Patient Encounter 1 Part 1

A 25-year-old Caucasian woman presents to the university student clinic with complaints of intermittent crampy abdominal pain and four to five loose stools per day. She describes some visible mucus and blood in the stool and states that these symptoms have been present for 6 to 8 weeks. She also has intermittent lower back pain, fatigue, fever, and a 4.5-kg (10-lb) weight loss. The back pain started about the same time as her Gl symptoms. She denies any sick contacts and has not eaten any takeout or restaurant food over the last 2 months. She takes nonprescription naproxen as needed for aches and pains. She has been using more naproxen recently because of the back pain. She also takes an oral contraceptive pill once daily. She consumes alcohol socially and currently smokes one-half to one pack of cigarettes per day.

What symptoms are suggestive of IBD in this patient?

Are these symptoms more suggestive ofUC or CD?

What factors may be contributing to her IBD symptoms?

What additional information would you acquire prior to recommending drug therapy?

A similar classification scheme is used to gauge the severity of active CD. Patients with mild to moderate CD are typically ambulatory and have no evidence of dehydration; systemic toxicity; loss of body weight; or abdominal tenderness, mass, or obstruction. Moderate to severe disease is considered in patients who fail to respond to treatment for mild to moderate disease, or those with fever, weight loss, abdominal pain or tenderness, vomiting, intestinal obstruction, or significant anemia. Severe to fulminant CD is classified as the presence of persistent symptoms or evidence of systemic toxicity despite outpatient corticosteroid treatment, or presence of cachexia, rebound tenderness, intestinal obstruction, or abscess.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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