CRONS PPT.pptx
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Mrs. X, a 45-year-old female, presented with vomiting, abdominal pain, and diarrhea for 3 days. CT scan and colonoscopy revealed inflammation in the intestine without mass and multiple colon ulcers with skip lesions. She was diagnosed with Crohn's disease. Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the digestive tract. Treatment involves medications like 5-ASA, corticosteroids, and immunomodulators to reduce inflammation and induce remission.
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- 1. A CASE PRESENTATION ON CROHN'S DISEASE Presented by A. Suresh PharmD 5th year 194T1T0006
- 2. P A TIENT DEMOGRAPHIC DA T A • Patient Name: Mrs. X • Age/ gender:45 years/Female • Department: Gastroenterology • IP no : 2023 Chief complaints • Vomiting's since 3 days • Abdominal pain since 3 days • Diarrhea since 3 days
- 3. PAST MEDICAL HISTORY Nill PAST MEDICATION HISTORY Nill Personal history: Diet : mixed diet Appetite : loss of appetite Body weight:70 kg GENERAL EXAMINATION Patient is conscious and coherent
- 4. PHYSICAL EXAMINATION • Temp: 98.4;f • Pulse rate:88bpm • BP:130/80 mm hg SYSTEMIC EXAMINATION • CVS: S1&S2 + • CNS:NAD • P/A:SOFT • tenderness over the lower abdomen and umbilical region
- 5. LAB INVESTIGATION Parameters Observation Normal range Hb 13.0 13-15 gm/dl WBC 8,000 4,000 – 11,000 cumm Sr. Creatinine 0.8 0.6 to 1.3 mg/dl Sodium 132 135 to145 mmol/L Potassium 3.3 3.5 to 5 mmol/L Chloride 90 90 to 110 mmol/L
- 6. DIAGNOSIS • CT Scan abdomen performed IMPRESSION: Inflammation process in the intestine without mass • COLONOSCOPY was performed IMPRESSION: multiple colon ulcers with skip lesions
- 7. DRUG CHART drug Category Dose Frequency ROA Metocloprami de Dopamine receptor antagonist 10 mg TID IV Morphine Opiod analgesic 5 mg OD IV PCT Analgesic or anti pyretic 500 mg OD P/O Buscopan Antispasmod ic 20 mg OD IV
- 8. SUBJECTIVE FINDINGS • A female patient of age 45 years was a admitted in general medicine ward with complain ts of vomiting since 3 days with nausea... abdominal pain and diarrhea a since 3 days. OBJECTIVE FINDINGS Ct scan: Inflammation process in the intestine without mass Colonoscopy: multiple colon ulcers with skip lesions • ASSESSMENT: • Based on subjective and objective findings the case is diagnosed as crohn’s disease SOAP NOTES
- 9. DISEASE INFORMATION DEFINITONS: Crohn's disease is a chronic disease that causes inflammation in the digestive tract. It can affect any part of the digestive tract, But it usually affects the small intestine and the beginning of large intestine Types of Crohn's disease 1.Ileocolitis 2.Ileitis 3.Gastro duodenal chrons disease 4.Jejuno ilitis
- 10. ETIOLOGY: • Exact cause is not known • Alteration in bacterial microflora • Smoking • Alcohol • Genetics • Norovirus • Nutrition deficiency • Long term use of certain medications eg: NSAIDS
- 11. PATHOPHYSIOLOGY
- 12. Signs and symptoms Pain , inflammation of the gut Ulceration in gut Vomitings Mouth ulcer Mild or moderate diarrhea Fatigue Weight loss Anemia DIAGNOSTIC TOOLS USG ABDOMEN CT SCAN COLONOSCOPY INTESTINAL ENDOSCOPY
- 13. TREATMENT PHARMACOLOGICAL TREATMENT 1. 5 Amino salicylic acid (5-ASA) Eg: Mesalamine, Mesalazine 2.Prednisolone and Methylprednisolone 3.Immuno modulators Eg:Azathioprine,Mercaptopurine,Methotrexate,Ifliximab,ad alimumab 4. Hydrocortisone should be used in severe conditions of Crohn's disease.