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Dan, a 51 yo man with a 4 month history of epigastric pain presents to your clinic. Characterization of the pain is as follows: Location: epigastrium; quality: dull ache; 6/10 pain baseline; intermittent, increases to 8/10; intermittent decreases to 0/10; no radiation; aggravating factors: coffee only; relieving factors: milk, most meals; intensity and location have stayed the same; no significant pain syndromes in the past, including no h/o this type of pain; associated symptom of heartburn; symptoms affect quality of life some, although not markedly. PMH: on no meds (specifically ASA or NSAIDS). SH: his profession is “high-powered executive.” Admits to being “workaholic.” PE: epigastric tenderness. No other abnormalities found.
SCIENCE
HEALTH SCIENCE
NURSING

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