Cholecystitis Role Play: History Taking

History:

PAIN: sharp, cramping, dull,
WHEN: come and go, acute
WHERE: begin at epigastric, then localized at right hyppchondrium; radiate to the back or below the right scapula
Aggregating factors: Breathing deeply , after meal (esp: large meal or high fat meal)
Associated symptoms: Chills


GIT system review:

Abdominal pain AS ABOVE
Appetite YES
Weight NO
Nausea YES
Vomiting YES
Vomiting blood (haematemesis) NO
Heartburn NO
Difficulty swallowing (dysphagia) NO
Bloating (Abdominal fullness) YES (at RUQ)
Change in bowel habit NO
Blood in stools/ bowel motion NO
Black-tar like stools (malaena) YES
Fevers YES (above 38’c)
Jaundice YES
Itch NO
Overseas travel NO


References:
http://www.nlm.nih.gov/medlineplus/ency/article/000264.htm
http://emedicine.medscape.com/article/171886-overview
http://www.mayoclinic.com/health/cholecystitis/DS01153/DSECTION=symptoms