Directions
Students should complete Part 1. All students should select three (3) clients (of your choosing) from Part 2 to assess.
Part 1
K.S. is a 35-year-old man who has been homeless for the past 5 years. He presents to the health department complaining of flulike symptoms and abdominal pain. K.S. has multiple tattoos and piercings. He admits to intravenous drug use and unprotected sexual behavior with multiple female partners. Blood tests reveal that K.S.’s liver enzymes are elevated. The healthcare provider suspects some type of hepatitis.
1. Considering K.S.’s lifestyle, which type or types of hepatitis has he most likely contracted? Explain your choice or choices.
- Hepatitis A
- Hepatitis B
- Hepatitis C
2. How would you expect a differential diagnosis of hepatitis to be confirmed?
- Presence of viral particles in stool
- Elevated bilirubin and prothrombin time and low albumin
- Presence of the specific hepatitis antibodies in the blood
- Inflammation of the liver on ultrasound
3. Choose all of the following results that are consistent with an acute episode of hepatitis B infection. Discuss what each test measures.
- Anti-HBs positive
- Anti-HBc (IgM) positive
- HBsAG positive
- HBsAG negative
4. K.S.’s girlfriend is also developing similar symptoms. Which of the following factors likely explains the onset of the girlfriend’s symptoms?
- They probably ate the same food.
- They likely obtained the virus from contaminated water.
- They probably infected each other through sexual contact or drug activity.
- They likely became infected because of poor living conditions.
Part 2 – select three (3) clients (of your choosing) to assess
In which client cases would gastrointestinal cancer be a risk and what would be the likely type of cancer?
- A 40-year-old man who smokes and has a duodenal ulcer.
- A 50-year-old woman with long-standing GERD and recent evidence of Barrett esophagus on upper endoscopy.
- A 60-year-old obese woman with a history of alcohol abuse and chronic pancreatitis.
- A 25-year-old man who contracted hepatitis A on an international trip.
- A 60-year-old woman with type 2 diabetes mellitus and a history of long-standing constipation and consuming one or two alcoholic drinks every other day.
- A 25-year-old with a history of Hashimoto thyroiditis and Crohn disease.
Expert Solution Preview
Introduction:
In this assignment, we will address various aspects related to hepatitis and gastrointestinal cancer. We will analyze a clinical case of a homeless man with symptoms of hepatitis and answer specific questions about his condition. Additionally, we will assess six different client cases to determine the risk of gastrointestinal cancer and identify the likely type of cancer in each case.
Answer to Part 1:
1. Considering K.S.’s lifestyle, which type or types of hepatitis has he most likely contracted? Explain your choice or choices.
Given K.S.’s history of intravenous drug use, multiple female sexual partners, and elevated liver enzymes, it is most likely that he has contracted Hepatitis C. Hepatitis C is commonly transmitted through blood contact, such as sharing needles for drug use or through unprotected sexual activities. This mode of transmission aligns with K.S.’s lifestyle choices.
2. How would you expect a differential diagnosis of hepatitis to be confirmed?
To confirm a differential diagnosis of hepatitis, the presence of viral particles in stool, elevated bilirubin and prothrombin time, low albumin levels, and the presence of specific hepatitis antibodies in the blood can be assessed. However, among the options provided, the confirmation of hepatitis diagnosis is most likely achieved by the identification of specific hepatitis antibodies in the blood.
3. Choose all of the following results that are consistent with an acute episode of hepatitis B infection. Discuss what each test measures.
Among the options provided, the following results are consistent with an acute episode of hepatitis B infection:
– Anti-HBs positive: This test measures the presence of antibodies against the hepatitis B surface antigen. A positive result indicates immunity to hepatitis B.
– Anti-HBc (IgM) positive: This test detects the presence of IgM antibodies against the hepatitis B core antigen. A positive result suggests recent infection with hepatitis B.
– HBsAG positive: This test detects the hepatitis B surface antigen, indicating active infection with the hepatitis B virus.
– HBsAG negative: A negative result for the hepatitis B surface antigen indicates the absence of active hepatitis B infection.
4. K.S.’s girlfriend is also developing similar symptoms. Which of the following factors likely explains the onset of the girlfriend’s symptoms?
Among the factors mentioned, the most likely explanation for the onset of the girlfriend’s symptoms is that they probably infected each other through sexual contact or drug activity. Considering K.S.’s history of unprotected sexual behavior and intravenous drug use, it is plausible that he transmitted the hepatitis virus to his girlfriend through these modes of transmission.
Answer to Part 2:
In which client cases would gastrointestinal cancer be a risk, and what would be the likely type of cancer?
Among the client cases provided, the following cases present a risk of gastrointestinal cancer:
– A 40-year-old man who smokes and has a duodenal ulcer: This client is at risk of developing duodenal cancer, which can be associated with chronic inflammation from the duodenal ulcer and smoking.
– A 50-year-old woman with long-standing GERD and recent evidence of Barrett esophagus on upper endoscopy: This client is at risk of developing esophageal adenocarcinoma, as long-standing GERD and the presence of Barrett esophagus are known risk factors for this type of cancer.
– A 60-year-old obese woman with a history of alcohol abuse and chronic pancreatitis: This client is at risk of developing pancreatic cancer. Chronic pancreatitis, obesity, and alcohol abuse are risk factors for the development of pancreatic cancer.
It is important to note that the other client cases mentioned in the assignment are not directly associated with an increased risk of gastrointestinal cancer based on the information provided.
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