Guest guest Posted June 18, 2009 Report Share Posted June 18, 2009 Hello boys and girls. Uncle Gene is back with a nice new puzzler. Can you say puzzler? I thought you could. 44 year old male calls 911 complaining of dizziness, nausea, and vomiting for the last four days. On arrival you find an overall normal looking male who says he has been dizzy, has had nausea and vomiting for four days and not able to keep much of anything down. He takes lisinopril for mild hypertension and a baby aspirin every day at his doctor's suggestion. He denies allergies, any significant past medical history, and any provoking causes. Your physical exam reveals a well nourished male, HEENT unremarkable except for some jaundice that shows up in the sclera and conjunctiva, breath sounds clear and equal bilaterally, heart sounds S1 and S2, slight tenderness in the supraumbilical region to palpation, which the patient describes as soreness from throwing up. No Cullen's sign. No rebound tenderness. Psoas, obturator, and Rovsing's signs are negative. Torso appears slightly jaundiced. HR 100, monitor shows sinus rhythm, Respirations 16, BP 110/66, temp. 99.8 F. What's most likely wrong with this patient? Of what significance is the jaundice? What questions can you ask to get a better history? Gene G. ************** Dell Days of Deals! June 15-24 - A New Deal Everyday! (http://pr.atwola.com/promoclk/100126575x1222677718x1201465083/aol?redir=http:%2\ F%2F ad.doubleclick.net%2Fclk%3B215692163%3B38015526%3Be) Quote Link to comment Share on other sites More sharing options...
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