c****i
发帖数: 40 | 1 不忍心看着你焦急的心情，其实这里很多人都愿意帮忙，但是由于种种原因，无法给你
回复。
就以一般性的回复几句，首先你给的非常有限的病史体检化验结果等等，所以基本上没
人能在这里给你一个诊断。我search了一下，下面是链接以及原文，希望对你能有帮助
。另外，也不要小看国内的医生，有很多是不错的。
点击链接可以发现更多的内容。
http://emedicine.medscape.com/article/958739-overview
History
Despite the extensive differential diagnoses of splenomegaly, careful
history taking and physical examination, along with a CBC count and liver
function tests, often help in narrowing the list of possible causes. The
history should include attention to the following importan... 阅读全帖 |
|
n*****n
发帖数: 119 | 2 别处看到的，觉得还不错，不排除有些拼写错误~
POMR (Problem-Oriented Medical Records)表格式住院病历
Biographical data:
一般项目：
Name Age Sex Marital status Nativity Race
姓名 年龄 性别 婚否 籍贯 民族
Occupation Date of admission Informant History
职业 入院日期 病史叙述者 病史
Chief complaint
主诉
History of present illness
现病史
Past history
既往史：
Previous health status: well ordinary bad Infectious diseases
平素健康状况： 良好 一般 较差 传染病史
Immunizations Allergies: N Y clinical manifestation
预防接种史 过敏史 无 有 临床表现
allergen: Trauma: Surgery:
过敏原 外伤... 阅读全帖 |
|
d**o
发帖数: 618 | 3 谢谢包子！
班门弄斧再说两句，另一个常听说的查体伤害是深呼吸过度晕过去，要记得先跟病人说
stop whenever you want，另外我习惯是后面深呼吸听肺，前面正常呼吸听心，再前面
深呼吸听肺，好有个break。
还有palpate neck不要两边一起用力按，palpate liver记得先让人弯腿，palpate
abdomen先按不痛的那边。
还有啥？ |
|
t*****u
发帖数: 8966 | 4 对了，周末看了视频。感觉似乎和咪宝不太一样。不过没看到外力碰触小花的反应。当
时咪宝还是能动的，就是非常的痛，所以我摸她后腿，尤其是关节，她还是会缩。小花
貌似右后腿完全没感觉了……
不知道现在如何。我没找到咪宝的全部用药记录，应该就是一般光谱抗生素。
把咪宝的诊断给你看看，等到专家看到她的时候，她已经几乎痊愈了，所以所谓的神经
专家没有发挥专业知识。前后看了N遍Vet，几次specialist
Presenting complaint: Waxing and waning fever, hind limb paresis
History: Meebo is a 13 week old female spayed Domestic shorthair cat that
presented to the Texas A&M emergency service for fever and hind limb paresis
. Meebo was adopted about a month ago from the shelter. On October 5, she
was taken ... 阅读全帖 |
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h***l
发帖数: 90 | 5 2-3分钟能做什么体检？尤其是neuro, cranial nerve, mini mental status这些根本
不够时间啊。
另外问下，FA上老强调不要重复painful maneuver。那么假设一个病人腹痛，先
superficial palpation过一遍，第二遍deep palpation还摸不摸痛处？如果摸了，那
不成了重复painful maneuver?另外你说的注意leg extension是个什么东西？谢谢。
or |
|
m******r
发帖数: 1904 | 6 ☆─────────────────────────────────────☆
IHeartPN (IHeartPN) 于 (Wed Apr 25 21:31:59 2012, 美东) 提到:
响应小麦版主的号召，简短写一下自己的CS。
准备时间 < 4个星期, 考试材料FA+UW，我前后一共过了有5遍。 因为个人口语不错，
加上时间有限, 没有参加任何小组, 没有请tutor, 从头到尾都是一个人练的。一开始
匆匆过了一遍FA后就参加了NJ的两天班，感觉收获非常大，尤其是学到了如何系统的查
体。所以如果条件允许，建议还是最好参加一个辅导班，会更有把握。
我是在芝加哥考的。当天有2／3是AMG, 其他的有印度的，中东的，非洲的，只有我一
个中国人。 12个cases的病人都是白人，有2个对我态度不是很友好。考试内容大部分
都不难，只有一个是我怎么想都不知道是什么。有一个pediatric case, 没有neuro or
telephone case。总体的感觉是没有FA上那么多阳性体征，大部分就是一个主诉，其
他的无论怎么问问什么都回答NO。 所以我考的时候还是挺confu... 阅读全帖 |
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e****0
发帖数: 678 | 7 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
|
e****0
发帖数: 678 | 8 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
|
p********3
发帖数: 5750 | 9 INTRODUCTION — The word "acupuncture" is derived from the Latin words "acus
" (needle) and "punctura" (penetration). Acupuncture originated in China
approximately 2000 years ago and is one of the oldest medical procedures in
the world.
