Case Study: Analyzing Jordan's Medical Condition and Treatment

This case study presents the medical condition of Jordan, a patient suffering from Crohn's disease and experiencing rapid weight loss, malabsorption, and various other symptoms including hypotension, tachycardia, fever, and anemia. The assignment delves into the physiological mechanisms behi...Read More

Running head: CASE STUDY 1
Case Study
Name of the Student
Name of the University
Author Note

CASE STUDY 2
Question no. 1
People suffering from acute inflammatory disease or Cronh’s disease undergoes rapid weight
loss. This weight loss can be an indication of malnutrition caused by insufficient uptake of
calories. Also there is excessive fluid loss from the patient body owing to diarrhea or
intestinal bleeding(Cohen, 2011). Moreover, people with Crohn’s disease have less or poor
apetite, they do not feel the urge to eat. The patient was suffering from malabsorption and had
difficulty in maintaining their weight even if they consumed enough food, since his body is
unable to breakdown the food properly, utilizing the nutrients. Malabsorption lead to diarrhea
or bloating. The patient also developed food aversion which caused a sensation of pain while
eating. That is why, the patient used to avoid eating in order to avoid the pain or unpleasant
experience, thus leading to weight loss. Moreover, since Jordan was not being able to keep up
with his work, he remained depressed and refused to eat. The side effects of medications can
trigger a loss of appetite in the patient, since the medications are found to change the taste
sensation of the , making the person less interested in eating. Besides, the abdominal pain and
nausea reduced Jordan’s apetite which resulted in insufficient calorie intake. Rectal bleeding
from ulcer in the intestine leads to deficiency of iron, leading to anemia followed by severe
weight loss and weakness. Jordan was also diagnosed with perianal abscess or anal fistula
which reults in the leakage of bacteria into the abdomen, forming a collection of pus through
a process known as abdominal sepsis. As a result, there is less absorption of nutients and
calories in the body, which led to malnourishment and subsequent weight loss of Jordan.
Jordan had poor skin turgor due to severe fluid loss from the body. Mild dehydration occurs
when there is a fluid loss of 5% of the body weight whereas, severe dehydration accounts for
15% or more loss of total body weight.

CASE STUDY 3
Question no. 2
The “Pain pathway” consist of three separate orders of neurons which are involved in
carrying the action potential signal responsible for pain. The “first order” neurones are also
called pseudounipolar neurones which have cell body and ganglion at the dorsal root region.
The “second order” neurons have cell bodies which are found in the spinal cord or within the
cranial nerves. The cell body of the “third order” neuron lies within the ventral posterolateral
nucleus of the thalamus(Blanco, Rodriguez & Vadivelu, 2018). The first order neurons
consist of specialized receptors called nociceptors which are present at the nerve endings of
the primary afferent neuron, also called unencapsulated cutaneous receptors. These receptors
transduce the signal of pain when a specific region of the skin gets stimulated. They can be
found in skin, joints, muscles and bones. There are three types of nociceptors: mechanical
nociceptors helps in detecting sharp and intensive pain, thermal and mechano-thermal
nociceptors helps in detecting sensation which gives a burning or cold sensation and
polymodal nociceptors can detect mechanical, chemical and thermal sensations.
Morphine directly shows its activity on the opioid receptors, which is a type of “G-protein
coupled receptor”(GPCR) and helps in modulation of pain in the nervous system. The opioid
receptors are present mainly in the brain and spinal cord, it binds with a compound named
encephalin to control pain. Morphin mimics the structure of encephalin and binds itself with
the opioid receptors and triggers a series of events. It activates GPCR , which increases the
rate of conduction through potassium channel, and decreases the rate of conduction through
calcium channel, followed by adenylyl cyclase inhibition. Together, these modulations
interferes with the transmission of pain signal to the nervous system(Nealon et al, 2018).

