Question

Table 28.5.1
Analyte	Results
Hemoglobin	8.1 g/dL
Hematocrit	30%
RBC count	4.1 x10^6/uL
Serum sodium	134 mmol/L
Potassium	3.4 mmol/L
Serum carotenoids	14 ug/dL
Fecal fat	22 g/24h
D-Xylose absorption test (25-g dose)	5-h excretion of 1.3g and blood level at 2h of 8 mg/dL
Prothrombin time	15.8 s (12-14 s)
Activated partial thromboplastin time	56 s (30-45s)

A 26-year-old woman appeared in the outpatient clinic with the complaint o abdominal discomfort, diarrhea, and an 18-lb, unintentional weight loss during the past 2 to 3 years. She related a similar period of 5 to 6 years of abdominal distress and diarrhea in childhood, but this essentially disappeared when she was about 12 to 13 years old. She was now having three to five bowel movements daily, which were described as bulky, malodorous, and floating. She weighed 106 lb and was 67 in. tall. She never had surgical procedures. Physical examination revealed poor skin turgor, general pallor, and a protuberant abdomen. Abnormal clinical laboratory values included those in Case Study Table 28.5.1. Fecal examination revealed no ova or parasites, and bacteriologic culture revealed no pathogens.

1. What is the disease process?

2. What is the probable etiology in this case?

3. What is the cause of the abnormal coagulation tests?

4. What is the probable major cause for the anemia, and what are other possible contributing causes?

Answer 1

1. The disease process if inflammatory bowel disease .

2. The cause of the disease are :-

- smoked food

- peptic ulcers

- NSAIDS

- intake of spicy ,oily foods

- inheritance

3. The cause of abnormal blood coagulation is the loss of blood in the diarrhoea due to ulcer and it resulted in increased blood coagulation time .

4. The probable major cause of anemia is blood loss in the diarrhoea and other contributing factors are less intake of iron containing food , any disease affecting the iron absorption etc .