Over its long history and dissemination, acupuncture has diversified and
encompasses a large array of styles and techniques. Common styles include
Traditional Chinese, Japanese, Korean, Vietnamese, and French acupuncture,
as well as specialized forms such as hand,... 阅读全帖 |
|
g*****j
发帖数: 1211 | 10 Don't think you should take the risk. Not all breast cancer can be palpated
, and early diagnosis is key. The anesthesia in US is very safe, local
anesthesia isn't necessarily safer than general anesthesia. |
|
g*****j
发帖数: 1211 | 11 Finger rectal exam can palpate prostate gland from the back. It can be used
to identify some prostate cancer. It is not a very sensitive test, and if
prostate problem is suspected, blood PSA test and imaging are necessary.
But as a 28 year old men, prostate cancer or even benign prostate
enlargement is not very likely. Urine exam is necessary in my opinion,
because it is a good screening test for many problems, including infection,
chronic kidney disease etc. Unexplained weight loss is alwa |
|
l*****O
发帖数: 402 | 12 heaven forbidden, if it were a solid mass, 10cm can be easily found by
pelvic exam. and you can feel it yourself by simple palpation with a bit
pressure. so i guess, the probability of solid mass is small. MRI might be
used to rule out complex cyst. Complex cyst is complex (so can be either way
). Simple cyst is always benign. |
|
c********e
发帖数: 496 | 13 it makes no sense to suspect it is a lung disorder,
if it is exacerbated by breath, it is pleural pain,
if it is tender on palpation, it is rib or intercostal damage,
Others are muscle or joint, you don't have to worry too much, most likely it
is just a stretch of muscle. good luck. |
|
s*******c
发帖数: 5161 | 14 这个老儿医有点奇怪呀~为啥要每次都按卤门呢……
我家那个儿医在check up的时候会跟我们说娃的头骨还没长好，用手摸摸，然后让我们
摸摸感觉一下……
肚子倒是按过，而且娃超级不配合，直接打挺，儿医说摸着肚子硬，不知道是肝比较大
还是那块有肌肉，就refer了一个B超给娃做，结果出来也算正常。
“假如前囟的部位比头颅表面突出来，象个小鼓包似的，用手按一按，感觉很硬，绷得
很紧，这说明头颅里面压力增高。引起压力增高的原因很多，最常见的原因是感染，如
各种脑炎、脑膜炎、颅内有出血或脑肿瘤、脑积水时也都可以引起颅内压增高。有时小
儿吃鱼肝油过多，造成维生素A中毒也可引起。”希望这个儿医这样按压宝宝的卤门只
是为了检查宝宝的健康状况。
The anterior fontanelle is useful clinically. Examination of an infant
includes palpating the anterior fontanelle. A sunken fontanelle indicates
dehydration, whereas a very tense or ... 阅读全帖 |
|
f***r
发帖数: 851 | 15 OB可以palpate检查，如果有怀疑的肿块，再去做ultrasound，routine检查应该没有
ultrasound吧 |
|
c******t
发帖数: 1733 | 16 篮球我是外行，但我想所有对抗性运动的基本道理都是一样的。运动场的performance
提高，离不开身体素质训练，包括力量，爆发力，耐力，平衡力等等，而且这些能力还
必须在对抗的情况下能表现出来。我对训练的几点心得
1。高强度训练， 但要适可而止。 多做HIIT
2。训练中身体work as a unit,
3。core strength 及其重要
4。一定要读理论，了解身体
贴几篇文章给你读一下，希望对你有些帮助
Supper stiffness
At a gymnastics or martial arts meet, or at a weightlifting competition,
listen to the coaches advice to the athlete – Stay tight! This means to
maintain stiffness. Being stiff ensures that there will be minimal energy
losses as forces are transmitted through the linkages.... 阅读全帖 |
|
w****1
发帖数: 4931 | 17 No sign of AT problem in my recovery run today. While there was pain upon
palpation on the back of my lower right leg yesterday, it is significantly
better today, even after the run. It appears that most of the recovery
happened during sleep, as I feel significantly better after I wake up than
before going to bed each day. An important lesson is that, one is most
vulnerable during recovery runs, because it follows hard workouts and
inflammation starts to develop at that time. While one can run t |
|
w****1
发帖数: 4931 | 18 Today I have not felt any discomfort from running, walking, or climbing
stairs. The only way I know the injury
is not completely gone is that there is some slight pain upon palpation, so
I'm still observing it. But if I don't
press with my fingers, I wouldn't notice any injury at all.
