Friday, December 17, 2010

Dyspepsia

A 44-year-old previously well bangladesh gentleman presented to the Klinik Kesihatan with a one day history of epigastric pain associated with vomitting. On examination, he was alert, pink with BP of 100/ 70, HR 100 and T 37.1. Per abdomen, there was tenderness at the epigastrium with generalised guarding and board like rigidity. The following is his CXR erect done at your Klinik Kesihatan.






Question 1: What are the abnormalities in the above xray? What is the most likely diagnosis?

Question 2: Lets say the same patient presented to you with an epigastric pain and his condition is stable. How would you approach and manage this patient?

Question 3: What are your differential diagnoses of an epigastric pain?

Drug Discussion: What are the different types of antacids available? What are their mode of actions and common side effects?

2 comments:

  1. answ q1: is it the air trapped under the diaphragma?the most likely diagnosis is intestinal obstruction..i think so

    answ q 2: ask for how long he had dyspepsia.any vomiting?

    answ q3: GERD, heart failure, angina, gastric ulcer.

    discussion: Gelusyl, ranitidine

    gelusyl: constipation
    ranitidine: gynecomastia

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  2. Thank you for the answer. You must be confident when answering questions in medicine.

    Question 1: This CXR shows air under the diaphragm. From the history, the most likely diagnosis is PGU (Perforated Gastric Ulcer).

    Based on some of the tips I have given in the bronchial asthma section, please try again in answering the rest of the questions.

    Thank you.

    ReplyDelete