J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.

Hello, I am needing (2) responses to a discussion for a case study. I will provide the original case study information. I do not need you to create an initial response. What I need is (2) responses to two classmates discussion post. I will attach the (2) discussions you need to respond to below. The instructions for the post will also be provided below. Please reach out to me if you are needing any clarification on what needs to be done. Thank you.

Original case study:

J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.


Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.

Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.

Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.

Case study questions:

  1. Please name the potential most common sites for metastasis on J.C and why?
  2. What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
  3. Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
  4. Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
  5. Describe the carcinogenesis phase when a tumor metastasizes.
  6. Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer.

DO NOT ANSWER CASE STUDY QUESTIONS; IT IS THERE FOR YOU TO REFERENCE WHAT THE ASSIGNMENT WAS.

INSTRUCTIONS:

  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Each response to peers must be at least 150 words, Formatted and cited in current APA style with support from at least 2 academic sources.
  • All replies must be formatted and cited in current APA style with support from at least 2 academic sources.
  • All replies must be constructive and use literature where possible.
  • Content is evaluated and must demonstrate critical and original thought and synthesis of the information.Your writing should demonstrate that you understand the material you are discussing. Copy and paste from your sources will not amount to a meaningful and thorough posting. Additionally, posts are intermittently submitted to Turnitin for plagiarism checks so be sure you are not using verbatim from your sources unless properly cited. Properly cited direct quotations should be very, very infrequent, if at all, and should only be used when there are no other way to convey the information. Information in table form, bullet points, or directly quoted out of the literature does not convey the synthesis of information necessary for this course.
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