patent has autoimmune disease. It can also occur more naturally when a disease such as HIV/AIDS completely destroys the body’s immune system. The effect of immunosuppression on the body is that any condition however small or trivial that now gets in the body will be very hard to treat. This is how HIV/AIDS kills through other conditions.
Conclusion
Diverticulitis is a chronic inflammatory bowel disease. It causes lower abdominal pain, constipation, and fever due to inflammation. There is a gene that predisposes one to suffering from diverticulitis. This is the LAMB4 gene and its deficiency causes the expression of diverticulitis.
References
Coble, J.L., Sheldon, K.E., Yue, F., Salameh, T.J., Harris, L.R., Deiling, S., Ruggiero, F.M., Eshelman, M.A., Yochum, G.S., Koltun, W.A., Gerhard, G.S. & Broach, J.R. (2017). Identification of a rare LAMB4 variant associated with familial diverticulitis through exome sequencing. Human Molecular Genetics, 26(16), 3212-3220. http://dx.doi.org/10.1093/hmg/ddx204
Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8th ed. McGraw-Hill Education.
Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2018). Harrison’s principles of internal medicine, 20th ed. McGraw-Hill Education.
Strate, L.L., & Morris, A.M. (2019). Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology, 156(5), 1282-1298. http://dx.doi.org/10.1053/j.gastro.2018.12.033