's |
|
w****1
发帖数: 4931 | 19 10.5 mile GA run this morning. Splits 7:54, 7:36, 7:32, 7:25, 7:20, 7:15, (
bathroom break) 8:03, 7:27, 7:20, 7:14 (last .54 mi @ 7:09.) AT completely
fine after the run, no pain at all upon palpation. So it was probably only
an accidental inflammation, not any serious tendonitis. Good thing that I
quit early when the injury first occurred. Lost about 10 miles of training
in total but nothing more. |
|
w****1
发帖数: 4931 | 20 update: muscles around my left AT largely recovered today, felt nothing at
all in recovery run. slight pain upon palpation afterwards but much much
better than yesterday. my wife gave me a calf massage every night and that
helped a lot.
you |
|
w****1
发帖数: 4931 | 21 generally when suspecting an injury, do a few basic checks: does it hurt
walking upstairs? downstairs? weight
bearing? upon palpation? sharp pain or dull pain? any drastic change in
mileage/speed in the past couple
weeks? it's important to nail down the cause of the injury so that you can
make appropriate adjustments.
息? |
|
T******y
发帖数: 798 | 22 In my case, it doesn't hurt for walking up/down stairs, weight bearing,
upon palpation.
The pain starts slightly at the beginning of a run, feeling slightly
uncomfortable, then gets worse till mile 2, stays there for a while, and
then disappears.
Looking back into my training history, I had been increasing mileage
gradually, but no sharp increase. I guess it is a combined result of
being tired from training while trying to increase speed too much
recently.
Got to slow down and reduce volume ... 阅读全帖 |
|
w****1
发帖数: 4931 | 23 shin splints would definitely hurt upon palpation though. |
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w****1
发帖数: 4931 | 24 I no longer feel any pain in activities, though there is still a little pain
upon palpation. By any normal measure,
I would have been up running by now. But I'm taking extra caution this time
and will start doing some very
easy barefoot running on the treadmill either today or tomorrow. |
|
p***r
发帖数: 4859 | 25 ☆─────────────────────────────────────☆
whxhm1 (whxhm) 于 (Tue Dec 7 00:58:21 2010, 美东) 提到:
在于不习惯用左腿翘二郎腿。
根本原因是左侧hip flexibility缺乏，导致左膝盖抬到同样的高度比右膝盖困难，身
体自然地为了弥补这个缺陷使右脚向外，从而导致右侧shin受的压力比左侧大，所以从
来伤的都是right shin, left shin从来没有问题。
☆─────────────────────────────────────☆
eve (小东东~长大脚的小脚老太) 于 (Tue Dec 7 01:06:45 2010, 美东) 提到:
very interesting!
this can explain my right side problem as well.
I will try to "用左腿翘二郎腿" anytime I can from now on.
☆─────────────────────────────────────☆
yo ( y... 阅读全帖 |
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g*2
发帖数: 658 | 26 i hope it is just medial tibial stress. if you still have concerns after
resting, I would recommend you to see an orthopedic doctor since it is
basically a clinical diagnosis of stress fracture on physical examination
with localized pain to palpation and swelling.
The tibia is the major weight-bearing bone in the leg. Tibial stress
fractures are common in athletes and nonathletes who suddenly increase their
physical activity.
