Rhinitis Case Study
R.J, 48, Male, Asian Indian, United Healthcare
Nasal congestion, rash and pain abdomen.
History of present illness: MR. R.J is a 50 year old male presented to the clinic with chief complaints of nasal congestion, rash and abdominal pain for last one week. He also stated that he has some sneezing, nasal pruritus with clear nasal discharge, nausea and fever. He reported some occasional vomiting episodes and a fever spike of 100 degree Fahrenheit during this period.
Onset: one week ago
Location: Nasal congestion, rash on the face and legs, pain on the right upper quadrant of abdomen.
Duration: Symptoms got worsened for a week
Characteristics: Associated with feeling tired, sneezing and itching, decreased appetite, nausea …show more content…
Allergens include seasonal pollens and molds as wells as indoor allergens. In the United States, the prevalence of allergic rhinitis is 15 percent on the basis of physician diagnoses and as high as 30 percent on the basis of self-reported nasal symptoms. Allergic rhinitis causes sleep problems, missed or unproductive time at work and school. Allergic rhinitis increases the probability of asthma. Atopic eczema frequently precedes allergic rhinitis. Patients with allergic rhinitis usually have allergic conjunctivitis as well. The diagnosis of allergic rhinitis is made clinically on the basis of characteristic symptoms and a response to empirical treatment with an antihistamine or nasal glucocorticoid (Wheatley & Togias, …show more content…
Cholecystitis: Cholecystitis is an acute inflammation of the gallbladder mostly caused by the stones in the cystic duct. The remaining cause is acalculous cholecystitis. Risk factors of cholecystitis includes, female sex, increasing age, obesity or rapid weight loss, certain ethnic groups, drugs and pregnancy. The classical clinical features of cholecystitis includes abdominal pain, nausea and vomiting. Symptoms may include, abdominal distension, loss of appetite and pain in the right hypochondrium and epigastrium, radiating to the back and or to the right shoulder. Pain mostly described as colicky in cholecystitis. Other signs include fever, tachycardia and tenderness often with rebound or guarding in the right upper quadrant or epigastric region. A positive murphy’s sign is highly suggestive of cholecystitis. Uncomplicated cholecystitis has an excellent prognosis, but, delays in making the diagnosis can increase morbidity and mortality (Thomas, 2013).
Pertinent positives: Abdominal pain, which is especially on the right upper quadrant, nausea, vomiting, loss of appetite, and fever.
Pertinent Negatives: Nasal congestion, sneezing, nasal pruritus, nasal discharge and watery