Hey what's going on guys and welcome to episode 52 of the Physician

System boards.com podcast and today what I want to do before jumping into the

disease process I want to start off with a case presentation and this is a patient that came in two days ago,

and I thought this would be a good, you know, a good disease process to kind of go over.

But first I want to present the patient to you and see if, as I'm presenting the patient, you're able to pick up the diagnosis and so I think this will be good

for the students that are starting out and all right so let's just get started right this was

a 35 year old female who came in with a chief complaint of

abdominal pain. Now, before I, you know, get further as to what her symptoms were

exactly, as soon as I walk into the you know get further as to what her symptoms were exactly.

As soon as I walk into the room I see this lady and she's hunched over in her chair

trying not to move.

She's laying very still because any movement actually causes

abdominal pain, right? So she's holding on to her stomach, you know, with both

arms across her abdomen and she's just kind of hunched over in her chair trying

not to move.

She's complained of abdominal pain.

When I ask exactly where the abdominal pain, she's pointing up to the upper abdomen, right?

So her epigastric area. When I ask her if it radiates or does it go anywhere, she says, well, it's mostly up on the top, however, I have pain everywhere, and I feel like my back hurts as well, right?

So we have some abdominal pain, some diffuse abdominal pain,

more localized to the epigastric region,

and we have a little bit of radiation to the back.

Laying very still, trying not to to move because movement will exacerbate the pain.

...