Read the information below. Do not simply answer the questions! You will hand in
ID: 68185 • Letter: R
Question
Read the information below. Do not simply answer the questions! You will hand in your work on a separate piece of paper. Please pm your information in paragraph form. Include any information you have found which helped you to answer your questions. The better job you do of explaining your results, the more points you will receive. Use as many resources as you can and be sure to cite them! The patient was a 35-year-old man who consulted his physician because of upper abdominal pain. The pain was described as a steady burning or gnawing sensation, like a severe hunger pain. Usually it came on 11/2 - 3 hours after eating, and sometimes it woke him from sleep. Generally, it was relieved in a few minutes by food or antacid medicines. On examination, the patient appeared well, without evidence of weight loss. The only positive finding was tenderness slightly to the right of the midline in the uppermost part of the abdomen. A test of the patient's feces was positive for blood. The remaining laboratory tests were normal. Endoscopy showed a patchy redness of parts of the stomach lining. A biopsy was taken. The endoscopy tube was passed through the pylorus and into the duodenum. About 2 cm into the duodenum there was a lesion 8 mm in diameter that lacked a mucous membrane and appeared to be "punched out." The base of the lesion was red and showed adherent blood clot. After the endoscopy, a biopsy portion was placed on urea-containing medium. Within a few minutes, the medium began to turn color, indicating a developing alkaline pH. What is the patient's diagnosis? What would you expect microscopic examination and culture of the gastric mucosa biopsy to show? Outline the pathogenesis of this patient's disease. Why did it take so long for doctors to accept that this condition had an infectious etiology? What is the best treatment option for this patient?Explanation / Answer
1. The patient diagnosis shows Peptic ulcer. It is due to Helicobacter pyroli.
2. For biopsy of gastic mucosa, urease it used. The specimen when tested in solution containing urea and phenol red, Urease enzyme in H.pyroli hydrolyses urea to ammonia leading to increase in pH to alkaline.Microscopic examination with eosin and hematoxylin stain shows epithelium lining with H.pyroli with purple color.
3.Pathogenesis include excess secretion of gastric acid and gastrointestinal mucosal layer damage.
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