· Case Study #3: Abdomen and Gastrointestinal 

· Bates Assessment Videos – OSCE 2 – Abdominal Pain(transcripts)

(This is a 64‐year‐old stock broker, recently separated from his wife, who presents with increased epigastric pain over the prior two days and excess drinking. On examination, his blood pressure is slightly elevated to 140 over 88 and his heart rate is elevated to 110. His temperature is slightly elevated, suggesting alcohol withdrawal. His heart and lung examinations are normal. His abdominal examination shows epigastric tenderness and liver tenderness. There is no CVA tenderness. He has no nystagmus, tremor, or asterixis also often seen in alcohol withdraw)

1-Assess the case study

2-Answer the questions within the case study

What possible causes of abdominal pain are you considering?

What further questions would you have in light of this drinking pattern?   

What areas of the physical examination are most important for this patient?

List your diagnostic considerations in order of importance and explain your rationale

List 5 next steps in your diagnostic workup.