(S)A N P 2 M 6 Case

QUESTION

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1. Maria, a 66-year-old female, visits her physician complaining of sudden onset abdominal pain, nausea, and diarrhea. She does not take any prescription medications, but does take aspirin each day to lower her risk of heart disease. She has no notable history of digestive system issues. Maria has a family history of pancreatitis. She is slightly obese and has been mostly sedentary since her recent retirement. Her doctor performs multiple tests and diagnoses Maria with diverticulitis.
 
Diverticulitis affects which digestive organ?

Large intestine

Small intestine

Stomach

Liver

QUESTION 2

1. Briefly explain, in your own words, the anatomy of diverticula. Include information about the layers of the alimentary canal.

QUESTION 3

1. Diverticula may be asymptomatic for years or for a lifetime. Describe, in your own words, why diverticula may cause sudden pain.

QUESTION 4

1. In addition to the symptoms Maria reported, which of these symptoms is commonly related to diverticulitis?

Pain in the upper right quadrant

Pain in the upper left quadrant

Constipation

Vomiting

QUESTION 5

1. Which part of Maria’s history is NOT a risk factor for diverticulitis?

Aspirin

regimen

Obesity

Sedentary lifestyle

Family history of pancreatitis

QUESTION 6

1. Maria’s doctor asks about her diet. Which of these diets is most closely related to diverticulosis/diverticulitis?

Low fiber diet

Low carbohydrate diet

High fat diet

Vegetarian diet

QUESTION 7

1. One of the tests Maria’s doctor orders is a fecal occult blood test. It was positive. Briefly describe why this test was positive in Maria’s case.
 

QUESTION 8

1. One of the diagnostic tests that Maria’s doctor ordered was a visual exam of the inside of the large intestine with a camera that is inserted through the anus and rectum. What is this procedure called?

Endoscopy

Colonoscopy

Computerized tomography

Angiogram

QUESTION 9

1. If Maria’s case is severe, she may choose to undergo a colon resection. Which of these statements describes that procedure?

A portion of the small intestine is used to replace the affected portion of the large intestine.

The affected portion of the large intestine is removed and the remaining end of the large intestine are joined together.

Feces is redirected from the colon to a pouch on the outside of the body.

Diverticula are removed by lasers.

QUESTION 10

1. Briefly describe the difference between diverticulosis and diverticulitis. Include information about the prevalence of each condition.

QUESTION 11

1. Jim is a truck driver who is on the road for long hours. He admits to eating “unhealthy” foods and often stops at fast food restaurants after his late shifts, choosing cheeseburgers, French fries, and pizza most often. He does not drink alcohol because his job requires him to drive at a moment’s notice, but he does drink coffee throughout the day to keep awake during his odd hours. He has a history of intermittent heartburn, but the chest pain is getting more frequent and more severe, so he decides to seek treatment.
 
What is the medical name for heartburn?

QUESTION 12

1. Briefly describe, in your own words, why chest pain occurs in patients who have heartburn.

QUESTION 13

1. Which of the following anatomical structures is weakened, causing Jim’s heartburn?

Pyloric sphincter

Lower esophageal sphincter

Fundus of the stomach

Muscularis layer of the stomach

QUESTION 14

1. From what you know about Jim, do you think his recent chest pain could be related to more than just heartburn?

QUESTION 15

1. Jim’s doctor would like him to try OTC medication before prescribing something stronger. Which of these medications would likely help Jim? (Select all that apply.)

Antacids

H-2 receptor blockers

Proton pump inhibitors

Antihistamines

Diuretics

Aspirin

QUESTION 16

1. List and describe 3 risk factors that Jim has for GERD.

QUESTION 17

1. Jim is at risk for developing a complication known as Barrett’s esophagus. Briefly describe the pathophysiology of this condition. 

QUESTION 18

1. After two weeks, the OTC medication Jim tried isn’t helping, so his doctor wants to perform a diagnostic imaging procedure that uses a light and camera to look for inflammation inside the esophagus and test for Barrett’s esophagus. What is this procedure called?

Colonoscopy

Ambulatory acid probe test

Esophageal manometry

Upper endoscopy

QUESTION 19

1. Which of the following lifestyle changes is NOT typically recommended to patient’s with GERD?

Avoid eating several hours before sleeping

Avoid spicy and acidic foods

Weight loss

Monitor blood glucose levels

QUESTION 20

1. In addition to Jim’s risk factors, which of these conditions may increase the likelihood of a patient developing GERD?

Anorexia nervosa

Hiatal hernia

Laryngitis

Crohn’s disease

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