Question

Hello Mr. Napier How do you feel? What brought you in today? Morning, Doc. I'm here because my stomach hurts. Did you take the prednisone after eating, as prescribed? When did the pain start? It started about a week ago after taking some prednisone. The prednisone was for my asthma. No. I was in a bit of a rush. I think all I had was coffee that morning. How does it feel when you eat? Do you still smoke and drink alcohol? How is your stool? Have you noticed any change in color? I'm smoking less. And I only drink alcohol on weekends. No. It looks normal Oh. It definitely hurts worse. Actually, last weekend I could not drink because of the pain. Okay. Sounds like we need to perform a panendoscopy and order some blood tests.

Please help

Answer 1

Panendoscopy is a procedure used to visualize the upper part of gastrointestinal tract lining the esophagus,stomach and deudenum.It is used to find any ulcers.Prednisone is a corticosteroid which cannot be taken in empty stomach or without food.Doing so may lead to irritation of the gastric mucosa and overtime leading to ulcers in the GIT.Foods like gastric stimulants coffee, alcohol should be avoided.Smoking can lead to aggregation of asthmatic symptoms and alter absorption of prednisone

Ans:

• The differential diagnosis is duodenal ulcer
• Panendoscopy is used to visualize the esophagus, stomach and duodenum
• The important antecedents related to patients symptoms are alcoholism, coffee,previous use of prednisone ,smoking
• The patients chief complaint is pain in gpepigastric region
• The stool test is usually done to assess any bleeding on the GIT
• The presumptive diagnosis is acute gastritis which needs a confirmation by doing tests or diagnostic procedure
• In panendoscopy the erythematus area ,inflammation can be viewed