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Upper abdominal paine "eclampsia"
1. Upper Abdominal Paine
Done By: Ahmed Sami Alwesaibie
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2. Objectives:
What possible diagnosis can you think of here ?
What must you ask, exam, and test to reach more
conclusive option ?
What laboratory tests are required here ?
4. Our patient symptoms
She was very nauseous at 1st three months
Since a couple of weeks, she develops swollen
ankle
Since a while, she notes right hand numbness
Fundal height was too small ( at the umbilicus +1 )
Pain in her upper right side of abdomen
Finally with seizure
6. Most Favorable DD
Digestive disorder
Preeclampsia
Clampsia
HELLP syndrome
Adrenal Insufficiency and Adrenal Crisis
7. Hint
3rd trimester increase the risk
1st pregnancy increase risk ratio by 2.91
The theory say that may be due to limited exposer to
partner antigen.
Family history “ as the missed point regarding her
sister “ increase the risk ratio by 2.90
Her presentation of
Nausea
Ankle swollen which may be edema
Upper abdominal pain
seizure
Eclambsia
8. What must you ask, exam, and test
to reach more conclusive option ?
12. History
After taking a general history especially regarding
our patient case and her symptoms, we can
specified the Q to be regarding our thinking;
At beginning general Q about
Main complain
biographical data
13. Regarding her sexual life
Regarding menstruation and her period
Her sexual life with her husband
…
14. Regarding nausea
When it start?
How is it sever?
Persist to how?
Aggravating and relieving factors?
Till when it persist?
15. Regarding abdominal pain
Since when?
At which site?
How it sever?
Is it referred?
Can you prescribe it?
Frequency of attacks?
Any related or other symptoms?
Aggravating and relieving factors?
16. Other Q
Regarding the edema and since when it developed?
Regarding any allergy
Any history of drugs use
History of chronic disease
Surgical history
Family history for same condition
20. Specific Examination
BP in supine and setting position
Patient weight and how it speed grown
Liver tenderness
Edema in different body parts (face, sacrum,
hands, and ankles)
Funduscopic examination to detect any
vasoconstriction