Mr. Stein's pain
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

Mr. Stein isn't looking or feeling so good.
  • Continues with pain and nausea.
  • His monitoring EKG is showing more than just a few PVCs.
  • His calcium could be dropping which might be the source of the irritable heart conduction system. 
  • Where's the calcium going and why's this such a big deal?
It's definitely time for consultation
  • See about getting a surgeon to give an opinion on his gallbladder.
  • Gastroenterologist could be of help in short run. She could, by means of endoscopy, access the the sphincter of Oddi,  cut into it and thereby releasing a trapped stone. 
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