Sandbox/v23: Difference between revisions

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==Management==
<div style="text-align:center;">
The algorithm is based on the American Journal of Gastroenterology guidelines for management of Crohn's disease in adults.<ref name="LichtensteinHanauer2009">{{cite journal|last1=Lichtenstein|first1=Gary R|last2=Hanauer|first2=Stephen B|last3=Sandborn|first3=William J|title=Management of Crohn's Disease in Adults|journal=The American Journal of Gastroenterology|volume=104|issue=2|year=2009|pages=465–483|issn=0002-9270|doi=10.1038/ajg.2008.168}}</ref>
<div style="float:left; padding: .5ex 0; font-weight:bold; background-color:#cedff2;  border:2px solid #a3b0bf; border-bottom:0; font-size:90%">&nbsp;&nbsp;1. [[Sandbox/v22|Introduction]]&nbsp;&nbsp;</div>
<div style="float:left; padding: .5ex 0; font-weight:bold; background-color:#dfe0e1;  border:2px solid #999; border-bottom:0; font-size:90%">&nbsp;&nbsp;2. [[Sandbox/v23|Create a username]]&nbsp;&nbsp;</div>
<div style="float:left; padding: .5ex 0; font-weight:bold; background-color:#dfe0e1;  border:2px solid #999; border-bottom:0; font-size:90%">&nbsp;&nbsp;3. [[Sandbox/v24|Introduce yourself]]&nbsp;&nbsp;</div>
<div style="float:left; padding: .5ex 0; font-weight:bold; background-color:#dfe0e1;  border:2px solid #999; border-bottom:0; font-size:90%">&nbsp;&nbsp;4. [[Sandbox/v25|Join in!]]&nbsp;&nbsp;</div>
</div>


{{Family tree/start}}
<div style="clear:both; width:100%; border:3px solid #fc0;">
{{familytree |border=2|boxstyle=background: WhiteSmoke;| | | | | | | | | | | | | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | A01=<div style="float: left; text-align: left; height: 46em; width: 30em; padding: 0.5em;">'''Characterize the symptoms:'''<br>
  <div style="padding:1ex; ">
----
❑ [[Abdominal pain]] <br>
❑ [[Diarrhea|Chronic diarrhea or nocturnal diarrhea]] <br>
❑ [[Nausea]] <br>
❑ [[Vomiting]] <br>
❑ [[Bloating]]/[[Abdominal distention]]<br>
❑ [[Constipation]]/[[Constipation overview|Obstipation]]<br>
❑ [[Fever]] <br>
❑ [[Malaise]] <br>
❑ [[Loss of appetite]] <br>
❑ [[Loss of weight]] <br>
❑ [[Hematochezia|Rectal bleeding]] <br>
❑ [[Rectal pain|Painful defecation]] <br>
❑ [[Altered mental status]]
----
'''Extraintestinal symptoms:'''<br>
----
❑ [[Skin lesions]] <br>
❑ [[Oral ulcer|Oral ulcers]] <br>
❑ [[Odynophagia]], [[dysphagia]] <br>
❑ [[Joint pains]] <br>
❑ [[Dysuria|Burning micturition]] <br>
❑ [[Cough]], [[breathlessness]] <br>
❑ [[Eye pain]], [[blurring of vision]] <br>
----
'''Obtain detailed history:'''<br>
----
❑ Medical and surgical history <br>
❑ Recent medication history <br>
❑ Recent travel history <br>
❑ Family history <br>
❑ Abdominal/pelvic radiation
</div>}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | B01 | | | | | | | | | | | | | | | | | | | | | | | B01=<div style="float: left; text-align: left; height: 28em; width: 25em; padding:1em;">'''Assess volume status:'''
----
❑ General condition <br>
❑ Thirst <br>
❑ [[Pulse]] <br>
❑ [[Blood pressure]] <br>
❑ Eyes <br>
❑ Mucosa
----
'''Examine the patient:'''<br>
----
❑ Skin (swelling, pain, erythema or ulceration) <br> ❑ Oral cavity (ulcers) <br> ❑ Respiratory system (wheezing or crackles) <br> ❑  Cardiovascular system <br> ❑ Abdomen (mass, distension or tenderness) <br> ❑ Anorectal (perianal skin tags, sinus tracts or bleeding) <br> ❑ Eye (swelling, pain, edema or vision loss) <br> ❑ Musculoskeletal (Axial, large and small joints) <br>  </div>}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | C01 | | | | | | | | | | | | | | | | | | | | | C01=  <div style="float: left; text-align: left; height: 21em; width: 25em; padding:1em;">'''Order tests:'''<br>
❑ [[Complete blood count|Complete blood count (CBC)]]  <br>
❑ [[Erythrocyte sedimentation rate|Erythrocyte sedimentation rate (ESR)]]<br>
❑ [[C-reactive protein|C-reactive protein (CRP)]]<br>
❑ [[Serum electrolytes]]  <br>
❑ Serum [[iron]] and [[vitamin B12]] levels<br>
❑ [[Diarrhea laboratory findings|Stool analysis (occult blood, WBC's, calprotectin, lactoferrin, culture, ova and parasites)]]<br>
❑ [[Clostridium difficile laboratory findings|Stool for Clostridium difficile toxin]] <br>
❑ [[Urinalysis]] <br>
❑ [[BUN]] <br>
❑ [[Creatinine]]<br>
❑ [[Serum glucose]]<br>
❑ [[Liver function tests]] <br> </div>}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | D10 | | | | | | | | | | | | | | | | | | | | | | D10= <div style="float: left; text-align: left"> '''Confirmatory diagnostic tests:'''<br> ❑ [[Colonoscopy|Colonoscopy and biopsy]] <br> ❑  Upper GI scopy and biopsy<br> ❑ [[Computed tomography|Computed tomography (CT)]] <br> ❑ [[Barium enema]](length and location of strictures) <br> ❑ Upper gastrointestinal series with small bowel follow through (SBFT) <br> ❑ [[Magnetic resonance imaging]] (enterography)<br> ❑[[Wireless capsule endoscopy]]<br>
</div>}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | D10 | | | | | | | | | | | | | | | | | | | | | | D10= <div style="float: left; text-align: left"> '''Findings suggestive of Crohn's disease:'''<br> ❑ Discontinuous lesions <br> ❑  Biopsy (Transmural inflammation, noncaseating granuloma) <br> ❑ Cobblestoning (Serpiginous and linear ulcer)<br> ❑ Normal rectum <br> ❑ Isolated terminal ileum involvenent <br> ❑ Aphthous ulcers<br> ❑ Negative stool examination for infectious causes <br>
</div>}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | | B01 | | | B01=Assessment of severity}}
{{familytree | | | | | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|.| | | | | | | | | | | |}}
{{familytree | | | | | | | C01 | | | | | | | | | | | | | | | | C02 | | | | | | | | | C03 | | | | | | | | | | | | C01=<div style="float: left; text-align: left">'''Mild to moderate'''
----
❑ Ambulatory patients <br>
❑ Tolerating oral diet <br>
❑ No dehydration <br>
❑ No toxicity <br>
❑ No abdominal tenderness or mass <br>
❑ No obstruction <br>
❑ [[Weight loss]] <10 percent <br>
</div>
| C02= <div style="float: left; text-align: left">'''Moderate to severe'''
----
❑ [[Fever]] <br>
❑ Intermittent nausea or vomiting <br>
❑ Mild to moderate dehydration <br>
❑ [[Anemia]] <br>
❑ Abdominal pain and tenderness <br>
❑ No obstruction <br>
❑ Weight loss > 10 percent <br>
</div>
| C03=<div style="float: left; text-align: left">'''Severe to fulminant'''
----
❑ High fever <br>
❑ Persistent vomiting <br>
❑ Severe [[dehydration]] <br>
❑ Significant [[peritoneal signs]] <br>
❑ Evidence of [[abscess]] <br>
❑ [[Intestinal obstruction]] <br>
❑ [[Cachexia]] <br>
</div> }}


