Abdominal pain Flashcards
(18 cards)
**4
Reason(s) for visit: Abdominal Pain
History of present Illness:
A 22-year-old female presents to the emergency room with abdominal pain, lethargy, and vomiting x2 days. Her vomiting is non-bloody. Her abdominal pain is diffuse, which she rates as a 6/10. She also claims to have had an increased appetite prior to having these symptoms. She also claims that she’s been developing blurry vision, dizziness, and drowsiness. She also states that she is having increased urination
Past Medical History
Past Medical History: None
Current medications: Birth control
Allergies: None
vaccines.
Vaccinations: The patient received her childhood vaccinations. She has never received any HPV
Women’s health: The patient cannot remember when her last a smear was done.
Women’s health: The patient cannot remember when her last pap smear was done.
Family History: The patient has a brother with Diabetes.
Social History:
Marital/Family: Single. She is an undergraduate student at a local university.
Personal habits: The patient denies smoking. She drinks socially. She smoked marijuana “a few times” with her friends. She denies other illicit drugs or misuse of medications.
Occupation/educational: She is a student at a local university
Recreational: She plays the piano and sings in a band.
Skin: Her skin is dry.
HEENT: Her throat is dry.
Cardiorespiratory: She feels that her heart is beating faster.
DKA
Insulin, normal saline , Potassium
Tx urinalysis
acu
hba1c
instruct diabetes
DKA
9
Reason(s) for visit: Abdominal Pain
History of present Illness:
The patient, a 24-year-old waitress, is brought to the emergency department by ambulance from her home. The patient reports that 6 days after an appendectomy, she began to develop a fever, chills, nausea, decreased appetite, and episodes of non-bloody, non-bilious emesis. She also developed 9/10 RLQ abdominal pain that has not improved with oxycodone. Pain is aggravated when she moves and staying still improves the pain. She spent 3 days in the hospital after the appendectomy, and was able to eat and ambulate and control her pain by oral medications when she was discharged.
Past Medical History:
Hospitalizations/Procedures: Appendectomy 7 days earlier for an episode of acute appendicitis.
ACL repair at age 16.
Current medications: Oxycodone as needed, Oral contraceptives
Initial History
vaccinations: one receivea ner chianooa vaccinations.
Women’s health: The patient is sexually active with her boyfriend of 2 years. Her last PAP smear was done 5 years ago which was normal.
Family History: Her father has diabetes. Her mother has high cholesterol. Her sister is in good health.
Social History:
Marital/Family: She is currently living with her boyfriend of 2 years. She has no children.
Personal habits: She smokes 2-3 cigarettes a day after work. She drinks socially on the
weekends, drinking 1-2 drinks.
Occupation/educational: She works at a restaurant as a waitress
Recreational: She enjoys mountain biking.
Review of systems:
General: See HPI
Skin: Warm to touch
Abdominal abscess
BLOOD CULTURE
URINALYSIS
URINE CULTURE
ABSCESS CULTURE
ABSCESS STAIN
IMAGE GUIDED ABSCESS DRAINAGE
CT ABDOMEN
CT PELVIS
CONSULT INFECTIOUS DZ
ANTIBIOTICS
11
Reason(s) for visit: Abdominal Pain
History of present Illness:
The patient is a 35-year-old male who presents to the emergency room with complaints of abdominal pain. It is described as a sharp, 7/10 pain localized to the RUQ which worsens with movement and improves with rest. He also complains of concomitant shortness of breath and pain with deep breaths. The patient recently went on a 3-week cruise to the Caribbean. He has felt increasing worse since the symptoms began 7 days ago. During this time, he also developed fatigue, subjective fever, chills, poor appetite, nausea, intractable vomiting, and intermittent chest pain. An emergency stop was made on a Caribbean island on his behalf. He was treated with an anti-emetic and was discharged with minimal symptomatic improvement. As he was heading home on a flight after the cruise, he noticed his skin was yellow-tinged, and he developed severe pruritis.
His wife has told him that he has putrid breath since his illness.
Past Medical History:
Past Medical History:
Patient denies any prior health problems. He goes to his PCP once every 2-3 years for a routine checkup. Last visit was unremarkable.
Hospitalizations/Procedures: The patient denies any prior hospitalizations or past surgeries.
Current medications: None
Allergies: None
Vaccinations: He received his childhood vaccinations.
Family History: His father is 68 years old and has no health conditions. His mother has hypertension which is controlled by medication.
Social History:
بحاله…
Marital/Family: He is currently living with his wife. He has 2 children, ages 7 and 5, both
Family History: His father is 68 years old and has no health conditions. His mother has hypertension which is controlled by medication.
Social History:
Marital/Family: He is currently living with his wife. He has 2 children, ages 7 and 5, both
without medical problems. His children were staying with grandparents during the cruise.
Personal habits: The patient does not smoke. The patient is a social drinker and drank more
during the cruise than usual, consuming an average of 1-2 alcoholic drinks a day. He denies any illicit substances.
Occupation/educational: He is an entrepreneur. He is currently opening franchised businesses.
Recreational: The patient enjoys traveling with wife, investing in the stock market, and reading.
13
Reason(s) for visit: Stomach pain
History of present Illness:
The patient is a 50-year-old Hispanic male who presents to your office with epigastric abdominal pain. It is a dull pain that he rates as 5/10 and has been present for the past two weeks. He also experiences chest discomfort sub-sternally at night. His abdominal pain is improved with eating meals. One week ago, he developed a severe episode of abdominal pain to the point that he could not work, accompanied by nausea and loss of appetite. The patient is a construction worker and works long hours to support his family. He was recently diagnosed with chronic osteoarthritis of both knees and has been taking 800 mg of Ibuprofen 3x daily so that he may fight through the pain, and he has been doing this for the past two months.
Past Medical History: The patient has been diagnosed with chronic osteoarthritis of both knees and hyperlipidemia. The patient recently had a screening colonoscopy which showed no abnormalities.
Past Medical History: The patient has been diagnosed with chronic osteoarthritis of both knees and hyperlipidemia. The patient recently had a screening colonoscopy which showed no abnormalities.
Hospitalizations/Procedures: He was hospitalized at age 18 due to an appendectomy.
Current medications: Simvastatin, Ibuproten
Allergies: None
Vaccinations: He received his childhood vaccinations.
Family History: His father and mother died of natural causes, at age 75 and 72, respectively.
Social History:
Marital/Family: He is married to his wife of 30 years. He has 4 children, all in good health.
Personal habits: The patient smokes a 1/2 pack of cigarettes daily. He will drink 2-3 beers on
the weekend. He is sexually active with his wife. He denies illicit drug use.
Occupation/educational: Construction worker. He graduated from High school.
