Functional

Gastrointestinal System


0

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S13_F1.jpg"}},{"insert":"\n\n"},{"insert":"You are sitting at your favorite cafe, sipping on an intricate Italian roast and idly flipping through a magazine.\n\n\u0022Nothing related to medicine today\u0022, you remind yourself, skipping past a glossy article on bariatric surgery. It\u0027s your day off and you don\u0027t want to see so much as a ball of cotton.\n\nRight on cue, your phone rings. It\u0027s your colleague, Patrice.\n\n\u0022Hi! Can you please cover for me today? I have a huge family emergency and I really have to go. I\u0027ll owe you one, thanks!\u0022. She sounds frantic, and hangs up before you can utter a word.\n\nWith a sigh, you put down the periodical and trudge to the car. \u0022So much for \u0027nothing related to medicine today\u0027\u0022, you mutter to yourself.\n"}]}

1

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S13_F2.jpg"}},{"insert":"\n\n"},{"insert":"A patient is already waiting by the time you arrive at the ER.\n\nForty-two-year-old Mrs. Parker complains of right upper quadrant abdominal pain that started quite suddenly and radiates to the right upper back.\n\nShe woefully states that she has also had severe nausea after her spaghetti dinner.\n"}]}

2

{"ops":[{"insert":"\u0022Sometimes it gets a little better but then it gets really bad again\u0022, she says. When asked to rate the pain, Mrs. Parker marks it 9\/10 on the pain scale.\n\nShe has taken some over-the-counter antacids, which were of no help. Changing her posture was of no use either, and the pain did not lessen after bowel movements.\n\nShe did not have fever, chills, vomiting, recent trauma, or urinary symptoms and denies any significant history of substance use.\n\nShe is not on any medications at present, and had her period three weeks ago.\n"}]}

3

{"ops":[{"insert":"You now proceed to examine her. Her vitals are as follows: Temperature 99.0 \u00b0F (37.2 \u00b0C), blood pressure 152\/92 mmHg, pulse 110bpm, respiratory rate 20 cycles\/min. Her BMI is 32kg\/m2\n\nNoticeably, Mrs. Parker is all hunched over and grimacing in pain.\n\nAs you examine her abdomen, you find no distension, severe right upper quadrant tenderness, mild rebound tenderness, no guarding, and no hepatosplenomegaly. Murphy\u0027s sign is positive.\n\nAn examination of her other systems reveal no abnormality.\n"}]}

4

{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/S13_F5.jpg"}},{"insert":"\n\n"},{"insert":"You order a complete blood count, comprehensive chemistry, serum amylase and lipase, and liver enzymes.\n\nHer urinalysis reveals no abnormalities, and a urine HCG test returns negative.\n"}]}

5

{"ops":[{"insert":"Her labs all come back normal.\n"}]}

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