History and Physical Exam
You are asked to see a 42 yr old man who comes to the ER with severe epigastric pain radiating to his back.
He admits to drinking 8-10 beers/ day since he lost his job 2 weeks ago. He is annoyed that he has not been given a food tray.
Physical examination
General appearance: uncomfortable appearing man
HEENT: Normal conjunctiva, no scleral icterus, dry mucous membranes, clear oropharynx
Cardiovascular: No JVD, regular rhythm, rapid rate
Respiratory: clear bilateral breath sounds
Abdominal: soft, moderate epigastric tenderness, no guarding or rebound, hypoactive bowel sounds. No ascites or hernias.
Extremities: warm and well perfused extremities, 1+ bilateral pitting edema to shins bilaterally
Neurologic: Alert, Oriented X 3 with no focal deficits
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