SECTION 4 GASTROINTESTINAL DISORDERS Atrial tibeillation x 12 years Asthma × yea
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SECTION 4 GASTROINTESTINAL DISORDERS Atrial tibeillation x 12 years Asthma × years Type 2 DM x 5 years ETN x 10 years GASTROESOPHAGEAL REFLUX DISEASE A Burming Question Patient married with three children. She is a nctired school bu driver. She drinks one to two plases of wine 4-5 days per wck She does not use tobacon. She has Hlae Cross pecripion dg oncrage Level FH LEARNING OBJECTIVES Ather completing this case study, students should be ableto Father died et pecumoniaage 75.motherdiedatage68ef gaat Descnibe the dinical presentation of gastroesophageal seflux Meds dsease (GERD), inclading typical, atypical and alam symp Dtiasem CD 240 mg po once daily oms. Dsass·ppropriate degnostc 4pcades for CHI, nld ing when poets should be referred for further degostc valuson Metormin S00 mg po twice daly Aspirm 81 mg po daily Fleneesalakool DP110050dme daly . Reommend appeopriate norhmacdlogic and pha pharmacoPeanuts hives) logic measures for treating GERD Develop a treatment plan for a patient with GERD, includ ROs and pharmacologic measuresrports being tired all the time, end monitoring for eicacy and toxicity of selected drug regimens Eflectively counsel pašents with GERD on the proper use of dyvoria, mocturia, or freqaency heir drug theapy night, (+)freguent episodes of hearthurm,semetimes after meal but is worse at night NN; (-) BRIRR or dark tarry stock(- Gen Well-developed African-American woman in NAD VS PATIENT PRESENTATION Chief Complaint I'm having a lot o hearthurn. These pills I have been using ave P1%2, P90, RR 17,TC W helped a lintle but it's still keeping me up at night 100kg.1h 7 in No leions or rashes lanet Swigel is a 8 year-old woman who presents to the Gl clink with complaints of heartburs four to five tima a week over the last HEENT lso reports PERILA; EOME moie a oopharyns clear mous membrane intat dentition membrane itat deiticn that her symptom are much wore at night, particularly she goes to bed. She finds that her heartburn worens and she coughs lot at night, which keeps her awake She has had difficulay sloeping Necktymph Nodes and feels far gued dur has tried OTC Pepacid Trachea midlac ynom plyi lymph deep thys nodifficulity wallowing food or liquids She has tried OTC Prevacid 24HR once daily for the last 3 weeks. This has reduced the freqency ofher symptoms to 3-4 days per week, but they are ll bothering her, and she meeds help. Mosty CTA bilaterally, some intermittent wheExplanation / Answer
1a. The medicine like OTC drugs for heartburn may increase atrial fibrillation. However, H-2-receptor blockers will more effective in such cases.
1b. This is typical heartburn. That is because she has difficulty swallowing, severs coughing and difficulty in sleeping.
1c. The most important factor in heartburn is backflow of stomach acids in esophagus. That feels burning in chest and/or back.
1d. Factors, like patients disease history and drug failure recommends for more diagnosis.
1e. If heartburn not treated for long time, it will cause degradation of linings of esophagus. This will lead to inflammation and then to cancer.
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