Welcome back to Mystery Case Monday! We will be posting a hypothetical case every week to get our pre-health students thinking about various clinical issues and the anatomical/physiological causes that underlie them. Join us in the comments section to share your insights and tentative diagnoses, then check back on Friday to read about the diagnosis and recommended treatments of these cases.
This week's hypothetical patient is a 25-year-old female who is admitted to the ER with sharp abdominal pains, vomiting, dizziness, nausea, and weakness. Her boyfriend, who brought her into the ER, states that her pain began suddenly and that she said she felt as if she were going to faint all the way to the hospital. Because she was stable upon arrival, a physical examination was done. When asked if she could be pregnant, she stated that she could not be as she has an IUD, but did acknowledge that the couple were sexually active. She also stated that she had missed her last period, but assumed it was because she had recently started training for a 5K and was trying to quit smoking. The patient's vital signs were normal. The patient was experiencing diffuse abdominal tenderness. During the exam, the patient began to bleed vaginally and started feeling pain in her shoulder that radiated up to her neck. She was immediately given a FAST (focused assessment with sonography in trauma) exam. An OB/Gyn was called in for an emergency surgical consultation.
Thought Questions:
This week's hypothetical patient is a 25-year-old female who is admitted to the ER with sharp abdominal pains, vomiting, dizziness, nausea, and weakness. Her boyfriend, who brought her into the ER, states that her pain began suddenly and that she said she felt as if she were going to faint all the way to the hospital. Because she was stable upon arrival, a physical examination was done. When asked if she could be pregnant, she stated that she could not be as she has an IUD, but did acknowledge that the couple were sexually active. She also stated that she had missed her last period, but assumed it was because she had recently started training for a 5K and was trying to quit smoking. The patient's vital signs were normal. The patient was experiencing diffuse abdominal tenderness. During the exam, the patient began to bleed vaginally and started feeling pain in her shoulder that radiated up to her neck. She was immediately given a FAST (focused assessment with sonography in trauma) exam. An OB/Gyn was called in for an emergency surgical consultation.Thought Questions:
What is the most likely diagnosis for this patient?
What are the risk factors for this condition?
What caused the patient's shoulder to begin hurting?
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