Name: A&P Date: At the Clinic: Digestive System Directions: Use information from reputable Internet resources to diagnose and describe treatment options for the patients in the following case studies. Multiple diagnoses may apply. Additionally, be sure you are able to define/explain terms that are italicized within the case studies. Diagnostic Options to Consider: Liver Disease Cirrhosis Hepatitis (A/B/C/D/E) Gallbladder Disorders Cholelithiasis Cholecystitis Pancreatic Disorders Pancreatitis Diabetes Mellitus Intestinal Disorders Gastroenteritis Enteritis Diverticulitis Appendicitis Colitis Colorectal cancer Giardiasis Cholera Mucosa Disorders Thrush Gingivitis Gastric Disorders Gastric ulcers Gastritis Esophogeal Disorders Peritonium Disorders Esophagitis Ascites Gastroesophogeal reflux (GERD) Peritonitis Achalasia Patient 1: Sam, a 77 year old male, enters your office complaining of fatigue, jaundice, and loss of appetite. Upon examination, you notice that Sam has an enlarged liver and spleen, an extremely swollen abdomen that appears to be due to fluid build-up, and dark urine output. Sam’s medical history reveals that he has been a heavy drinker for about fifty years. He does not smoke, nor exercise. Patient 2: Jessica, a 56 year old woman, comes into your office with a plethora of symptoms. She has noticed over the past year that she has an unquenchable thirst. This causes her to take frequent trips to the bathroom. She has also complained of fatigue and neuropathy in her feet. She broke a toe last year and didn’t know it for three weeks. Her CBC has revealed that her blood counts are normal. Her plasma glucose test indicated a glucose level of 234 mg/dL. Her blood pressure is 120/78 and pulse is 70. Patient 3: John, a 46 year old engineer, is complaining of a sharp pain in his lower left abdomen. He tells you that the pain started a few days ago and has progressively worsened. As you feel the area to see if you can detect swelling , he reports that the area is quite tender. Further questioning reveals he has felt bloated and had numerous episodes of both diarrhea and constipation over the past few months, but both would only last a few days. Barium X rays reveal fluid pouches protruding from the colon wall. Patient 4: Mary has brought her 10 month old daughter, Jolie, to you because her appetite has decreased signigicantly. Mary also noticed whitish, velvety lesions on Jolie’s mouth and tongue. Microscopic analysis of mouth scraping reveals the presence of fungus. Patient 5: Dan reports extreme discomfort after eating including heartburn (burning discomfort behind the breastbone) and nausea as well as difficulty swallowing and hiccups on a less frequent basis. He has noticed that the symptoms are worse after a fatty meal or eating meals with tomato sauces such as pasta and pizza. An EGD reveals erosion of the internal mucosa of the esophagus.