Discussion


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Surgeries: None

AllergiesNKDA

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GI Case Study:

Chief complaint: “I accept alternate H. Pylori infection”.

HPI: M.C. a 46-year-old Hispanic changeable presents to the GI dispensary for complaint of alternate H. Pylori infection. She was advised about 2 ½ months ago with H. Pylori amateur analysis and bootless treatment. She has PMH of dyspepsia, and GERD. She additionally indicates that she has noticed that her affection of dyspepsia are deepening for accomplished 2 months. She has associated her affection with nausea, agitated abdomen with all foods. Denies associated affection of hematochezia, melena, hemoptysis, belly pain, fever, chills, affliction or any alternative symptoms.

PMH:

H. Pylori infection gastritis

Diabetes Mellitus, blazon 2

Surgeries: None

AllergiesNKDA

Vaccination History: Up-to-date

Social history:

High academy graduate, affiliated and no children. He frequently eats out in restaurants. He drinks one 4-ounce bottle of red wine daily. He is a above smoker that chock-full 3 years ago.

Family history:

Both parents are alive. Father has history of DM blazon 2, Tinea Pedis. Mother animate 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 belly pain.

Physical examination:

Vital Signs

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

ABDOMEN: No belly distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Accustomed contour; No apparent masses.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine accustomed 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 again po daily.
  3. Cipro      500 mg po BID for 2 weeks

Plan: Tests

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

Urea animation analysis 8 weeks afterwards analysis with H. Pylori medications. Pt needs to stop PPI’s 2 weeks above-mentioned to Urea Animation test.

Labs: No new labs are needed.  

Referrals: may accredit based on aftereffect of medication analysis accustomed for 2 weeks.

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

As a approaching assistant practitioner, it is important that you actuate the medications acclimated for alternate H. Pylori infection.

Please altercate new analysis guidelines for H. Pylori treatment, and accommodate accommodating education.

Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the adapted H. Pylori therapy. Feel chargeless to argue alternative peer-reviewed accessories aural 5 years of publication.

Total of 2 column needed. 1 antecedent and 1 reply.

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

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