A 48-year old male complains of severe epigastric pain that is worse after eating x 3...

A 48-year old male complains of severe epigastric pain that is worse after eating x 3 weeks. Symptoms are accompanied by nausea but the patient denies vomiting or diarrhea at this time. Reports stools as “normal” in color and consistency. Discuss what questions you would ask the patient, and what physical exam elements you would include.

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Expert Solution

physical examination

The abdomen is inspected by positioning the patient supine on an examining table or bed .the head and knees should be supported with small pillows of folded sheets for comfort and to relax the abdominal wall musculature.the entire abdominal wall must be examined and drapes should be positioned accordingly.

Palpation is the examination of the abdomen for crepitus of the abdominal wall, for any abdominal tenderness,or for abdominal masses.the liver and kidneys may be palpable in normal individuals,but any other masses are abnormal.

Auscultation of the abdomen is performed for detection of altered bowel sounds, rubs,or vascular bruits.normal peristalsis creates bowel sounds that may be altered or absent by disease.irritation of serosal surface may produce produce a sound ( rub) as an organ moves against the serosal surface.

* how long have you felt epigastric pain?

* are there certain times your epigastric pain is more severe?

* Do you have any other symptoms?

* what medications are you taking?

* does it hurt throughout your abdomen or is it just in one particular area?

* when does hurt? Always? More often in the morning or at night?

* does hurt after you eat certain foods or drink alcohol?

* if each episode of pain starts gradually or suddenly?

* how frequently episodes of pain occur?

Nightingale answered 2 years ago

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