When developing strategies in public health, it is essential for the health professionals involved to understand the conditions that they are dealing with in-depth, as this would give them a better front through which to deal with the health issues effectively. That creates the need for having to adopt a strategic approach through which to examine different aspects associated with the diseases affecting the human system. The focus of this report is to explore some of the critical conditions that health professionals are likely to encounter as part of their approaches to dealing with individual patients. The requirements include the celiac and Crohn diseases, hepatitis A, B, C, viral hepatitis, and pancreatic cancer. Specifically, the report seeks to examine the pathogenesis and pathophysiology of the conditions, as well as embark on a process of having to differentiate between the different types of hepatitis.
Pathogenesis of Celiac Disease
The evaluation of the pathogenesis associated with the Celiac disease requires engaging in a proper examination of the causation factors that come into focus when trying to understand this condition. Kagnoff (2005) indicates that celiac disease is mainly attributed to three main factors, which are environmental, genetic, and immunologic. Dietary proteins, which can be found in cereals that include wheat, rye, and barley, are critical ecological contributors to the activation of the disease. Expressly, it can be noted that gluten in the cereals leads to an activation of the disease among persons that have been diagnosed with the condition. Genetics has a significant role in the activation of the situation, taking into account that celiac disease is a hereditary condition that can be passed on from parents to children.
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Pathophysiology of Crohn’s Disease and Other Genetic Issues
The onset of the disease and other genetic issues are often identified based on crypt inflammation and abscesses, which then progress, resulting in the formation of tiny focal aphthoid ulcers, which are seen as mucosal lesions (Cerrillo et al., 2015). However, continued exposure to high acidity levels within the bowel results in the progression of the mucosal lesions resulting in transverse ulcers. At this point, the intestine is characterized by a cobblestoned appearance taking into account that the ulcers have affected the surface of the intestine. Without proper treatment, the inflammation resulting from the ulcers is likely to spread to lymphedema, which is an aspect that thickens the bowel walls and mesentery. The thickening of the bowel walls is much more likely to lead to bowel obstruction, fibrosis, and stricture formation.
Difference between Hepatitis A, B, C, and Viral Hepatitis
Hepatitis refers to an illness that results in the inflammation of the livers, which impacts its ability to function effectively. Hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis C virus (HCV), and viral hepatitis are some of the common types of hepatitis that affect a significant number of people around the world today (Sarin et al., 2016). The main difference between the four types of hepatitis can be attributed to their severity and ability to spread both within the body and to other persons. Hepatitis A contributes to an inflammation within the liver but most often gets better without dividing it into other parts of the body. However, older persons are likely to be affected significantly by this type of hepatitis while considering that their immune system may not be as secure as that of younger persons.
Hepatitis B, on the other hand, projects itself as both an acute and chronic condition. One of the key aspects to note is that this type of hepatitis can spread through the body through the blood and other body fluids. Some of the areas that have been affected by hepatitis B are Asia and Africa. Hepatitis C is considered as one of the most dangerous types of hepatitis, as it always chronic and can only be spread through blood. When comparing hepatitis C to A and B, one of the key aspects to note is that both A and B are preventable through vaccinations, which is not the case of hepatitis C (Sukowati, El-Khobar, Ie, Anfuso, Muljono, & Tiribelli, 2016). Lastly, viral hepatitis is a type of hepatitis that can be spread with ease within a given population. Hepatitis A, B, and C are limited in their capacities to cover within a specific community; thus, highlighting the real difference when compared to viral hepatitis.
Pathogenesis and Pathophysiology of Pancreatic Cancer
An evaluation of the pathogenesis of condition indicates that the condition results from genetic changes occurring within multiple subsets of genes during the process when this type of cancer is developing. The first step to note is the activation of the oncogenes, which is a type of gene that has the capacity and ability to transform a healthy cell into a tumor within the body. However, the body fails to respond effectively, considering that tumor suppressor genes are inactive. The inactivation of these genes means that the body is not able to prevent the formation of a tumor within the pancreas as one of the main organs in the body; thus, paving the way for pancreatic cancer (Norris et al., 2015).
Regarding its pathophysiology, pancreatic cancer begins when metastasizes, affecting some of the lymph nodes within the pancreas, then moving into the liver and, in some of the more severe cases, into the lungs (Whitcomb, Frulloni, Garg, Greer, Schneider, Yadav, & Shimosegawa, 2016). One of the key aspects to note when focusing on pancreatic cancer is that it tends to spread; thus, affecting some of the other organs in its surrounding, including duodenum, stomach, and colon. Pancreatic cancer can must more likely to cause ascites, which refers to an abnormal buildup of fluids with part of the abdomen resulting from a disruption in the normal functioning of the abdomen. Other parts of the body that can be affected by pancreatic cancer include the skin, which is likely to develop painful nodular metastases. Although uncommon, pancreatic cancer can also metastasize to affect the brain, which is considered as having fatal outcomes for the patients.