X-ray is <50% sensitive for stress fracture, especially within 2-3 wee... 阅读全帖 |
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g*2
发帖数: 658 | 27 这个要慎入。有问题，查个关键词，看看。
SPECIFIC INJURIES
Hip injuries
Overview and approach — Hip injuries are less common in runners than
injuries to the lower extremity and they can be difficult to diagnose.
Nevertheless, during jogging, the hip joint is subjected to loads up to
eight times body weight and both acute and chronic injuries can occur [55].
In runners, the differential diagnosis of hip pain includes gluteus medius
tendinopathy, piriformis syndrome, stress fracture of the femoral neck,
labral tear, a... 阅读全帖 |
|
R******k
发帖数: 4756 | 28 "Both meanings of "taktisch" and "haptisch" are "nahsichtig (close-up or
close-range vision)". As to this close-up vision, Riegl himself mentions it
with the expression of "palpating (betasten)" the relief figure and ground
in a note of SK. It can be considered as an expression that presents the
mode of close-up vision as "seeing like groping".
- Ota Yoshitaka, Kyoto University, "What is 'the Haptic'?", Aesthetics No.17
(2013): 13-24
of |
|
b*s
发帖数: 82482 | 29 这个是日本人穿凿的吧，英语字典都没有收
"Both meanings of "taktisch" and "haptisch" are "nahsichtig (close-up or
close-range vision)". As to this close-up vision, Riegl himself mentions it
with the expression of "palpating (betasten)" the relief figure and ground
in a note of SK. It can be considered as an expression that presents the
mode of close-up vision as "seeing like groping".
- Ota Yoshitaka, Kyoto University, "What is 'the Haptic'?", Aesthetics No.17
(2013): 13-24
of |
|
I****2
发帖数: 1091 | 30 Staging the Degree of Kidney Disease
Chronic kidney disease is staged depending on the severity. The severity
is estimated based on the level of waste products in the blood and
abnormalities in the urine.
The International Renal Interest Society (IRIS) developed a method to
gauge the severity of the disease in four stages. Stage 1 is the least
severe and Stage 4 is the most severe. Staging the disease is useful for
treatment and monitoring of patients.
Stage 1 is characterized by cre... 阅读全帖 |
|
s*****d
发帖数: 2451 | 31 不觉得Culture和UPC是“是早期腎臟損害的發現和準確的測試值”
你列出的几项已经是UA的项目了。而且这种自己free catch的urine不适合做culture。
相对来说，还是血检和palpation发现得最早。
一般医院只是抽血的话都不用麻醉的，找个稍微有经验点儿的tech就行了。打电话问问
看吧。 |
|
s****y
发帖数: 1574 | 32 我说过我不懂中医，所以没法跟你辩论这些~~~~这个话题我就讨论到这里了。
目前研究中医的除了中国和日本，还有很多其他国家。
这是英国的：Journal of Chinese Medicine http://www.jcm.co.uk/
最近一期的文章：
# Channel Palpation and the Utilisation of Classical Theory by Jason Robertson & CT Holman
# Electroacupuncture & TENS: Putting Theory Into Practice by Katherine Berry & Sean Walsh
# Analysis of the Effectiveness of TCM Treatment of Multiple Sclerosis by Dan Jiang
这是美国的：American Journal of Chinese Medicine http://www.worldscinet.com/ajcm/
还有很多世界级的中医都是欧美人。
东: 西太容易被检验了，你能 |
|
T**********e
发帖数: 29576 | 33 ----几个明军的辅兵从张勇身边经过时，其中一个人俯下身，把手指放在张勇鼻前探了
一会儿，然后站直身子，摇了摇头：“没气了。”
They should check the vitality by palpating the carotid arteries or the body
temperature. |
|
y***c
发帖数: 676 | 34 Clinical Pearls
**************
1. Temporomandibular joint (TMJ) disorder, which is a very common disorder
that can usually be detected by palpating the area just in front of the
tragus. Joint clicking may be found when the patient opens and closes his
mouth. Symptoms of TMJ include orofacial pain, a noisy joint, and restricted
jaw function.
2. Treatment for preventing recurrence of HBV after liver transplant is HBV
Ig + Lamivudine.
