Digestive Disease
Case #1: A 64-year-old man presents to the emergency department (Links to an external site.) with abdominal pain and distention, as well as constipation of 8 days’ duration. He denies vomiting, fever, diarrhea, or dysuria. Except for hypertension, he is otherwise healthy with no prior surgeries.
His vital signs are normal except for a borderline pulse of 99 bpm. His physical examination is unremarkable except for his abdomen, which is large, rotund, and tympanitic. There is diffuse tenderness everywhere in the abdomen.
- What history would you want to obtain?
- What differential diagnoses would you consider?
- List and describe the specific diagnostic tests you might order to determine cause of his concern?
Case #2:
Kyle is a 58-year-old man who is experiencing lower abdominal discomfort nausea and diarrhea lasting 2 days. He thought he had eaten something that “disturbed his stomach†but since this has lasted so long, he is afraid it’s something serious.
- As you obtain a history from this patient what differential diagnoses are you considering. Give rational for your choices.
- Discuss the pathophysiologic relationship between nausea and vomiting?
Three days after Kyle’s initial visit his labs confirmed a diagnosis of cirrhosis.
- Discuss the pathophysiologic relationship between cirrhosis and portal hypertension.
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