Question

Mr. Franklin is a 60-year-old patient with a history of a thrombotic cerebrovascular accident two years ago. After the stroke he started with seizure attacks. He has been suffering from hypertension for the last ten years and ulcerative colitis since last year. He currently takes lisinopril, hydrochlorothiazide, aspirin, carbamazepine, and a low dose of prednisone.

Mr. Franklin has been suffering from epigastric pain, sensation of fullness, and occasional nausea for the last six months. This time, he was brought to the ER because, while he was talking to his son, he had a dizzy spell and fell to the floor. He is conscious and is complaining of severe epigastric pain. He began with mild abdominal pain two days after he started taking a new cycle of prednisone for his colitis, around seven days ago. The pain increases when he eats or drinks something. He is also complaining of suffering from pyrosis, malaise, and dizziness, and he has noticed that his feces are dark.

The patient was a heavy alcohol drinker until he had the stroke. He is a cigarette smoker since he was 20 years old. His mother suffered from Alzheimer's disease and died of colon cancer, and his father died of cirrhosis of the liver.

• Abdomen: Pain on palpation on epigastric region
• SOMA: Right hemiplegia and hyperreflexia
• Integumentary system: Pallor, diaphoresis, coldness
• Cardiovascular system: Tachycardia. Blood pressure 70/50 mmHg. Radial pulse 110.
• Digestive system: Tenderness of epigastric region. Rectal exam showed melena.
• Neurologic system: The patient is conscious and well oriented to time, place, and person. Right hemiplegia and hyperreflexia

Respond to the following

• Identify and differentiate the symptoms from the signs in this patient.
• Did you find any remarkable detail in the personal and social history of our patient that can help to make the diagnosis?
• What results do you expect to find in the tests ordered?
• What are some future complications the patient is at risk of developing?

Answer 1

Ans 1

Signs of gastric ulcer are there

1.Epigastric pain

2.nausea

3. Dark stools

4.melena

5. Fullness feel

Rest are symptoms

Ans 2.

Patient was a chronic alcoholic and smokers which are predisposing factor for gastric ulcer. Nsaids (aspirin) can also develop ulcer. Prednisolone is also a predisposing factor for gastric ulcer development. And pain after food intake is a sign for gastric ulcer.

Ans 3

Result for gastric ulcer can be found in endoscopy.

Ans 4

Patient can develop severe haemorage, perforation and malignant growth in stomach. Due to this loss of iron occur causing anemia also.