Tutorial 8: Case 2 Flashcards
(3 cards)
Kenneth is a 48-year-old gentleman, comes into your pharmacy and asks for your advice. Kenneth asks: ‘Can you give me something for a sore stomach please?’
A) Who is it for?
B) What are the symptoms?
C) How long have you had these symptoms?
D) Action taken
E) Medications being taken?
F) Medical conditions
G) Allergies
A) Myself
B) I have this pain on one side of my stomach
C) Since last week, and it is gradually getting worse
D) I have used some ibuprofen thinking it might help with the pain, but the pain just seems to be getting worse over time
E) Panadol osteo regularly, naproxen (NSAID) which was prescribed by my doctor and occasionally I use ibuprofen or diclofenac that I buy from the supermarket if I feel like I need more pain killers.
F) Osteoarthritis
G) None
Appropriate extended questions
- Are there any other symptoms?
- Can you describe the pain? On a scale of 1 to 10, how severe is the pain?
- Where exactly is the pain?
- Is the pain worse or better after eating
- Any vomiting or bowel movement changes
- Has anything changed recently? Any activities?
- Besides the pain in my stomach, I feel a little nauseous and bloated and only I realised my bowel motion is darker
- Describe it as burning/gnawing, just constant pain that is about 7 or 8 out of 10. Pain wakes me up at night.
- Right side of my belly
- More painful after eating (stomach ulcer)
if it is less painful after eating = duodenal ulcer
- No vomiting, just feeling a little nauseous. I am still passing motion every day, like usual, but the color of my bowel motion is darker than before
- I take my panadol osteo and naproxen every day without fail. My joints have been hurting more due to OA so I have also tried to take some ibrupofen and diclofenac, about three or four of them a day.
What is the diagnosis? Explain reasoning to patient.
Based on the signs and symptoms you have told me, I believe you have Peptic Ulcer Disease (PUD). The burning pain, pain on one side of the stomach, darker bowel motion, feeling nauseous and bloated has confirmed my diagnosis. It is most likely caused by your excessive use of NSAIDs
