DY CROHN DISEASE For the Disease Summary for this case study, see the CD-ROM. PATIENT CASE HPI C.D. is a 32 yo woman with a 14-year Hx of Crohn disease who presents with a three-day Hx of diarrhea and...

What is the pathophysiologic mechanism for adrenal insufficiency in this patient? What is the Potential cause of the abnormal DEXA scan in this patient? For which condition has trazodone been subscribed for this patient? Why is this patient taking cyanocobalamin IM?

Extracted text: DY CROHN DISEASE For the Disease Summary for this case study, see the CD-ROM. PATIENT CASE HPI C.D. is a 32 yo woman with a 14-year Hx of Crohn disease who presents with a three-day Hx of diarrhea and steady abdominal pain. She has been referred by her PCP to the GI clinic. The clinical course of her disease has included obstruction due to small intestine stricture and chronic steroid dependency with disease relapse when attempting to taper steroids. Endocrine tests reveal that she has developed adrenal insufficiency as a result of steroid use and a DEXA scan has demonstrated significant demineralization of bone. Patient Case Question 1. What is the pathophysiologic mechanism for adrenal insuffi- ciency in this patient? Patient Case Question 2. What is a potential cause of the abnormal DEXA scan in this patient? PSH • Portion of small bowel resected 5 years ago (obstruction from scarring and stricture) • Ovarian cyst drained, age 18 • Appendectomy, age 13 РМН • Crohn disease diagnosed 14 years ago (weight loss, severe diarrhea with multiple bowel movements, abdominal pain, dehydration) • Major depression


Extracted text: CASE STUDY 21 CROHN FH No family Hx of IBD SH • Has been married for 11 years and has two daughters who are healthy • Works as a nurse with a local home healthcare agency • Non-smoker and non-drinker ROS • Up to 10 loose to semi-solid stools/day, non-bloody • Denies chills and canker sores • Stable weight with good appetite • Denies joint pain, skin lesions, blurred vision, and eye pain • Some mild fatigue Meds • Prednisone, 40 mg po QD • Trazodone, 100 mg po BID • Cyanocobalamin, 250 ug IM Q month Patient Case Question 3. For which condition has trazodone been prescribed for this patient? Patient Case Question 4. Why is this patient taking cyanocobalamin IM? Pation Cro