3. Rx acute attacks of migraines : Rizatriptan
4. Rx for acute a |
|
c**********k
发帖数: 4 | 35 请教几个问题：
1 A previously health 23-year-old woman, gravida 2, para 1, at 32 week's
gestation comes to the physician because of urinary urgency and pain with
urination for 3 days. Her pregnancy had been uncomplicated.Her temperature
is 37.C, pulse 78, BP 110/68. Examinations show a uterus consistent in size
with a 32-week gestation. There is mild suprapubic tenderness but no
costovertebral angle tenderness on palpation. Urinalysis show numerous WBCs
and RBCs and 3+ bacteria. The patient is at great |
|
l********z
发帖数: 810 | 36 a 42 yo man who is an accountant comes to the physician because of an 8
month history of anxiety during company meetings since being promoted to
area manager in his new position, he isrequired to make weekly presentations
to the five othr area manager and the board of directors. he says he is
gripped by anxiety whenever he conducts the presentations or even thinks
about them. he describes feelings of dizziness palpations, seatiness, and
general dread. he tries to awoid making the presentations a |
|
w********n
发帖数: 202 | 37 41. A 49-year-old woman is admitted to the hospitalbecause of renal failure.
She has had episodes of flank pain over thepast 20 years. She has also had
nocturia 2 to 3 times nightly for 10years. Her blood pressure is 160/100 mm
Hg. Examination shows palemucous membranes. A mass is palpated in the right
flank. Which of thefollowing is the most likely diagnosis?
A) Horseshoe kidney
B) Nephrolithiasis
C) Papillary necrosis
D) Polycystic kidney disease
E) Renal cell carcinoma
How about E |
|
m****n
发帖数: 322 | 38 maybe there is a left mass too, but not palpated:)
20 years history with hypertension with possible anemia, I would go
polycystic kidney disease instead of cancer. |
|
R**********n
发帖数: 473 | 39 37 year old woman 1 day history of throbbing facial pain, has had nasal
congestion,purulent nasal discharge sore throat and nonproductive cough for
9 days. 38.5C, there is tenderness to palpation over the left cheek and no
transillumination over the left maxillary sinus. no erythema of throat. no
cervical adenopathy. lungs are clear
what's the organism?
D. strep Pneumoniae
E. GAS
is the facial pain erysipelas or cellulites? why not GAS?
Ck tomorrow. Thanks so much! |
|
l********y
发帖数: 2295 | 40 B1Q14. An 80-year-old man has had poor balance for 6 months. He has a
history of hypertension treated with hydrochlorothiazide. His blood pressure
is 136/86 mm Hg. Neurologic examination shows mild tremor of the hands when
his arms are outstretched and decreased vibratory sensation at the knees.
Deep tendon reflexes of the quadriceps and gastrocnemius-soleus muscles are
hyperactive. Babinski's sign is present bilaterally. He is unable to stand
with his eyes closed. Which of the following is most... 阅读全帖 |
|
D*****G
发帖数: 105 | 41 Addition to item 5. When you do PE on sencond system, you just need to do "
half". For example, if cardiovascular system is the second one, you only
need to do auscultation rather than inspection, auscultation, percussion and
palpation. I learned this from a 2-day cs class and did this way in my cs
test.
by
much
is |
|
h***y
发帖数: 834 | 42 ☆─────────────────────────────────────☆
mei5 (mei) 于 (Sat Mar 12 11:33:17 2011, 美东) 提到:
First thank you lovelypony gave us the talk and it is very valuable. I
summarize as the following\; If it is not correct, correct me. It is my
understanding.
1. time management is the key. When u do practise, try to have it done by
14 min.
2. SPE: don’t look down urself. Be confident and try to practise as much
as can and make the ur own protocol and talk it with smooth way.
3. Empathy: very imp... 阅读全帖 |
|
h****6
发帖数: 41 | 43 17. A 20-year-old man comes to the health center because of ankle pain. Two
days ago he sustained an inversion injury of his left ankle in a basketball
game. He has been able to walk unassisted since the injury. Today he has
pain and moderate swelling and discoloration over the lateral malleolus.
Physical examination shows tenderness on palpation over the anterolateral
corner of the ankle joint. He has had two similar injuries in the past.
Which of the following is the most appropriate initial m... 阅读全帖 |
|
f****i
发帖数: 129 | 44 20. A 47-year-old woman comes to the emergency department because of severe
abdominal pain for 3 hours. The pain began after a 2-week drinking binge.
