A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating. Â
PMH:Â seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,Â
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn painÂ
Family Hx-non contributary Â
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters. NURS-6501N-21-Advanced Pathophysiology
Breath test in the office revealed + urease.Â
The healthcare provider suspects the client has peptic ulcer disease.
Questions:
ANSWER
NURS-6501N-21-Advanced Pathophysiology
A 65-year-old female comes to the clinic with a complaint of abdominal pain in the epigastric area. The pain has been persistent for two weeks.  The pain described as burning, non-radiating and worse after meals. Denies N&V, weight loss or obvious bleeding. She admits to frequent belching with bloating. Â
PMH:Â seasonal allergies with Chronic Sinusitis, positive for osteoarthritis,Â
Meds: Claritin 10 mg po daily, ibuprofen 400-600 mg po prn painÂ
Family Hx-non contributary NURS-6501N-21-Advanced Pathophysiology
Social history: Separated recently pending divorce; stressful situation with trying to manage two homes. Works as a Legal Assistant at a local law firm. She has 35 PPY of smoking, drinks 1-2 glasses of wine a day, and 6-7 cups of coffee per day. She denies illicit drug use, vaping or unprotected sexual encounters. Â
Breath test in the office revealed + urease. NURS-6501N-21-Advanced Pathophysiology
The healthcare provider suspects the client has peptic ulcer disease.
Question:
ANSWER
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A 44-year-old morbidly obese female comes to the clinic complaining of  “burning in my chest and a funny taste in my mouthâ€. The symptoms have been present for years but patient states she had been treating the symptoms with antacid tablets which helped until the last 4 or 5 weeks. She never saw a healthcare provider for that. She says the symptoms get worse at night when she is lying down and has had to sleep with 2 pillows. She says she has started coughing at night which has been interfering with her sleep. She denies palpitations, shortness of breath, or nausea.Â
PMH-HTN, venous stasis ulcers, irritable bowel syndrome, osteoarthritis of knees, morbid obesity (BMI 48 kg/m2)Â
FH:non contributary  Â
Medications: Lisinopril 10 mg po qd, Bentyl 10 mg po, ibuprofen 800 mg po q 6 hr prnÂ
SH: 20 PPY of smoking, ETOH rarely, denies vaping. NURS-6501N-21-Advanced Pathophysiology
Diagnoses: Gastroesophageal reflux disease (GERD).Â
Question:
ANSWER
A 64-year-old male presents the clinic with complaints of passing dark, tarry, stools. He stated the first episode occurred last week, but it was only a small amount after he had eaten a dinner of beets and beef. The episode today was accompanied by nausea, sweating, and weakness. He states he has had some mid epigastric pain for several weeks and has been taking OTC antacids. The most likely diagnosis is upper GI bleed which won’t be confirmed until further endoscopic procedures are performed. NURS-6501N-21-Advanced Pathophysiology
Question:
ANSWER
A 54-year-old schoolteacher is seeing your today for complaints of passing bright red blood when she had a bowel movement this morning. She stated the first episode occurred last week. The episode today was accompanied by nausea, sweating, and weakness. She states she has had some LLQ pain for several weeks but described it as “coming and goingâ€. She says she has had a fever and abdominal cramps that have worsened this morning. NURS-6501N-21-Advanced Pathophysiology
Diagnosis is lower GI bleed secondary to diverticulitis.
Question:
ANSWER
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