ABDOMINAL PAIN

ABDOMINAL PAIN Acute viral hepatitis - CORRECT ANSWER -42-year-old man with fever, malaise, muscle and joint aches, headache, nausea, vomiting, abdominal pain, jaundice, and dark urine. AST and ALT are elevated. Biliary colic - CORRECT ANSWER -38-year-old woman with steady pain in the epigastrium and right upper quadrant that lasts for several hours and resolves spontaneously. She had a similar episode last week. Acute cholecystitis - CORRECT ANSWER -38-year-old woman with fever, nausea, vomiting, and pain in the right upper quadrant. Palpation beneath the right costal margin in the mid-clavicular line causes her to wince with inspiration. Ascending cholangitis - CORRECT ANSWER -38-year-old woman with fever, chills, rigors, jaundice, and right upper quadrant pain. She becomes confused and hypotensive. Serum alkaline phosphatase and bilirubin levels are elevated. Duodenal ulcer - CORRECT ANSWER -53-year-old man with a "gnawing" pain in the epigastrium that improves with eating. Gastroesophageal reflux - CORRECT ANSWER -60-year-old man with heartburn and regurgitation. Acute pancreatitis - CORRECT ANSWER -32-year-old man with severe upper abdominal pain, nausea, and vomiting. Serum amylase and lipase levels are elevated. Irritable bowel syndrome - CORRECT ANSWER -35-year-old woman with bloating, cramping, and bouts of diarrhea alternating with periods of constipation. Bowel movements relieve abdominal discomfort. Intestinal obstruction - CORRECT ANSWER -50-year-old man with crampy mid-abdominal pain, vomiting, and inability to pass flatus or stool. His abdomen is distended and tympanitic to percussion.