Today's case;Vomiting 39 y/o F - cis2010

[ArchivalUser]

Ddx?
Hx,PE,Counsel,w/up

[ArchivalUser]

D/D-pregnancy
gastritis
dm
UTI
hypercalcemia
depression
GI malignancy
intestinal obstructional dis,appendicitis,pancratitis

PE- vital signs ,B.P
eyes-for jauindce, check for enlarged l/N.
heart auscultation
abdomen superficially, deeply,(murphy sign,psoas sign, obturator sign if with pain symptoms.)
w/up-urine pregnancy test
cbc with diffr.,electrolytes
amylase, lipase
usg abd
upper endoscopy if needed.

[ArchivalUser]

Ddx:mcc
Pregnancy
GE
Inflamation(intra abd.organs)
obstraction
psychological(common in women)

[ArchivalUser]

O,Freq.,Setting,
describe amount,appearance,color,coffee grounds,projectile,non pr.,
Al. fac.:position,stress,food,rest,dark room
Ag. fac:what trigers u vomit ? light,food,..." '' ''
Ass. sx :pain,fever,chills,appetite,wt change
ROS:headache,abd pain,diarrhea,const,opstipation,skin discoloration,urine change
ob&gyn,LMP,contraception,gravid,para,abortion,
travel,dining out,other relatives/friends with same problem
similar problem before,
health in the past
med &all
surgical /hosp :r/o adhesion
social:family relationship,spousal support,sex life,jobtress at work
Life style,smoking,al(oH),Drug
Fam health Hx.

[ArchivalUser]

email drfrankmd

[ArchivalUser]

wow nice thanks

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email drgandhi99d

[ArchivalUser]

good

[ArchivalUser]

well done

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up