She has a 15-year history of alcoholism. She has no history of jaundice or
hepatitis. Current medications include multivitamins and iron. Her
temperature is 38°C (100.4°F), blood pressure is 110/80 mm Hg, and pulse
is 110/min. Examination shows mild jaundice and diffuse spider angiomata
over the trunk and abdomen. The liver is tender to palpation. ... 阅读全帖 |
|
f****i
发帖数: 129 | 45 A previously healthy 32-year-old woman comes to the physician because of a 2
-day history of fever and an area of swelling and redness on her right
forearm. Six hours ago, she noticed red streaks extending from her forearm
to her elbow. She has not traveled, and there is no history of trauma. Her
temperature is 37.8°C (100°F). Epitrochlear lymph nodes are enlarged.
Examination of the distal radial aspect of the right upper extremity shows
an 8 x 13-cm warm, erythematous area of edema that is ten... 阅读全帖 |
|
l******g
发帖数: 278 | 46 NBME form 4
1. A 22-year-old woman with asthma comes to the physician for a follow-up
examination. She feels well. She has been treated for six acute episodes of
wheezing and nonproductive cough during the past year; her last episode was
1 month ago. Her symptoms are exacerbated when she is outside during the
spring and fall. Current medications include an albuterol inhaler and
echinacea. She has smoked one-half pack of cigarettes daily for 5 years and
does not drink alcohol. She is employed in ... 阅读全帖 |
|
J**b
发帖数: 182 | 47 10.A 40yo WM patient presents with severe pain to his back that started
earlier today. He is pacing restlessly in the exam room, clutching his flank
and groaning. Urinalysis shows red blood cells and crystals. He reports
that his pain has moved, over the last few hours, and now involves his
abdomen on the right side.
His pulse and his blood pressure are elevated and he has a low grade fever.
Before you jump to conclusions, you should eliminate other serious
conditions as followings:
A. C... 阅读全帖 |
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n***j
发帖数: 184 | 48 考试的时候，enter是占格的。但是全一起写又太难看了，我是分成下面的几个块写的
，下面有空行的地方考试的我没有空行。最后PN是*，希望能有帮助。 good luck
CC: A 45 yo M c/o bloody vomiting.
HPI: 2 episodes, 2 hours ago and 30 mins ago, w/o known causes. Feels dizzy.
A cupful each time, bright red, no clots, smelly. Epigastric pain at the
same time,dull, buring, 6-8/10, radiating to the back, intermittent,
aggravated with drinking fluids, no alleviating factors. Heartburn for a
long time. No previous episode of bloody vomiting/ nausea/ fever/ chest pain
/ cough/ bla... 阅读全帖 |
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d****y
发帖数: 2180 | 49 ☆─────────────────────────────────────☆
Jane27 (小简) 于 (Sun Nov 25 23:53:22 2012, 美东) 提到:
在USMLE官方网站上面练习PN的链接， 如果每次点enter的话就会take up 很多的space
,结果是我的PN上面的history taking 部分总是不够space。听人说在真正的考试的时
候，这个问题是不存在的，只要你字数不超就可以，你可以按enter来分行。
因为我写PN用的是bulletin的格式，需要分行很多，所以这个问题大大困扰了我。 有
考过的同学可以进来说说吗？
谢谢！
☆─────────────────────────────────────☆
largebird (largebird) 于 (Mon Nov 26 00:04:46 2012, 美东) 提到:
不能分行，要不写不下。一气呵成吧。没办法
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Jane27 (小简) 于 (Mon Nov 26 10:51:23 2... 阅读全帖 |
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h*******r
发帖数: 182 | 50 CC: Epigastric intermittent pain for 15 days, nausea and vomiting for 1 week.
PE: Patient is awake and alert, not in acute distress. There is tenderness
in epigastric area upon deep palpation. An epigastric mass is noted,
hepatomegaly, supraclavicular lymphadenopathy (#, size, left side?).
FOBT (+), Abd U/S: ascites is noted, hepatomegaly
EGD: 3x2.5 cm irregular lesion found on anterior wall of antrum.
Dx: Gastric cancer, stage IV.
有错请纠正.
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