A 36 years old Caucasian obese femaike presents to the ER with a complaint of ep
ID: 134399 • Letter: A
Question
A 36 years old Caucasian obese femaike presents to the ER with a complaint of epigastric pain for the last 2 days. the pain radiates through to her back, is constant, sharp in nature and reliever with sitting up. Associated symptoms include nausea and non bloody emesus. eating makes the pain worse and therefore she has not eaten for the last 24 hours. she is married with 2 children. she denies any alcohol or drugs use. on exam she is afebrile, HR is 100, RR 22 and Bo is 110/70mmhg. she is restless from the pain, diaphoretic and has icteric sclera. heart and lung exam are unremarkable. Abdomen is soft with hypoactive bowel sounds and tender in the epigastric area and RUQ.
labs:
sodium 140. potassium 3.0. creatinine 1.0. BUN 20. WBC 12000, HCT 54. hgb 18. plt 200000. AST 70. ALT 75. Alkaline phosphatase 294. total bilirubin 8.0. GGT 65. Lipase 1050.
1. what is the diagnosis
2. what clinical scenario supports this diagnosis.
3. what are the two common causes of the diagnosis.
4. for what actual or potential complications related to the diagnosis does she need to be monitored?
Explanation / Answer
A 36 year old obese Caucasian female presents with the epigastric pain for the last two days that radiates to her back. The pain increases on having a meal.
1) The diagnosis is heartburn
2) The clinical scenarios that suggested this diagnosis are,
3) The two common causes of diagnosis are gastro-oesopgageal reflux disease (GERD) and peptic ulcer.
4) Heartburn if left untreated may lead to hematemesis, perforation of oesophagus and oesophageal carcinoma.