History of abdominal pain

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Reference no: EM133843530

Questions

1. What are the key features of the case?

2. List three differential diagnosis and one working diagnosis for each case.

3. What logic/techniques/resources did you use to analyze the case and develop an ordered differential?

Dalia is a 3-year-old girl who presents to her pediatrician's office with a two-day history of abdominal pain. Her parents say she was well until the night before last, when she vomited three times. Since then, she has intermittently complained about her stomach hurting. In the past 24 hours, she vomited just once, but now has started to have profuse diarrhea, with 6-8 loose stools during that period. These stools have been foul-smelling and slightly greenish, but mom has not seen any blood. None of the emesis had blood or bile. She has not been eating well but has been quite thirsty and has been making plenty of wet diapers (urine). She is in day care, but the family does not know if anyone there is sick. She has not had any new or concerning foods recently.

ROS - No dysuria, no hematuria, no rash

PMH - Iron deficiency anemia, mild constipation

Meds - None

All - NKDA

FH - Noncontributory

SH - In day care

PE - 98.7- 110- 20- 105/75 100% on RA

Gen - Alert, slightly uncomfortable appearing

HEENT - Moist mucous membranes, lips pink

CV - RRR S1S2, no murmur

Lungs - CTA bilaterally

Abd - Soft, minimally tender around umbilicus, nondistended, hyperactive bowel sounds

Ext - Warm and well perfused, capillary refill < 2 seconds

Neuro - Alert, normal tone, moves all extremities equally

Rectal - Deferred by parent request

Reference no: EM133843530

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