Week 7 Assessment. Discussion Assessing the Abdomen

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Week7 Assessment. Discussion Assessing the Abdomen

Case3

A20-year-old female complains of nausea and has vomited three timesover the past 48 hours. The patient also experienced a low-gradefever this morning. She states that she recently ate shellfish at anew restaurant with two friends who are suffering from similarsymptoms.

CC.

Nausea,vomiting and low grade fever.

HIP:

A20-year-old female complains of nausea and has vomited three timesover the past 48 hours. The patient also experienced a low-gradefever this morning. She states that she recently ate shellfish at anew restaurant with two friends who are suffering from similarsymptoms.

Medications

None

Allergies

Nodrug allergies

Medicalhistory/ surgical history

None

Physicalexamination

Lowgrade fever

Heightand weight

Notavailable

Differentialdiagnosis

Foodpoisoning/ shellfish poisoning

Shellfishpoisoning is difficult to diagnose. Differential diagnosis can beused to rule out other causes of the symptoms. Differential diagnosiswould involve consideration of the history of disease, physicalexamination and laboratory tests. Possible conditions include

  • Paralytic shellfish poisoning

  • Neurologic shellfish poisoning

  • Diarrheal shellfish poisoning

  • Amnestic shellfish poisoning

  • Shellfish allergy

  • Stomach obstruction

  • Cholelithiasis

  • Appendicitis

Physicalexamination may include stomach physical examination, cough andwheezing sound, cases of indigestion, tongue and lips examination tocheck for swelling and skin to check blue or pale coloration.Diagnostic tests may include blood test, urine test,electrocardiogram or heart tracing test, fluid by IV test, memory andspeech test and coordination test. Patient history is critical indetermining whether the case involves poisoning or an allergicreaction. Past incidence of allergic reaction to shellfish wouldsuggest an allergic condition. On the other hand, no past history ofallergic reaction supported by reported cases in other patientsuggests a case of poisoning. The fact that other individuals whoconsumed the shell fish reported similar symptoms suggests a case offood poisoning.

Treatment

Treatmentinvolves management of the symptoms. Medication may includeantiemetic such as raglan to reduce nausea and vomiting andacetaminophen to reduce fever.

Followup

Thepatient is required to visit the office after three to four days forfollow up or immediately incase the symptoms becomes worse.

References

GoldfrankL. R. (2011). Goldfrank`sToxicologic Emergencies.9th ed. New York, NY: McGraw-Hill.

JamesK. J. et al (2010). “Shellfish toxicity: human health implicationsof marine algal toxins”. EpidemiolInfect.138(7):927–940.

Metcalfe,D. (2013). FoodAllergy: Adverse Reaction to Foods and Food Additives.Wiley-Blackwell.

SichererS. H. et al (2004). “Prevalence of seafood allergy in the UnitedStates determined by a random telephone survey”. JAllergy Clin Immunol.114(1):159–165.

Woo,C. &amp Bahna, S. (2011). “Not all shellfish “allergy” isallergy!” Clinicaland Translational Allergy.1(3)

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