Discussion #4 Bryan Ulcerative Colitis & Anemia

Discussion #4 Bryan Ulcerative Colitis & Anemia Bryan is an 18 y/o freshman college student who presents to the College Health Clinic reporting increased fatigue over the past several weeks. He is concerned because he is unable to keep up with his course work & fearful that he may not pass this semester. He is a thin young man who appears pale. He reports no history of medical problems or surgeries. He takes no medications. He denies using marijuana or any other recreational drugs. He was an athlete in high school as a long distance runner. He reports smoking cigarettes 1 ppd for 3 years. The Health Care Provider completes a review of systems (ROS) to obtain a complete health history & that finds that Bryan reports having intermittent various GI issues for the past 6 months, which at times include diarrhea, sometimes including a fair amount of blood. He reports that he was anxious over moving away from home & starting college & thought it was r/t that. Pre-College PE: Height 6’0″, Weight 189 lbs (89.5 kg) BMI 25.96 Today: Vital Signs: BP 128/76, HR 102, RR 20, POX 95% RA, Temp 98.6, Height 6’0″, Weight 165 lbs (75 kg), BMI 22.64 Physical Assessment: Neuro A & x3; Lungs breath sounds clear; Heart Sounds regular, tachycardic; Abd soft, tender to touch, nondistended, hyperactive bowel sounds; Extremities PP+, no edema. Labs are drawn & Bryan returns the next day. He is told he is anemic, & probably has developed ulcerative colitis. Labs: WBC 6.1 Hemoglobin 11.3 g/dL Hematocrit 28% Platelets 210,000 per microLiter NA 138 mEq/L K 4.2 mEq/L BUN 16.4 mg/dL Cr 1.2 mg/dL Response to Questions Review & contrast the pathophysiology & clinical manifestations of UC & Crohns. Why is Bryan anemic & what type of anemia do you think he has? What diagnostic test(s) should be ordered to confirm the UC diagnosis? SCIENCE HEALTH SCIENCE NURSING NURSING 3324

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