{{Family tree/end}}
    <div style="float: left; width: 90%; margin-left: 4.5%; margin-bottom: 2%;">
      <div style="float: left; padding-right: 8%;">
<h3 style="font-size: 100%; margin: 0;">What is a username...</h3>
* A username identifies you on WikiDoc.
* It's '''very easy''' to set up, and all we will need is you to create a username and a password.
* Once you create a username, you'll be able to contribute content and get credit for your contributions (your username will appear in the page history), view all of your contributions, and you will be able to create a user page to tell others about you. Other users will be able to contact you on your user talk page.
      </div>
    </div>


<div style="width: 80%; margin: 0 auto; clear: both; white-space: nowrap; text-align: left; border-bottom: 1px solid #c0c0c0; margin-bottom: 1%;"> </div>


{|
|
{{divbox|navy|Step 1|Click on the '''create an account or log in''' link at the top of any WikiDoc page.}}




{{divbox|navy|Step 2|Pick a username and password and fill out the form.}}
|[[Image:Sign_up.PNG|300px|frame||'''Step 1''' - Select this link]]
|[[Image:Username.PNG|100px|frame|right|'''Step 2''' - Fill out the simple form]]
|}


</div>
<div style="width: 17em; margin: 0 auto; clear: both; white-space: nowrap; text-align: left;"> </div>


==References==
<!--
{{Reflist|2}}
<div style="border-top:1px solid #fc0;padding:.3em 0;text-align:center;background-color:#ff9;margin-top:.5em;font-size:90%">[[Insert Link|'''Insert Text&gt;&gt;''']]
</div>
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__NOEDITSECTION__

Latest revision as of 23:23, 19 January 2014

  1. Introduction  
  4. Join in!  

What is a username...

  • A username identifies you on WikiDoc.
  • It's very easy to set up, and all we will need is you to create a username and a password.
  • Once you create a username, you'll be able to contribute content and get credit for your contributions (your username will appear in the page history), view all of your contributions, and you will be able to create a user page to tell others about you. Other users will be able to contact you on your user talk page.

Template:Divbox


Template:Divbox

frame Step 1 - Select this link
File:Username.PNG
Step 2 - Fill out the simple form


Retrieved from "https://www.wikidoc.org/index.php?title=Sandbox/v23&oldid=933688"