|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Interesting puzzling case- part 2 (LONG)From: ENDODOK@aol.comWed Aug 30 19:34:31 2006
Thank you all who responded re the initial communication on this case. Now part 2: Following the initial ER evaluation on day one of sx., pt. and her RN mother inclined to believe " a flare-up" of her long standing "stomach problem". The following late afternoon, pt. called and declared nothing had changed... pain the same, no anorexia, nausea, vomiting, distention, chills, fever, bleeding. 2 loose stools that day, moderate headache. Pt agreed to drive to my office for evaluation the following AM. Saturday AM pt seen. No change in history. P/E negative... afebrile, BP and pulse normal, no nausea or vomiting, no further diarrhea, no chills or fever. Abdominal exam = soft, no distention, Incisions healed, no tenderness/ guarding/ rebound. BS normal. Pelvic = no tenderness/ induration/ masses or warmth. Hospital UTZ = Small amount cul-de sac fluid. Hct 35%; WBC 24,000. Emperically started on Cipro ( something is infected but where??). Pt developed fever 101-103 during that night, I am called in early AM, immediately direct pt to our hospital facility. On admission, Hx. slightly changed -- Abdominal pain now at level of umbilicus. Temp 102. RN mom had administered a Harris flush for alleviation of "gas" ( no effect) and pt had on her own taken some MOM because of no BM for 2 days, resulting in 3 diarrheal stools while in transit from home. Abdominal and pelvic exam exactly as before... totally negative!! Hct on admission 35%, WBC 24,000. Your management thoughts?? JGB
|
|
Return to
|
Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:45:41 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.