White Presents Emergency Explained for Students (Easy Guide)

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Original Question

Mrs. White presents to the Emergency Department with a complaint of mid supraumbilical abdominal discomfort that has been intermittent over the past 6 days. Patient reports waking on Saturday with mid abdominal discomfort and diarrhea. Diarrhea persisted throughout the day with every po intake. She had voluminous diarrheal bowel movements on multiple occasions Friday and Saturday. She also had intermittent lightheadedness/dizziness with changes in position. Denies vomiting. Denies fevers or chills. Patient denies episodes of chest pain or dyspnea different than her baseline with underlying pulmonary disease. On Monday she was asymptomatic throughout the day. On the day of presentation, the patient reported that the midabdominal pain returned and so she sought evaluation. By the time she was seen in the ER, her pain had resolved. Patient states she feels well without complaints. She was notably hypotensive in ER despite fluid resuscitation. Also with elevated lactic acid and cardiac biomarkers. A4 1ST.9

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