Case study 7:Part OneOverview: Three months after the childrenâ??s abdominal illnesses, Kayla, still

Case study 7:Part OneOverview: Three months after the children’s abdominal illnesses, Kayla, still26 years old, has come to see you today for complaints of nausea and lowerabdominal pain. She has not had a well-woman exam since the birth of heryoungest child. The nausea and intermittent abdominal pain have beenintermittent for about 2 weeks.HPI: There is abdominal pain to the lower quadrants intermittent for 2 weeks.She has not had a fever, diarrhea, dysuria, rash, headache, blurred vision,and no other household members are ill. She is not taking any currentmedications. She has been able to eat and drink with some limitations. Shehas vomited on two occasions, once each week of the abdominal pain. HerLNMP was 3 months ago, and she has a history of irregular periods andPCOS, so this pattern is not unusual. She reports she is not currently sexuallyactive and has only been sexually active with her husband whom she isseparated from. Her last timing of sexual intercourse was 14 weeks ago, withher estranged husband after an emotional meeting of custody of theirchildren.She also has had trouble sleeping and reports continuing anxiety over herliving situation and the inability to adequately provide for her familyfinancially.PMH: G – 3, T-1, P-1, A-1, L-2; cesarean section X 2; no trauma history; 10 year1PPD smoker, smoking cessation 2 years ago; gestational diabetes with lastpregnancy; history of PCOS.Social History: She continues to live with her parents and is working part timeat the children’s school library. She reports her divorce will be final in amatter of a few weeks.Discussion Questions Part One:What are your differential diagnoses?What is your rationale for these diagnose

 

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