Case 49: Introduction

Case Published: August 2020

History of Present Illness (HPI)


A 65 year-old woman with a history of chronic kidney disease stage 3 (baseline serum creatinine 1.8 – 2.0mg/dL)  gastroesophageal reflux disease (GERD), hyperlipidemia, and hypertension presents to the Emergency Department with abdominal pain and fatigue.

She notes mild abdominal pain over the past 2 weeks. She also has generalized fatigue and feeling “a bit foggy.” She does not have headache, blurry vision, chest pain, shortness of breath, light-headedness, syncope, or lower extremity edema. The abdominal pain is diffuse and difficult for her to describe. She endorses mild nausea but denies vomiting. Denies diarrhea, last bowel movement was two days ago and she is passing flatus. She denies urinary symptoms.

She says she takes several medications but cannot recall all the names and doses right now. She lives with her partner in the suburbs and does not have any pets. She does not use tobacco, or illicit drugs.

Click here for the physical exam!