LG, age 58 years, has a chief complaint of diffuse, crampy abdominal pain, which has progressed to a severity scale of 7 of 10 . He is afebrile and denies nausea, vomiting and diarrhea
Family history is positive for intestinal polyps, diabetes mellitus, and Alzheimer disease. His past medical history is positive for kidney stones, gastroesophageal reflux disease, and hypercholesterolemia. The physical examination is positive for guarding and tenderness in the epigastric region but is otherwise normal. In an effort to confirm your hypothesis, you should schedule a(n): a. electrocardiogram, because you think he has referred cardiac pain.
b. colonoscopy, because you think he has diverticulitis.
c. flat and erect abdominal x-ray study, be-cause you think he has a perforated peptic ulcer.
d. glucose tolerance test, because you think he has diabetes-related gastroparesis.
C
Do not undertake procedures that are not reasonably related to your hypothesis. In this case, be-cause of his personal history and presenting symptoms, the most likely problem that unifies the presentation is peptic ulcer disease.
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