Diagnosis is a skill doctors learn by putting together a patient's symptoms, test results, and history. Can you identify the most likely diagnosis in the following situations? Hint: Answers are related to this unit!
For each:
a. What system is involved?
b. What organ is involved?
c. Guess the likely treatment method (surgery, medication, time--some thing are allowed to just work themselves out).
1. A 26-year-old male patient presents with abdominal pain. It used to be diffuse (widespread) in the umbilical region, but is now localized to his right lower quadrant. The patient is most comfortable in a fetal position, and does not like being asked to lay flat on his back.
2. A 55-year-old woman presents with right abdominal pain radiating to her right flank. The pain comes in waves every 3-4 minutes. She has a history of consuming a high protein diet.
3. A 32-year-old female presents with fever, chills, and generalized fatigue. She also reported urgency (of urination), frequency (of urination), dysuria, and hematuria. In addition, she noticed that her urine was cloudy with a fishy odor. A urinalysis revealed pyuria, bacteria, and a slightly acidic pH. Escherichia coli was grown in the culture.
4. A 42 year old male presents with abdominal pair- T He states that it usually hurts around 10 in the morning and 2 in the afternoon, and especially if he skips breakfast. Antacids help. He also black tarry stools also. He says his wife has been commenting on his weight loss, even though the reports nausea and occasional vomiting, and bright red blood when he vomits. He's noticed he's eating normally and isn't trying to lose weight. He's tired and hasn't been able to go to milk gym. His abdominal pain is better when he eats and he says he's been having a glass of every night before going to bed, with his regular aspirin for his ongoing back pain.

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Case 1
With around 250,000 appendectomies in the USA alone, the removal of the appendix is one of the most common operations of the gastrointestinal tract (Longo, Kasper, Jameson, Fauci, Hauser & Loscalzo, 2012). 66% of the patients describe periumbilical pain that migrates to the right lower quadrant afterward (Longo et al., 2012). Because of the peritoneal irritation that occurs during appendicitis, rebound or percussion tenderness and involuntary or voluntary guarding are present (Townsend, Beauchamp, Evers, & Mattox, 2017). Pain in the abdomen is provoked by any movement, so the patients usually refuse to move. Patients also take the fetal position in order to reduce intra-abdominal pressure and...

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