Back Pain Case Study

He was able to tolerate PO earlier around 6am. but now denies having an appetite. Patient had very small bowel movement earlier this morning that was not normal for him. He has not passes has the morning. 'he is voiding well. Denies fevers, chills or night sweats. The pain is localized to the RLQ without radiation at this point. He has never had a colonoscopy.

M. H. states that she is generally in good overall health. No cardiac, respiratory, endocrine, vascular, musculoskeletal, urinary, hematologic, neurologic, genitourinary, or gastrointestinal problems.

Visual fields full to confrontation. Extraocular muscles intact. Pupils are slightly enlarged on the left compared to the right, which she states is old since her eye injury. They do respond directly and consensually. Normal facial symmetry, sensation, and movement. Tongue and uvula are midline. Normal shoulder shrug. Normal auditory acuity.

Physical Examination: General: The patient is an alert, oriented male appearing his stated age. He appears to be in moderate distress. Vital signs: blood pressure 132/78 and pulse 68 and regular. Temperature is 38.56 oC (101.4 oF). HEENT:Normocephalic, atraumatic. Pupils were equal, round, and reactive to light. Ears are clear. Throat is normal. Neck: The neck is supple with no carotid bruits. Lungs: The lungs are clear to auscultation and percussion. Heart: Regular rate and rhythm. Abdomen:Bowel sounds are normal. There is rebound tenderness with maximal discomfort on palpation in the right lower quadrant. Extremities: No clubbing, cyanosis, or edema.

groups of her lower extremities bilaterally. Sensory exam is normal to pin prick and light touch

of 116 bpm, respiratory rate of 18 breaths/min, and blood pressure of 86/54 mm Hg. The

1. What new signs and symptoms does Suzie exhibit that would concern you if you were the doctor?

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

Mrs Levchenko has tachypnoea, as her respiratory rate is over 20 breaths per minute. Her rapid breathing would be a cause of impaired gas exchange. Which could be caused because of her smoking, and

Symptoms: Increased discomfort in her back, needs help repositioning, resistance to pain recovery medication, no apparent distress, tiredness, stomach ache, and high pulse rate.

12/18/15 Progress Report indicated that the patient presents with back pain radiating down his right leg; lower backache and right hip pain. The pain is 10/10-scale level without medications and 9/10-scale level with medications. His quality of sleep is poor. His activity level has remained the same. Current medications include Lidocaine 5 % patch, Cymbalta 30 mg and Vimovo Dr 500-20 mg.

The patient is a 44-year-old female who I saw for her physical in June 18, 2015. At that point, she was complaining of epigastric pain that radiated into her back. I did ask her to start Prilosec over the counter, daily. Initially, we had called her and she reported that this was helpful, although now, she reports that at the same time, she had a cold and she was more focused on the cold than the epigastric pain. Subsequently, she states her pain really has not changed and she continues to have epigastric pain, which does radiate to her mid-back. Her bowel movements have been soft, she has been somewhat nauseous, but no vomiting. She has not see any blood in her stools. She does think

Vital Signs: Temp. is 37.8 °C (100 °F). BP is 97/52 mmHg and pulse is 125. Respiration is 23 and O2 saturations 99%. Pain score is