Discussion Case Background: A 35-year old accountant presented to his physician with a steady burning pain...
Case 1 A 19-year-old male college student presents to the student health department with abdominal pain, diarrhea, and fever. He say that his symptoms started 1 day ago. He has had 10 stools in the past day and has noted blood mixed in with the stool on several occasions. He usually eats at home but reports having eaten chicken in the college cafeteria days ago. He has no history of gastrointestinal (GI) disease. On examination he has a temperature of...
A 25 year old female presents to her primary care physician for recurrent abdominal pain. She reports that she had daily episodes of cramping, lower abdominal pain and multiple episodes of diarrhea a day for 6 months. Her diarrhea has been bloody and she has been experiencing unintentional weight loss of 4.5 kg over the past 3 months. An abdominal examination reveals that she has diffuse tenderness. A rectal examination is significant for frank blood. Her CBC reveals that she...
Now…look at the following case scenarios and determine which diagnosis is most likely to be applicable to the patient. A 32-year-old female presents to the emergency room with complaints of abdominal pain. She describes generalized pain that started yesterday and worsened overnight. She indicates that the pain is now located in the RLQ. Upon auscultation, bowel sounds are hypoactive. Guarding noted with palpation, reports tenderness in RLQ, positive McBurney sign. Low grade fever noted, nausea with 2 episodes of vomiting...
Case Study #2 A 59 year old man presents with a one day history of fever, abdominal cramps and diarrhea. His symptoms began six hours after the onset of the "runs" in two of his grandchildren and their mother all of whom had been visiting from their dairy and poultry farm in Wisconsin. The day before becoming ill all had eaten a meal consisting of Caesar salad, pasta with stir fried vegetables, bread and apples. His wife prepared her popular...
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CLINICAL CASE 2 CARDIOVASCULAR SYSTEM Clinical Case 2 A 61 year old AAF was admitted to the hospital with a worsening of abdominal pain, upset stomach with heartburn, nausea, and vomiting. The pain and symptoms started 2-3 days ago. The antacid medication made her well until the morning of this day. Physical examination shows tenderness of the RLQ of the abdomen, but soft and no rebound. An ECG shows numerous abnormal beats and marked deviation of the...
Case 2 A 30-year-old dairy farmer was in good health until the day prior to admission, when he felt chilled and feverish. He developed nausea, vomiting, diarrhea, and lower abdominal discomfort and presented to the emergency room, where he was noted to be lethargic. His vital signs included, temperature of 40°C. His physical examination was remarkable for lower abdominal tenderness to palpation bilaterally. A rectal examination revealed occult blood in the stool the patient was lethargic but had no focal...
A 30-year-old dairy farmer was in good health until the day prior to admission, when he felt chilled and feverish. He developed nausea, vomiting, diarrhea, and lower abdominal discomfort and presented to the emergency room, where he was noted to be lethargic. His vital signs included, temperature of 40°C. His physical examination was remarkable for lower abdominal tenderness to palpation bilaterally. A rectal examination revealed occult blood in the stool the patient was lethargic but had no focal neurological deficits....
Scenario (page 48) A 59-year-old man came to the emergency department because of nausea and vomiting, a slight fever, abdominal tenderness, and jaundice. Upon examination, he admitted drinking as many as 12 servings of alcohol per week, which he had done for the past ten years. Because of a recent injury to his knee, he had been taking up to eight 500 mg tablets of acetaminophen every day for the past two weeks. Tests revealed elevated liver enzymes, bilirubin, serum...
A 48-year-old man presents to the emergency department with 2 days of crampy abdominal pain, nausea, vomiting, diarrhea, and fever. He has not had any blood in his stool. He denies contact with anyone with similar symptoms recently. He has not eaten any raw or unprocessed foods recently. The only food that he did not prepare himself in the past week was a breakfast of eggs “sunny side up” and bacon that he had at a diner the day before...
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CLINICAL CASE 2 CARDIOVASCULAR SYSTEM Clinical Case 2 A 61 year old AAF was admitted to the hospital with a worsening of abdominal pain, upset stomach with heartburn, nausea, and vomiting. The pain and symptoms started 2-3 days ago. The antacid medication made her well until the morning of this day. Physical examination shows tenderness of the RLQ of the abdomen, but soft and no rebound. An ECG shows numerous abnormal beats and marked deviation of the...