A 52-year-old woman presents to the urgent care center with several hours of worsening epigastric abdominal pain that radiates to the back. The patient also has malaise, chills, nausea, and vomiting. On physical exam, there is diffuse abdominal tenderness on palpation. She is afebrile. Other vital signs include a blood pressure of 126/74 mm Hg, […]
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A 53-year-old woman presents to her primary care practitioner because of generalized weakness, light-headedness, and fatigue for the past month. She also describes dysphagia, heartburn, and occasional regurgition after eating or lying down. She often takes over-the-counter antacids for heartburn, and recently she was told she was anemic, so she started taking an iron supplement.
A 68-year-old woman presents with left lower quadrant pain that worsens with defecation. She describes the pain as “crampy” and says she has had mild constipation for the past few years. The patient denies any recent weight change or urinary symptoms. Her temperature is 37.8°C (100.0°F), pulse rate is 102/min, respiratory rate is 16/min, and
A 41-year-old woman presents with pain in her abdomen for the last 3 hours. She says pain is intense, dull, constant, and localized to the right upper quadrant. The pain started about 30 minutes after she had a high-fat meal this morning and is accompanied by nausea. She has had similar episodes in the past
A 51-year-old man with a past medical history of peptic ulcer disease currently being treated with triple therapy presents to the urgent care center complaining of acute abdominal pain which began suddenly less than 2 hours ago. The physical examination shows his abdomen to be mildly distended, diffusely tender to palpation, and positive for rebound
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A 32-year-old man presents to the clinic because of a frequent “upset stomach” with indigestion and epigastric discomfort for the past 6 months. His symptoms often worsen after meals, and he has had significant fatigue for the past month. He has not had weight loss, blood in the stool, or melena. He does not smoke
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A family healthcare provider in a rural area is treating a 40-year-old woman for dyspepsia. The patient has had chronic heartburn and abdominal pain for the past 2 months and is suspected of having Helicobacter pylori (H. pylori) infection. The provider decides to perform a diagnostic test. Which of the following tests is the provider most likely test
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A 62-year-old man presents with epigastric pain for the past several months. The pain is worse after eating and especially after drinking coffee. He also complains of excessive belching. He recently tried taking omeprazole for 2 weeks, but it did not help his pain. He has no significant past medical history. On physical examination, there
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A 40-year-old woman presents to her primary care physician with ongoing reflux symptoms despite taking acid blockers. She describes a burning sensation in her chest, even after small meals. She avoids eating fatty and spicy foods that aggravate her reflux. She had previously used oral antacids but discontinued them due to intolerable constipation. For the last 2
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POST 1 A 30-year-old man presents to his doctor because of heartburn for the past 8 weeks. He says he feels a burning sensation in his epigastric area that is usually worse after eating certain foods and if he lies down after eating. His symptoms used to be only once or twice a week but
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