Free «Coursework» Essay Sample


Patient 1

A. Comparison between Ulcerative Colitis and Crohn’s Disease

1) Similarities

The two diseases are common amongst teenagers and young adults but it does not mean that the disease does not affect adults. In addition, the disease affects both genders with men and women affected equally. For the two diseases, there are unknown causes and no definite cure but the contributing factors are common and include genetic, environmental, and inappropriate immune system of the body (Baumgart, 2012). The environmental factors associated with inflammatory bowel disease (IBD) include temperate climates present in North America, the United Kingdom, Scandinavia, and other nations located in Western Europe. Further, IBD is more prevalent amongst urban populations unlike rural populations; amongst Caucasians unlike darker-skinned persons and Asians; IBD also links with people of higher socioeconomic status unlike poorer persons. In both cases, the patients expect to live with the disease their entire lives.

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2) Differences

In terms of location, Crohn’s disease involves inflammation occurring anywhere along the digestive tract, while ulcerative colitis involves an inflammation of a specific site in the large intestines (Lubin et al., 2009). In Crohn’s disease (CD), an inflammation may occur in patches that penetrate deep into the bowel tissue walls, while ulcerative colitis (UC) involves a big continuous area along the large intestine affecting a single layer of bowel wall and starts from rectum towards up through the colon. In both cases, patients experience pain with CD pain commonly occurring at the lower right abdomen, while pain in lower abdomen is common amongst the UC patients. In CD, colon walls are thickened and have rocky appearance, while UC involves thin walls with continuous inflammation. During bowel movement, only UC patients experience bleeding. CD is managed effectively using medications; unlike the UC that requires medication and removal of colon surgically.

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B. Appropriate Short Term and Long Term Care for Patient 1

The diagnosis for this patient is Crohn’s Disease characterized by persistent recurrent diarrhea, weight loss, and patches on inflammation gastrointestinal tract areas like rectum, sigmoid colon, ileum, and colon. The goals of treating Crohn’s Disease are to induce and maintain remission, improve the patients’ quality of life, and minimize toxicity (Zheng et al., 2011). In this case, the goal is to have the patients feeling normal with the least side effects and highest attainment of patients’ quality of life. This way, the patients can live normally without constraints from the disease. Short-term care involves the use of biologics like immunomodulators and novel biologic therapies to successfully heal the mucosa and reduce the instances of hospitalization and surgeries. In addition, patients should stop smoking to avoid exacerbation of the patients’ conditions, and avoid the use of non-steroidal anti-inflammatory drugs or NSAIDs.

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The long-term care for CD patients involves sustaining remission and requires a team of healthcare practitioners, including nutritionists, social workers, gastroenterologists, and physicians. The patient also actively takes part in the treatment process by understanding the functioning of medication, side effects, and surgical options. Nutritionists suggest the foods that contribute to CD and require the patients to avoid those using alternatives to replace the lost nutrition and promote healing and are customized to the patients’ needs (Elriz et al., 2011). The gastroenterologist suggests the complementary therapies for pain control and immune system boosting. Patients should learn to deal with stress and emotional factors by seeking support from family members and caregivers and seek medical support, where appropriate (Elriz et al., 2011). Further, the patients should proactively identify and learn numerous coping strategies to minimize the challenges of living with the illness. Further, patients should sustain strict medication adherence to reduce flare-ups.

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Patient 2

The Epidemiology and Risk Factors for Endometrial and Ovarian Cancers

Endometrial cancer occurs from the glandular tissue within uterine lining. Highest prevalence is amongst women and about 2-3% of US women experience it within their lifetime. Endometrial cancer has two biologically varying subtypes, namely low-risk subtype and high-risk subtype (National Cancer Institute, 2014). Low-risk subtype is a well defined carcinoma linked to bleeding symptoms during inception. The risk factors include obesity, nulliparity, chronic ovulation, tamoxifen usage, and therapy for estrogen replacement (Pfeiffer et al., 2013). High-risk subtype links with few malignancies of endometrial cancers, does not involve elevation in estrogen circulation, and is common amongst postmenopausal women. Spread of a cancer involves local invasion and vascular and lymphatic embolization around cervix, retroperitoneum, and adnexa. Both incidents are common amongst white women unlike black women but blacks have higher mortality rates. Additional risk factors include infertility history, diabetes, hypertension, gall bladder disease, and high-animal fat diets. However, this disease is curable, as patients have differentiated tumors during disease onset.

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Compared to endometrial cancer, ovarian cancer is linked to higher deaths due to gynecologic malignancy, particularly in the US (National Cancer Institute, 2014). About 90% of ovarian cancers are classified as epithelial ovarian carcinomas that are subdivided into clear cell, transitional, mucinous, serous, and undifferentiated carcinomas. Compared to ovarian epithelial carcinomas, the borderline ovarian carcinomas are less aggressive and occur in young women. Risks of ovarian epithelial carcinomas increase with age. Germ cell tumors are associated to 5% of all ovarian cancers and run through placental structures and developing embryo (Pfeiffer et al., 2013). This cancer can occur in women of any age, particularly in those below 30 years. Sex cord-stromal tumor occurs in connective tissue and holding ovarian stroma. Due to association with steroid production, this cancer accounts for virginal bleeding and hyperandrogenism. In the US, carcinoma ranks fifth as a death cause amongst women, especially those above 65 years. Risk factors include family history, genetic carriers of BRCA1 or BRCA2 mutations, post menopause hormone replacement therapy, cigarette smoking, high intake of alcohol, fertility drugs utilization history, and low consumption of fruits and vegetables.

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