Flashcards in Case Study Practice Deck (22):
Patient presents with tenderness in RUQ on palpation that worsens when he takes deep breaths. Pain has gradually gotten worse over the last week and is described as “steady and aching”.
Patient presents with melena, wheezing, and hoarseness. She is has chest pain that gets worse when she lies supine.
A 99 y/o patient recently had a stroke and has difficulty starting the swallowing process since the stroke.
24 y/o Jewish patient presents with diffuse abdominal pain, small amounts of hematochezia with small watery diarrhea. She complains that the diarrhea wakes her up at night. Upon auscultation, you hear increased bowel sounds.
A 59 y/o patient complains of strange shaped feces that he states “looks like a pencil” and has been experiencing red bloody diarrhea. He has lost a significant amount of weight in the last 3 months.
Sigmoid colon cancer
65 y/o female complains of wetting her pants. She says it began last week when she began experiencing normal seasonal allergy symptoms. G7 P7 delivered vaginally.
78 y/o male states he has noticed blood on toiler paper upon defecating. He takes laxatives for his constipation, but states that sometimes he forgets.
Patient complains of vomiting bile and mucous for 9 days. He says he has cramping in his upper abdomen. When auscultating, you hear rushes of high-pitched sounds.
Acute Intestinal obstruction
A recovering alcoholic with a previously noted smooth large liver comes to clinic because his abdomen has started to protrude. However, he states his exercise and eating habits have not changed. You percuss his abdomen and hear dull sounds. You ask the patient to lie on his side and notice that the dullness has shifted. Lastly, the patient shows a positive fluid wave upon testing.
A man has had difficulty swallowing solids and liquids off and on for years. After being diagnosed with angina and given nitroglycerin, he no longer has the difficulty swallowing.
Diffuse esophageal spasm
An African American mother brings her 2 year old child into clinic. She has just begun feeding him cow’s milk and has since noticed large volumes of watery diarrhea in his diapers.
A 89 y/o male with poor eyesight and arthritis lives alone. He is unable to drive to the grocery store and has difficulties opening jars. When visiting, his daughter noticed light yellow, foul-smelling diarrhea in the toilet and decided to bring her father to your clinic. She states that it looks like her father has lost weight since she last visited.
A 30 y/o female comes to the clinic because she has been having alternating constipation and diarrhea. She has lower abdominal pain that is relieved when she defecates. Upon examination, you notice her abdomen is distended.
A patient presents with N/V/D x 4 days after returning from Costa Rica. She enjoyed eating local cuisine cooked by her host family. Her temperature is 99.7F.
Patient visits your clinic for normal physical exam. Upon abdominal exam, you note a tender enlarged liver with irregular edges. When auscultating you hear a hepatic bruit and friction rub.
Carcinoma of liver
Young normal-weight woman comes with concerns about a small, soft lump on her lower back. You tell her that she has nothing to worry about because what she has is benign. What does she have?
About 6 months following an appendectomy, a patient presents with a protrusion near the scar.
An alcoholic patient presents to the ED with steady epigastric pain x 6 hours. As you go to lean back the hospital bed to due an abdominal exam, she screams out because lying supine makes the pain worse. She says that she’s had this pain before but can’t remember the diagnosis.
You are examining a 33y/o female patient during a routine physical exam. Her abdomen protrudes slightly. During percussion of the abdomen, you hear dull sounds, when you should be hearing tympanic sounds.
Patient presents to the ED with severe RLQ pain and rebound tenderness. She has a temperature of 100.
A patient complains of difficulty swallowing solid foods. It has been slowly gotten harder and harder. She also states she has burning in her chest.