HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now denies having an appetite. Patient had a very small bowel movement early this morning that was not normal for him. He has not passed gas this morning. He’s voiding well. He denies fevers, chills, or night sweats. The pain is localized to the RLQ without radiation at this point. He has never had a colonoscopy.…
Q: Which of the ff are branches of the aortic arch? A: Brachiocephalic, left common carotid, left subclavian Q: Which of the ff are branches of the subclavian arteries? A: thyrocervical, internal thoracic, and vertebral artery Q: Where is the carotid sinus located? A: Base of the internal carotid Q: Which of the ff are branches of the internal carotid? A: middle cerebral, anterior cerebral, ophthalmic artery Q: The gastroduodemal artery is a branch from which artery?…
Liver span is about 8 cm. Spleen cannot be felt. There is no suprapubic tenderness. Peripheral pulses are present. There is no calf tenderness.…
KIDNEY: (dull constant ache) Not always present if pt has renal disease (don’t have w/ proteinuria or hematuria) Have CVA tenderness (hit hand over kidney), lower abdominal pain, intermittent pain(indicates renal stones), flank pain (side) N/V, diaphoresis, s/sx of shock. Cause: Acute obstruction like stone, clot…
A 32-year-old female presented to the Emergency Department because of myalgia, muscle weakness, and severe abdominal pain often associated with nausea. Similar episodes had occurred since she was 18. She also complained of previous bouts of depression. She stated that these symptoms would occasionally disappear, but always returned especially around the onset of her menstrual period. Prior to her current episode, she had been prescribed antibiotics for a urinary tract infection. Routine blood and urine laboratory results were normal as well as a CT scan of her abdomen and pelvis. Two days after admission, the physician was notified by the clinical laboratory that her urine sample had turned a deep red color after sitting…
Abdomen: Protuberant with active bowel sounds, soft and nontender; no palpable masses or hepatosplenomegaly. Liver span is 7 cm in the right midclavicular line; edge is smooth and palpable 1 cm below the right costal margin. Spleen and kidneys not felt. No costovertebral angle tenderness.…
The patient was brought to my office by her daughter on the day of admission. She appeared dehydrated and weakened. There were periumbilical ecchymosis and…
The patient was transported from home by her daughter-n-law. According to patient daughter-n-law she has been complaining of pains in her right leg approximately one day. Family administered daily pain medications that did not help the condition of her persisting pain. After pain persisted daughter in law later brought the patient in to the emergency room for examination.…
| Patient often presents with hematuria (blood in urine) ranging from a rust like color to deep red. Frequent and/or painful urination and dysuria are also clinical signs, along with abdominal and back pain…
PHYSICAL EXAMINATION: The patient is a well-developed, well-nourished male who appears to be in moderate distress with pain and swelling in the upper left arm. VITAL SIGNS: Blood pressure 140/90, temperature 98.3 degrees Fahrenheit, pulse 97, respiration 18.HEENT: Head normal, no lesions. Eyes, arcus senilis, both eyes. Ears, impacted cerumen, left ear. Nose, clear. Mouth, dentures fit well, no lesions. NECK: Normal range of motion in all directs. INTEGUMENTARY: Psoriatic lesion, right thigh, approximately 1 mL in diameter. CHEST: Clear breath sounds bilaterally. No rales or rhonchi noted. HEART: Normal sinus rhythm. There is a holosystolic murmur. No friction rubs noted. ABDOMEN: Normal bowl sounds. Liver, kidneys, and spleen are normal to palpitation. GENITALIA: Tests normally descended bilaterally. RECTAL: Prostate 2+ and benign. EXTREMITIES: Pain and swelling noted above…
This 75-year-old Asian female was admitted through the ER with acute massive rectal bleeding of unknown origin, possibly diverticulitis; congestive heart failure in mild exacerbation; chronic renal failure, worsening since the day before admission, with dehydration and chronic atrial fibrillation.…
Review Systems: Patients complains of a lower abdominal pain for the past week that apparently got much worse last night and by this morning wasn’t tolerable. She is also having some nausea and vomiting.…
