Differential Diagnosis

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 three days of abdominal pain. It initially started three 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

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

Patients present with left lower quadrant pain, reiterating the tendency for diverticulitis to affect the sigmoid colon in western countries. The pain can be constant or intermittent, and lack of appetite, or nausea and vomiting can be present. Physical examination of the abdomen reveals localized tenderness but frank rebound or guarding should be negative. Bowel sounds are frequently distant or depressed, if bowel sounds are very active an obstruction may be present, in mild cases the bowel sounds may be normal. The WBC may be elevated and the patient may present with a fever. Occasionally a palpable mass may be felt and may be very painful. Eating exacerbated the pain of left-sided diverticulitis and pain can be lessened with the passage of feces or flatus. Patients may complain of a feeling of being bloated.

Recognizing that help is need is the first step toward sobriety. Once addicts realize that they need help, the next challenge is finding a New Haven heroin rehab center that suits their personal needs. While there are many treatment centers available, addicts and alcoholics need to find the right one if they want to recover. From looking for family programs to dual diagnosis treatment, the right treatment center will offer individualized treatment options that can be modified for each patient.

A woman is brought to an emergency room complaining of severe pain in her left iliac region. She claims previous episodes and says that the condition is worse when she is constipated, and is

What is Dual Diagnosis? Research has come close to answering what is dual diagnosis and how it pertains to individuals experiencing both substance abuse/dependence and severe and persistent mental illnesses (Drake, 2007). One significant aspect of dual diagnosis before examining it more closely is that on the information that we already know that pertains to dual diagnosis (Drake, 2007). After we can gather the general knowledge and the current information of dual diagnosis the next significant aspect is how we can approach dual diagnosis when it relates to individuals (Drake, 2007). Lastly as soon as we can develop an approach to helping individuals the next step is to create testing when research is done on dual diagnosis to

The second most likely diagnosis is dehydration. According to Arant and Canavan (2009), the diagnosis can be determined by if there has been vomiting, diarrhea, or decreased oral intake. The patient has had decreased tear production, a capillary refill time of more than two seconds, and decreased skin turgor (Arant & Canavan, 2009). All of this points to dehydration.

Sakeenah is 14 years old African american girl, she comes to the University of Michigan Pediatric Gastroenterology clinic on 5/22/2018 complaining of abdominal pain. She is accompanied mom and dad today and she provides the interval medical history, She states that the pain started month ago, epigastric, and occasionally radiate to right side, described as squeezing or burning pain. She states that the pain is on/off, in scale of 7-8/10, occur more in the morning. The pain lasts few hours several time a day. She feels that "food sits in my stomach and doesn't digest." Sakeenah states that pain is worse when she eating a grassy food, she stop eating it for a while and the pain seems

Sudden and severe pain in the abdomen, most often under the right rib cage. The pain can spread to the right shoulder and right back. It occurs most often after a plentiful, fatty meal and lasts 1-4 hours.

However the willingness of doctor can have an immense impact when they are working with dual diagnosis (Werner, 2012). Studies have shown that having preconceived attitudes can result in the unknowing to work with certain individuals (Werner, 2012). In addition studies have that the biggest factor of working with dual diagnosis is that of the willingness. In which the willingness plays a since the interest in working with/helping individuals can be a factor (Werner, 2012). Additionally, a study was conducted on 476 participants to determine if willingness and having a bias would be a contributing factor (Werner, 2012). What the researchers discovered was three specific results (Werner, 2012). The first result was that the study

I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.

It is always challenging to accurately diagnose abdominal pain in the primary care settings. An extensive knowledge of the anatomy and physiology could help narrow down possible causes of abdominal pain.

Pain is intermittent and worst when lying down on the back or sitting down, relief felt when lying on stomach.

First case study involves an 86 year old female arriving to the ED with abdominal pain on the left hand side of her abdomen, with pre-existing hypertension, but no other medical conditions nor medications, indicating appendicitis on the left hand side of her abdomen. Upon inspection, BP:

One symptom that is not definite, but may help decide what form of IBD is present, is where the pain in the abdomen is located. Typically Ulcerative Colitis patients experience pain in the lower left section of the abdomen, while Crohn’s Disease patients tend to suffer from pain in the lower right section of the abdomen. “With Ulcerative Colitis, bleeding from the rectum during bowel movements is very common, and bleeding is much less common in patients with Crohn’s Disease.” (Tresca, 2009)