Intractable Vomiting
History of Present Illness:
A woman in her 20’s presents to the UCC for 5 days of vomiting multiple times per day. She has a mild headache and tweaked her back at the gym about a week ago but now that is better. She denies abdominal pain, fever, diarrhea or any other complaints.
Vital Signs & Physical Exam:
Vital signs are normal as is the physical exam
Initial Diagnostic Testing:
- Labs: WBC 9.6, platelets 131, Cr 1.3, BUN 25, UA 3-5 RBC, 0-2 WBC, few bacteria, protein 100, CRP and sed rate normal
- Imaging: a CT scan is done
QUESTIONS:
- What does the case image show?
- What should you do next?
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- Want to know what happened with this patient?
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ANSWERS:
- What does the case image show? The image shows bilateral pyelonephritis
- What should you do next? Culture urine, repeat all labs, IV fluids and ABX, consider admission
- Want a 1-minute consult/tutorial on this case? See yellow area from sample page below.
- Want to know what happened with this patient? See case conclusion below tutorial page.
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CASE CONCLUSION: Admitted to the hospital