Use APA 7th Edition Format and support your work with at least 3 peer-reviewed references within 5 years of publication. Remember that you need a cover page and a reference page. All paragraphs need to be cited properly. Please use headers. All responses must be in a narrative format and each paragraph must have at least 4 sentences. Lastly, you must have at least 2 pages of content, no greater than 4 pages, excluding cover page and reference page.
Patient With Sudden Onset of Intermittent Mid-Epigastric Pain
PR is a 35-year-old female who presents with a sudden onset of intermittent mid-epigastric pain that started 4 weeks ago. Pain is 6/10 on the pain scale and described as burning that worsens after she eats Mexican food and when she is lying down. She has never experienced this before. PR reports that she has been taking over the counter (OTC) antacids that seemed to help at first, but now they provide no relief. She reports associated regurgitation and feeling of fullness all the time and this morning she had a sore throat.
Past Medical History
Anaphylactic reaction to penicillin Medications
OTC antacids
Family History
Noncontributory
Social History
Occupation: Elementary school teacher (10 years)
Nonsmoker
Denies illicit drug use
Consumes wine two to three times per month
Regular exercise
Physical Examination
Weight: 145 lbs.; blood pressure: 128/72; pulse: 80; respiration rate: 18; temperature: 98.7 °F
General: Calm, cooperative, in no apparent distress
Eyes: Pupils equal, round, reactive to light
Ears: Tympanic membranes clear
Nares: Without nasal septal deviation; pharyngeal mucosa pink and moist
Throat: Oropharynx without edema, erythema, tonsillar enlargement, lesions
Abdomen: Nondistended, soft, round, nontender; normoactive bowel sounds in all quadrants
Discussion Questions
1. What are the top three differential diagnoses for PR?
2. What diagnostic tests, if any, are required for PR?
3. What pharmacological, nonpharmacological, and/or nutraceutical therapies should be prescribed for PR?
4. The results from PRs H. pylori test returned positive. What treatment should be added to her plan of care?
