Case Study Analysis A 65-Year-Old Obese African American Male Patient Presents To His HCP With Crampy Left Lower Quadrant Pain

NURS 6501 PATHOPHYSIOLOGY DISCUSSION WEEK 2 CASE STUDY ASSIGNMENT

Case Study Analysis

The case study is about a 65-year-old male patient who presents with constipation, lower quadrant pain, and a high fever. Understanding the origins of a pathology in a patient is a critical part of diagnosis that informs treatment approaches. Some diseases are genetic in nature, but environmental and other factors can also influence them. Moreover, diseases cause cellular alterations that produce various symptoms used to diagnose a particular condition. The purpose of this paper is to evaluate symptoms of the patient in the cases study.

Presenting Symptoms

The symptoms are due to adenocarcinoma, which is the primary diagnosis. Adenocarcinoma is cancer that occurs in the colon and rectum, originating from the mucus glands found within these organs. The first symptom is lower quadrant pain, associated with obstruction of the colonic lumen. The second symptom is constipation, which is attributed to tumors in the colon causing reduced bowel movement due to narrowed rectum and bowel (Sitarz et al., 2018). High fever is associated with cancer, which fluctuates throughout the day. The patient also presented with the symptoms because of exposure to risk factors of the diagnosed disease, including sedentary lifestyle, obesity, fiber deficient diet, and history of inflammatory bowel sound disease.

Associated Genes

The case study notes that the patient has a family history of colon cancer; the paternal grandfather died of colon cancer. The history puts him at risk of hereditary colon cancer. The genes involved in colorectal cancer are MSH2, MSH6, and MLH1. The MLH1 is found on chromosome 3, while the other genes are located on chromosome two (Hong, 2018). The genes produce protein products that function as repairs for DNA replication mistakes. In some cases, the genes become muted, failing to work properly, meaning replication mistakes cannot be repaired. The result is damaged DNA, leading to colon cancer.

Immunosuppression

The process of immunosuppression involves reduced efficacy of the immune system making the body susceptible to diseases. Immunosuppression may occur due to various causes such as medications or diseases such as HIV and AIDs associated with low immunity (Cangemi et al., 2019). The effect of immunosuppression on the body system is reduced ability to detect and fight infections. The body becomes vulnerable as it cannot fight off pathogens. For example, for people developing cancer, the risk becomes higher because of the body’s inability to fight infections.

Conclusion

The diagnosis is adenocarcinoma, which is cancer that occurs in the colon or rectum also called colorectal cancer. The patient’s family history is positive for cancer, which explains why the patient has been exposed to cancer genes. The genes responsible for the mutation leading to colorectal cancer are MSH2, MSH6, and MLH1. People with immunosuppression have low ability to fight disease causing pathogens, hence vulnerable to any disease that attacks the system.

References

Cangemi, M., Montico, B., Faè, D. A., Steffan, A., & Dolcetti, R. (2019). Dissecting the Multiplicity of Immune Effects of Immunosuppressive Drugs to Better Predict the Risk of de novo Malignancies in Solid Organ Transplant Patients. Frontiers in oncology. Frontiers in oncology, 9, 160. https://doi.org/10.3389/fonc.2019.00160.

Hong, N. (2018). Genetic and epigenetic alterations of colorectal cancer. Intestinal Research, 16(3), 327–337. https://doi.org/10.5217/ir.2018.16.3.327.

Sitarz, R. S., Mielko, J., Offerhaus, G., Maciejewski, R., & Polkowski, W. (2018). Gastric cancer: epidemiology, prevention, classification, and treatment. Cancer management and research, 10, 239–248. https://doi.org/10.2147/CMAR.S149619.

This week we will have another case study to consider. You will review the below listed case study and present your findings in a 1-2 page case study analysis. Be sure to review all of the requirements carefully for this assignment. If you have questions be sure to reach out.

Case Study:

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.

Be sure that your paper is no one than 1-2 content pages. You are to also include both a title page and a reference page. No more than 1-2 content pages.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described. Identify the genes that may be associated with the development of the disease. Explain the process of immunosuppression and the effect it has on body systems.

Advanced Pathophysiology Dr. Magny-Normilus 12th December, 2020

Case Study Analysis Scenario: 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. Why Did the Patient Present with the Symptoms Described? Diverticulitis is the inflammation of diverticulum or diverticula that are commonly found in the sigmoid colon and are a described as outpouchings of the mucosa and submucosa through the colon wall (Hasudungan, 2018). Diverticulum are caused by increased pressure within the lumen of the colon due to episodes of constipation or hardened stool – which can result from a low-fiber diet, as is the case with our patient. The inflammation of diverticulum can occur from fecal matter blocking the diverticulum causing an inflammatory response, or the presence of