Need Help with Case Study Plz.

9 posts · started Apr 10, 2006

amynahmed Apr 10, 2006, 7:30 AM
Patient presents the following symptoms:
- pain in the right upper quadrant, epigastric area, and subscapular area.
-palpation reveals normal sized, but significant tenderness in right upper quadrant
-history of extreme indegestion following ingestion of fatty foods
-elevated temperature
-nausea and vomitting
-white count 12,500

a. what is your diagnosis?

b. what medical tests would you order to confirm this?

c. treatment?

d. additional blood work revealed elevated serum lipases and amylases. where would these come from? also, why did mr. frie's problem lead to these elevation? (you'll have to really dig into the anatomy to answer this one)

Thank you.
Amy
kimmiejs May 29, 2006, 11:37 PM
Did this patient have a positive Murphy's sign? A positive Murphy's sign is seen in acute cholecystitis. It is elicited by firmly placing a hand at the costal margin in the right upper abdominal quadrant and asking the patient to breathe deeply. If the gallbladder is inflamed, the patient will experience pain and catch their breath as the gallbladder descends and contacts the palpating hand. A similar manoeuvre in the left upper quadrant should not elicit discomfort.
doc.storm Oct 28, 2006, 9:57 PM
amynahmed wrote:...why did mr. frie's problem lead to these elevation?

Amy
Please, oh, please, tell me that this isn't a HIPAA violation in action?:confused:
cougarnurse Oct 28, 2006, 10:16 PM
Sounds like a textbook GB case. The name "Mr. Fries" also sounds like something my professors would use......Fries, as in FRENCH fries!
-history of extreme indegestion following ingestion of fatty foods

Kimmie is right with the palpation of the RUQ. It is NOT fun, trust me! I would suggest clear liquid diet, and the weird lab work is partially from inflammation.