Help...please?

Question

Please read the blog, I am doing a lot of my own research, but it doesn't hurt to have others input

thanks in advance

Answer 1

Wow there was a lot of stuff there... and i have to admit i skimmed a lot of it. I'll try to answer as many of the little things as I can but know that my clinical experience is limited (4th year med student in 6 year degree [I'm Australian, we do undergrad med here]).

first things first -

from what I've read it does not sound like CD it could be ulcerative colitis (difference being CD  has skip lesions that occur anywhere along the length of the GI tract, UC occur in the colon only in one patch)

now from you history it did sound like you had appendicitis in the first instance did the pain start off around your belly button? (RLQ pain which starts umbilical + nausea and rebound tenderness as the peritoneum becomes involved)

this lead to rupture and spillage of fecal material into the peritoneal cavity leading to sepsis which can account for your tachycardia (septic shock).

that was the simple part. now the hard one.

the two things at the  top of my head that is not an irritable bowel syndrome is either dysmotility due to the operation or diverticular disease [not likely]. those would be my top 3 guesses something else on my mind would also be colon cancer if you have a family history [but d**n unlikely for a 19 year old unless you have the genes... forgot which one it is. it's unlikely but something to keep in mind as something that should be ruled out]

if it's any help use this guide for your differentials

-infection

-infarction

-ischaemia

-inflammation

-trauma

-tumor

-toxin

-metabolic

-medical

-degenerative

your symptoms:

-Tachycardia (?septic shock - do you still have it?)

-Histamine Release (non-specific autoimmune/infection)

-Severe Malaise/Fatigue (non-specific)

-Anemia of chronic disease (non-specific)

-Abdominal Pain(have to sometimes take Vicodin, of late it has been every few days) (gastric)

-Diarrhea (gastric)

-Low Grade Fever (non-specific)

last thing is when reporting especially when you're an intern calling up their boss at 2 AM in the morning keep it short and to the point. so in your example: 19 year old female presenting with worsening stomach cramps (where is it?) with concurrent diarrhea and non-specific signs of inflammation. then go into the symptoms and then history.

not much but hope it helps

Answer 2

Really cool. I find it amazing that the majority of the medicine words come from greek. I really wanna become a doctor when i grow up.