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John Smith is a 32 years old who arrived at the ER with a history of sudden epigastric pain that radiates to the back and lower abdomen, nausea and vomiting.
Mr. Smith's abdominal problems appeared around 4 hrs ago when he woke up with severe epigastric and periumbilical pain accompanied by nausea and vomiting. Pain has progressively increased radiating to back, below the left shoulder blade and lower abdomen. He expresses that pain increases in supine position and is slightly relieved in a bend forward position.
Past medical history
Mr. Smith was diagnosed with pancreas divisum three years ago after a similar episode of abdominal pain. No further treatment was done. He has been treated with simvastatin for hyperlipidemia and hypertriglyceridemia for the past three years. He follows a low fat diet and exercises 3 times a week for 30 minutes. Mr. Smith suffers from peptic ulcer disease diagnosed by endoscopy 1 year ago. Mr. Smith does not smoke or drinks alcohol. No history of recreational drugs. He thinks he completed his vaccinations. Mr. Smith was diagnosed of rheumatoid arthritis last month and is being treated with azathioprine. His last physical was two months ago.
Review of systems is remarkable by the presence of frequent episodes of joint pain and joint swelling. There is a positive history of constipation, occasional palpitations, and the ...
The solution involves creating a medical report of an imaginary patient with pancreatitis that includes history, symptoms, and physical examination findings making sure that 20 key terms are used in the report.