Level 2: Abdominal Pain – Contrasting Case #2: Patient Information

Given these changes from the original case, what is your diagnosis?

What is your diagnostic explanation?

As compared to the long case, this patient is a 56 year old female who presents to the ED with abdominal pain for the past several hours. She states that the pain is diffuse. She also complains of nausea and vomiting, and she has vomited twice in the past two hours. She also has had 5 episodes of diarrhea since the pain started. She feels very fatigued and weak. She has not eaten since dinner the night before. She denies any hematochezia, hematemesis, acid reflux, travel, or prior occurrence. The pain does not radiate to the back. She has not had any sick contacts, and she has not eaten anything unusual in the past few days.

VS- Temp 101, HR 72, BP 128/84, RR 14, Height 5’6”, Weight 165, BMI 26.6

General- Alert and oriented. Appears fatigued and in pain.

HEENT- dry mucous membranes

Abdomen- Soft, non-distended. Bowel sounds present. Mild diffuse tenderness to deep palpation. No rebound tenderness or guarding. Negative Mcburney’s and Murphy’s signs.

Genital- Bimanual exam unremarkable.

Skin- poor skin turgor

Labs: Stool Culture is negative