Case #26
Determine the grade of vomiting during the last 24 hours.
The information from the case indicates that Mr. J.A. has grade 2 vomiting
How does amlodipine work to relieve hypertension?
Amlodipine, which is a type of calcium channel blocker, helps in relieving hypertension by help in the expansion of the blood vessels through blocking absorption of calcium; thus, aiding in the process of having to reduce blood pressure within the vessels.
How does glyburide work to control blood sugar in type 2 diabetes mellitus?
Glyburide, which is a sulfonylurea, aids in controlling blood sugar by stimulating the pancreas to produce insulin, which is essential towards ensuring that the blood sugar levels are contained and regulated.
What are the two major contributing factors for nausea and vomiting in this patient?
Based on the information from the case, it can be argued that the absence of bowel sounds and colonic pseudo-obstruction serve as the two main contributors to nausea and vomiting for this particular patient.
List twelve clinical manifestations in this patient that are consistent with a diagnosis of dehydration.
Sunken eyes
Skin tenting present
Lethargy
Increased sodium
Decreased potassium
Elevated bun
Low blood pressure
Dry skin
Weight loss
Cold skin
Dry mucous membranes
Tachycardia
Has the patient developed hypokalemia?
Based on the value of 3.2meq/L, which is lower when compared to the average level of 3.5-5meq/L, it can be argued that, indeed, the patient has developed hypokalemia.
Why can acute pancreatitis be ruled out as a cause of nausea and vomiting in this patient?
The main reason why acute pancreatitis can be ruled out as a cause of the patient feeling nausea and vomiting is the fact that the amylase results are typical. Additionally, if the patient had acute pancreatitis, he would likely have been experiencing pain in the left upper quadrant (LUQ) and right lower quadrant (RLQ).
Perforation of the cecum often occurs when a cecal diameter >10cm. Severe abdominal pain, fever, and leukocytes are clinical manifestations of aperture. Has the cecum perforated in this patient?
In this case, a cecum perforation cannot be considered in any way.
What is believed to be the pathophysiologic mechanism that underlies acute colonic pseudo-obstruction?
The pathophysiologic mechanism associated with acute pseudo-obstruction is unknown.
Are respiratory and reflex signs consistent or inconsistent with metabolic alkalosis?
From the information presented, the respiratory and reflex signs associated with the patient show notable inconsistencies with metabolic alkalosis.
Conclusion
Health professionals have an essential role to play in ensuring that they understand the pathogenesis and pathophysiology of a disease, which would provide them with a much better understanding of how to embark on treatment and management. The report is to examine some of the critical conditions, which are celiac disease, Crohn disease, hepatitis A, B, C, and viral hepatitis, and pancreatic cancer. Specifically, the focus is on evaluating the pathogenesis and pathophysiology, as well as providing a comparison of the different types of hepatitis.
References
Cerrillo, E., Beltrán, B., Pous, S., Echarri, A., Gallego, J. C., Iborra, M., ... & Nos, P. (2015). Fecal calprotectin in ileal Crohn's disease: relationship with magnetic resonance enterography and a pathology score. Inflammatory bowel diseases , 21 (7), 1572-1579.
Kagnoff, M. F. (2005). Overview and pathogenesis of the celiac disease. Gastroenterology , 128 (4), S10-S18.
Norris, A. L., Roberts, N. J., Jones, S., Wheelan, S. J., Papadopoulos, N., Vogelstein, B., ... & Eshleman, J. R. (2015). Familial and sporadic pancreatic cancer share the same molecular pathogenesis. Familial Cancer , 14 (1), 95-103.
Sarin, S. K., Kumar, M., Lau, G. K., Abbas, Z., Chan, H. L. Y., Chen, C. J., ... & Dokmeci, A. K. (2016). Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatology International , 10 (1), 1-98.
Sukowati, C. H., El-Khobar, K. E., Ie, S. I., Anfuso, B., Muljono, D. H., & Tiribelli, C. (2016). Significance of hepatitis virus infection in the oncogenic initiation of hepatocellular carcinoma. World journal of gastroenterology , 22 (4), 1497.
Whitcomb, D. C., Frulloni, L., Garg, P., Greer, J. B., Schneider, A., Yadav, D., & Shimosegawa, T. (2016). Chronic pancreatitis: an international draft consensus proposal for a new mechanistic definition. Pancreatology , 16 (2), 218-224.