CASE STUDY 4
Question no. 3
The condition of Jordan was worsening day by day. His blood pressure reading shows 92/52
mm/hg, which signifies a sudden drop in his blood pressure owing to hypotension. A low
blood pressure can be detrimental for the body and can make the person feel fatigued, tired
due to lack of energy. His pulse rate increased to 112 beats per minute which is well above
the normal pulse rate of 60-70 beats per min. This can be a sign of sinus tachycardia.
Moreover, he had weak peripheral pulses which can be caused by reduced blood flow to the
vital organs(Cgp Books, & Cgp Books, 2012).. His respiratory rate was recorded around 24
breaths per minute which is above the normal range (20 breath per minute) indicating a panic
attack or increased anxiety and stress. His body temperature was around 38.3oC which clearly
indicates that Jordan must be suffering from fever. Although the oxygen saturation level
seemed to be normal, his weight was below average, since the normal average weight of a 25
years old male having a height of 188 cm should have been around 82 kilograms. Lastly on
performing urinalysis, the appearance of the urine was dark with a very high specific gravity,
around 1035, which can be a clear indication of renal infection or pyelonephritis. On further
pathological examination, it was found that his haemoglobin level was around 109g/ litre,
which indicated that Jordan might be suffering from moderate anemia(Dignass et al, 2015).
The haematocrit value was 51% which is higher than the normal range of 35-47%, this is a
sign of dehydration. The Erythrocyte segmentation rate was found abnormally high
(26.5mm/hour) which is a sign of inflammation in the body. The amount of C-reactive
protein was found to be about 30.7mg/dl which is higher than the normal value (20mg/dl). A
high value of C-reactive protein can be a sign of inflammation of the arteries in the heart,
which may increase the risk of myocardial infaction. The concentration of albumin the blood
was found to be 30.5g/litre, which is below the normal range (35-50 g/litre). This can be a

CASE STUDY 5
clear indication of malnutrition or the patient may be suffering from a liver disease or
inflammatory disease(Hawkey, 2012).
Question no. 4
Hartman’s solution, also known as Ringer’s lactate solution is a mixture of sodium chloride,
potassium chloride, sodium lactate and calcium chloride in water. It is given intravenously to
the patient’s who have low blood pressure as a replacement for fluid and electrolytes. It is a
rich source of bicarbonate, which helps in the treatment of metabolic acidosis related to
dehydration or renal failure(Yung, Letton & Keeley, 2017).. It can also be used as a route of
intravenous drug delivery. Jordan has lost the necessary fluids and electorolytes from his
body due to diarrhea, Hartman’s solution will help in replenishing and restoring the
electrolyte balance.
Methylprednisolone is a class of anti-inflammatory agents called corticosteroids and is used
to treat inflammatory disease. It can be ideal for treating Jordan, since this drug works well in
treating Crohn’s disease. It helps in suppression of the immune system along with reduce the
inflammation of the digestive tract(Steinhart, 2017). The dosage of methylprednisolone
required for Jordan is around 60 mg/ day. The drugs starts to show its effects within the
fourth week and the dosage is gradually reduced depending on the rate treatment progress and
finally stopped. It can also be used to lower the exhaberation of the inflammatory bowel
disease.

CASE STUDY 6
REFERENCE
Blanco, P. T., Rodriguez, M. R., & Vadivelu, N. (2018). 1 Pathophysiology of Pain and Pain
Pathways. Perioperative Pain Management for Orthopedic and Spine Surgery.
Cgp Books, & Cgp Books. (2012). New a-level biology for aqa.
Cohen, R. (2011). Inflammatory bowel disease. Humana.
Dignass, A., Gasche, C., Bettenworth, D., Birgegård, G., Danese, S., & Gisbert, J. et al.
(2015). European Consensus on the Diagnosis and Management of Iron Deficiency
and Anaemia in Inflammatory Bowel Diseases. Journal Of Crohn's And Colitis, 9(3),
211-222.
Hawkey, C. (2012). Textbook of clinical gastroenterology and hepatology. Wiley-Blackwell.
Nealon, C. M., Patel, C., Worley, B. L., Henderson-Redmond, A. N., Morgan, D. J., &
Czyzyk, T. A. (2018). Alterations in nociception and morphine antinociception in
mice fed a high-fat diet. Brain research bulletin, 138, 64-72.
Steinhart, A. H. (2017). Steroid Therapy for Crohn’s Disease. In Crohn's Disease and
Ulcerative Colitis (pp. 315-319). Springer, Cham.
Yung, M., Letton, G., & Keeley, S. (2017). Controlled trial of Hartmann's solution versus
0.9% saline for diabetic ketoacidosis. Journal of paediatrics and child health, 53(1),
12-17.