Question Answered step-by-step pathophysiology please answer these questions based on case… pathophysiology please answer these questions based on case scenario 1. What is the significance of the findings described as “satisfactory turgor” and “moist mucous membranes”? Could these lead to any further complications? 2. What constitutes a positive Babinski sign? Is a positive Babinski sign significant? Could this lead to any further complications? Please explain HISTORY: X.P. is a 24-year-old man, who presents to the urgent care clinic with complaints of rectal bleeding and weakness. Five days ago, he noticed bright red blood in his stools. Furthermore, daily bowel movements have increased to five or six with significant diarrhea. He states that urges to move his bowels have rapid onset, but there has been no incontinence. He has been weak for approximately 21/2 days. He has not traveled outsideof the city, been hospitalized, or received antibiotics recently. PAST MEDICALHISTORY: Chronic sinusinfections since age 15Ventricular septal defect at birth, surgically repaired at age 1 year FAMILY HISTORY:Strong positivefamily history of autoimmune diseaseon maternal sideMother has SLEMaternal grandmother (deceased) had Grave’sdiseaseAunt has myasthenia gravis SOCIAL HISTORY:College graduateRecently discharged after 3 yearsof active military serviceCurrently employedas user consultant in information technology division at local community collegeSocial alcoholuse onlyDenies tobaccoand IV drug use REVIEW OF SYSTEMS:Negative for lightheadedness and feeling faint with standingNegative for nausea, vomiting, visual changes or eye pain,abdominal distension with gas, and joint painPositive for occasional malaise,mild abdominal cramps,loss of appetite, and weightloss of 4 lbs during the past month MEDICATIONS: None ALLERGIES: NKDA PHYSICAL EXAM: General A &O, pleasant, young,white male in NAD; skin color is pale Vital Signs BP (sitting, left arm) 120/75, P 93 bpm, RR 20/min, T 99.4°F, SaO2 95% on RA, Wt 161 lbs (usual weight 165 lbs), Ht 5’10” Skin Warm and dry with satisfactory turgorPositive for pallorNo rashes or other lesions Head, Eyes, Ears,Nose, and Throat PERRLAEOMINegative for uveitisFunduscopic exam normalTMs intactNose clear and not inflamedMoist mucous membranes Chest and Lungs Lungs CTA & P HeartRRRNormal first and secondheart soundsNo m/r/g or extra heart sounds Abdomen BS (+)Soft and NT/NDNo palpable massesNo HSMNo bruits Rectal Somewhat tenderNo hemorrhoids or otherlesionsHeme (+) stool Musculoskeletal and Extremities Equal motor strength at 5/5 in both arms and legsSensation normalNo CCEPeripheral pulsesnormal Neurological A&O x 3Sensory and motor levels normalCNs II-XII intactDTRs 2+Babinski response negative LABORATORY TESTS:Patient Case Table: Laboratory Blood Test ResultsNa+ 143 meq/L (Normal: 135-145 meq/L) (Panic:<125 or>155 meq/L) BUN 20 mg/dL (Normal: 8-20 mg/dL)Plt 315,000/mm3 (Normal: 150,000- 450,000/ mm3)(Panic: <25,000/mm3) AST 33 IU/L (Normal: 0-35IU/L)K+ 3.2 meq/L (Normal: 3.5-5.0 meq/L)Cr 1.1 mg/dL (Normal: 0.6-1.2 mg/dL)ESR 24 mm/hr (Normal: Males: 0- 10mm/hr; ALT 41 IU/L (Normal: 7-56IU/L) (Panic: <3.0 or >6.0 meq/L) Females: 0-20mm/hr) Cl- 108 meq/L (Normal: 101-112 meq/L)Hb 10.8 g/dL (Normal: Males: 13.6-17.5 g/dLFemales: 12.0-15.5g/dL). (Panic: <7.1g/dL) CRP 1.5 mg/dL (Normal: <0.5mg/dL) T bilirubin 0.9 mg/dL (Normal: 0.1-1.2mg/dL)-HCO3 18 meq/L (Normal: 22-32meq/L) (Panic: <15 or >40meq/L)Hct 36% (Normal: Males: 42-52%; Females: 37-46%)Ca+2 8.9 mg/dL (Normal: 8.5-10.5 mg/dL)(Panic: <6.5 or >13.5mg/dL) PT 11.3 sec (Normal: 10.0-13.0 sec)Glu, fasting132 mg/dL (Normal: 60-110 mg/dL)(Panic: <40or >500mg/dL)WBC 9,400/mm3 (Normal: 4,800- 10,800/ mm3)(Panic: <1,500/ mm3) PO4-3 4.0 mg/dL (Normal: 2.5-4.5mg/dL) Clinical Course The patientreceived 1 L of 0.9% saline with 30 meq KCl IV for 4 hours and was discharged with instructions to return to the urgent care clinic or immediately contact his PCP if symptoms developedagain. The patientwas referred to the GI clinic. A proctosigmoidoscopy was conducted three days after the patient's discharge from the acute care clinic. Significant pseudopolyp formation could be seen. Biopsies of the colon revealed erosions of the mucosa and ulcerations into the submucosa with mixed acute (i.e., neutrophils) and chronic (lymphocytes and macrophages) inflammatory cells. No dysplastic cells suggesting the development of colon carcinoma were seen. No multinucleated giant cells suggesting Crohn disease were seen. Inflammation and ulceration were limited to the rectum and sigmoid colon only. Crypts of Lieberku¨hn were intensely inflamed. Marked hemorrhaging of capillaries in the mucosa was also observed. Pathologist's Diagnosis Ulcerative colitis Health Science Science Nursing NURSING PNP401 Share QuestionEmailCopy link Comments (0)
Needs help with similar assignment?
We are available 24x7 to deliver the best services and assignment ready within 6-12hours? Order a custom-written, plagiarism-free paper
Get Answer Over WhatsApp
Order Paper Now