GI Case Study:

Chief complaint: “I have recurrent H. Pylori infection”.

HPI: M.C. a 46-year-old Hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has PMH of dyspepsia, and GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.

PMH:

H. Pylori infection gastritis

Diabetes Mellitus, type 2

Surgeries: None

Allergies: NKDA

Vaccination History: Up-to-date

Social history:

High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis. Mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea.

Cardiovascular: No edema. No palpitations.

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal

Assessment:

Primary Diagnosis: Recurrent H. Pylori infection gastritis

Secondary Diagnoses: Dyspepsia

Differential Diagnosis: Peptic Ulcer Disease

Previous medication plan: two months ago and failed.

  1. Clarithromycin      500 mg po BID for 2 weeks
  2. Omeprazole      40 mg po BID for 2 weeks and then po daily.
  3. Cipro      500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.

Urea breath test 8 weeks after treatment with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.

Labs: No new labs are needed.

Referrals: may refer based on effect of medication therapy given for 2 weeks.

Follow up: return to office in 8 weeks to reevaluate symptoms.

QUESTIONS

1. As a future nurse practitioner, it is important that you determine the medications used for recurrent H. Pylori infection.

2. Please discuss new therapy guidelines for H. Pylori treatment, and provide patient education.

Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel free to consult other peer-reviewed articles within 5 years of publication.

http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf

0

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

In the dynamic world we currently live in, it’s becoming increasingly difficult for students to balance academics, co-curricular activities and entertainment among others. Students are required to submit countless assignments in a short time frame. These assignments should not be taken lightly as they form a major part of the grade when it comes to the end of the semester. Understanding the value of education and how these grades are important to students, Infinite Essays has made it its mission in life to offer customized essays to students at an affordable cost.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

There are plenty of reasons why you should order a paper with Infinite Essays. We have reliable writers who are also very competent. They have over the years managed to work under tight schedules and deadlines. Whenever you order an essay with Infinite Essays, you are guaranteed a fast turnaround of your project and this is done on time. Other than writing custom papers, our writers provide value added services that include academic assistance in the areas that they have specialized in. We ensure that the work that we offer is free of plagiarism. Infinite Essays does not condone plagiarism in whatsoever manner. Our writers are very experienced and can handle of sorts of formats such as Turabian, Chicago, Harvard as well as APA and MLA. Infinite Essays covers a wide range of topics. At the moment, we specialize with over 68 topics. We understand the importance of maintaining confidentiality when dealing with our clients. It’s for this reason that we will never reveal the identity of our clients to whoever may be interested. Finally, we offer the most competitive rates in the industry.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Whenever you want to make an order with us, you will use our automated online ordering system. If you are having some difficulties of any sort, feel free to contact our live support and they will be more than happy to assist you. Ensure that you fill all the relevant information regarding your order. This is the area where you have to include the deadline of your assignment, the formatting style to be used and even the kind of academic paper you desire. The more information you give to our writers, the better.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Brief explanations of how our services work 1. Provide us with the necessary instructions. Go to the Order Now page and click the order now button. This is the part where you have to attach all the relevant attachments. At the same time, remember to add the instructions sheet here. Once you are sure that you have submitted all relevant information, please submit the final draft to us. 2. The second step will involve paying for the services. This is where an invoice will be sent to you. However, the easiest process is clicking the payment link and following all the prompts that come along. At the moment, all payments are made through PayPal only. 3. Working on your paper. Once you have made the payment, we will assign the order to a writer who will follow the instructions. Remember that our writers will spend countless hour laboring to ensure that the work they provide is meticulously researched. 4. Download your paper. When the writer is finished with the assignment, they will submit it to our writers who will then go through the paper to ensure that the paper has followed all instructions and there are no grammatical errors. We will then forward a copy of the assignment to your email. 5. Tell your friends. We always happy to receive a referral. Whenever a friend tells us that you recommended our services to them, we will give you a 40 percent discount for your next order. Whenever you have provided us with the necessary details, we will forward them to qualified writers who will handle the assignment for you. Remember that the writers will begin working on the assignment immediately. This is the sole reason we encourage our clients to provide their exact specifications during the first time.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Tackling an order may be challenging but we always offer the best. Before the assignment can be passed to you by our writers, it will be passed through a team of qualified editors and proofreaders to ensure that the paper is accurate and of the required quality. Once the editors are satisfied with the assignment, they will forward the assignment to your account and a copy to your email.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Discounts We offer the best prices in the industry. We currently have a 20 percent discount for all of our customers. If you feel the budget is putting a strain on you, contact our live support and they might consider you case. We treat each case differently. Remember that our main goal is to continue with education transformation. At the moment, we only accept payments in form of PayPal.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline

Why Choose Us While there are many companies in the writing service industry claiming to offer platinum services, none can match the services offered by Infinite Essays. Some of our writers have been with us since 2010. The testimonials that have been written by some of our happy customers is an indication of the good services that we offer.

Click HERE to order a unique plagiarism free paper done by 

professional writers and delivered before your deadline