Module 1 Assignment: Case Study Analysis
Module 1 Assignment: Case Study Analysis
The provided case study demonstrates an obese 65-year-old male patient with chief complaints of crampy left lower quadrant pain, fever, and constipation. The patient reports a history of diverticulitis (chronic inflammatory bowel disease) which might have contributed to his current symptoms. He also confirms taking an unbalanced diet low in fiber and adopting a sedentary lifestyle with no physical exercise. His father also passed away from colon cancer. He agreed to a colonoscopy, which revealed multiple polyps positive for colon adenocarcinoma. The purpose of this discussion is to demonstrate the pathophysiology behind the patient presenting symptoms and the role of genetics and his immune system in the disease development process.
Pathophysiology
The patient complains of crampy left lower quadrant pain, fever, and constipation in addition to being obese. He also reports a history of diverticulitis (chronic inflammatory bowel disease), which might have contributed to these symptoms, in addition to his low fiber unbalanced diet, and sedentary lifestyle. Studies show that small pouches normally bulge from the inner lining of the lower digestive tract of patients with diverticulitis (Kayano et al., 2019). Tearing one or several of these pouches normally causes inflammation, which may result from infections in some instances, presenting in the form of fever, lower abdominal pain, constipation, and nausea (Koo et al., 2020). Additionally, a high-fiber diet usually helps increase the bulk of feces. As such, the patient consuming a low fiber diet worsens constipation. Additional contributing factors to the patient’s condition include a sedentary lifestyle, advanced age, and obesity.
Genetics
Colon cancer is normally associated with several complex health complications in relation to genetic alterations which promote the progression of an adenoma to invasive adenocarcinoma. Colon cancer is considered one of the most common cancer syndromes that are inherited. Studies show that in the early stages, mutations of the adenomatous polyposis gene (APG) usually occur as an inheritable gene from patients with familial adenomatous polyposis (FAP) (Hassab et al., 2020). Additional genes involved in the development of cancer of the colon include the KRAS proto-oncogenes and Deleted in Colorectal Carcinoma (DCC) tumor suppression genes.
Immunosuppression
Immunosuppression is described as the dysfunction of the immune response of an individual either temporarily or permanently because of any kind of disruptions to the immune system functioning, predisposing the individual to infections among other health complications (McKechnie et al., 2021). Several factors have been associated with the cause of immunosuppression such as drugs like corticosteroids, and chronic health conditions like chronic inflammatory bowel disease (diverticulitis). Researchers have also reported that tumor cells normally release immunosuppressive factors that have both local and system effects on the functioning of the patient’s immune system (Kearney et al., 2021). The immunosuppressive factors which are normally produced by tumor cells include but are not limited to adenosine, Interleukin-10 (IL-10), PGE2, and Transforming Growth Factor-β (TGF-β). They are responsible for impairment of the immune cell function. Hence the patient’s body system is unable to defend itself against foreign bodies like microorganisms which increase the risks of infection among other health complications.
Conclusion
The patient in the provided case study is obese, with symptoms that suggest adenocarcinoma of the colon. The patient’s condition might have been contributed by diverticulitis, advanced age, and a family history of colon cancer. Several genetic factors including APG, KRAS proto-oncogenes, and DCC tumor suppression genes are normally involved in the development of colon cancer. Studies also show that tumor cells can also produce immunosuppressive factors which increase the patient’s risk of infection. With this understanding, it is necessary to manage the underlying causes of the patient’s condition and promote a healthy lifestyle for a better outcome.
References
Hassab, T., D’Adamo, C. R., Patel, S. D., Mavanur, A. A., Svoboda, S., & Wolf, J. H. (2020). Risk of Unexpected Colon Cancer after Operation for Suspected Diverticulitis. Journal of the American College of Surgeons, 231(4), e11-e12. DOI: 10.1016/j.jamcollsurg.2020.08.030
Kayano, H., Ueda, Y., Machida, T., Hiraiwa, S., Zakoji, H., Tajiri, T., … & Nomura, E. (2019). Colon cancer arising from colonic diverticulum: A case report. World Journal of Clinical Cases, 7(13), 1643. PMID: 31367623
Kearney, M. B., Williams, J. M., & Ebell, M. H. (2021). Colon Cancer and Diverticular Disease Association: a Case-Control Study. Journal of Gastrointestinal Cancer, 52(1), 120-124. https://doi.org/10.1007/s12029-019-00355-1
Koo, C. H., Chang, J. H., Syn, N. L., Wee, I. J., & Mathew, R. (2020). Systematic review and meta-analysis on colorectal cancer findings on colonic evaluation after CT-confirmed acute diverticulitis. Diseases of the Colon & Rectum, 63(5), 701-709. https://doi.org/10.1097/DCR.0000000000001664
McKechnie, T., Lee, Y., Kruse, C., Qiu, Y., Springer, J. E., Doumouras, A. G., … & Eskicioglu, C. (2021). Operative management of colonic diverticular disease in the setting of immunosuppression: A systematic review and meta-analysis. The American Journal of Surgery, 221(1), 72-85. https://doi.org/10.1016/j.amjsurg.2020.06.035
| Excellent | Good | Fair | Poor | ||
| Main Posting | 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. |
35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors. |
0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style. |
|
| Main Post: Timeliness | 10 (10%) – 10 (10%)
Posts main post by day 3. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not post by day 3. |
|
| First Response | 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Second Response | 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Responds fully to questions posed by faculty.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Response is effectively written in standard, edited English. |
14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English. |
12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited. |
0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited. |
|
| Participation | 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days. |
0 (0%) – 0 (0%) | 0 (0%) – 0 (0%) | 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days. |
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| Total Points: 100 | |||||