Name: Alejandro Alegre Leyva

Brigade: 5
Group: A
Cuarto Año
Facultad 2

Case report Appendicitis

A 55-year-old women whose name is Mary Anne Kennedy, lawyer that living alone
and since 3 years his husband death. He was admitted to the Militar hospital
complaing of abdominal pain and vomiting. In the mornig she began with a vague
pain localizated in epigastrium that within 12 hours the pain shifts to the right lower
quadrant, manifested as a steady ache that is worsened by walking or coughing. It
was accompanied by nausea with one or two episodes of vomiting. The patient had
a some years history of Hypertension. When she was 28 years she was operated
by tonsillectomy. Her father died of colon cancer. The patient doesn´t smoke.
On physical examination, the temperatura was 37.8 °C, dry skin tongue ,localized
tenderness with guarding in the right lower quadrant can be elicited with gentle
palpation with one finger. The psoas sign (pain on passive extension of the right
hip) and the obturator sign (pain with passive flexion and internal rotation of the
right hip) were present. No abnormalities were found on the other organs system.
The vital signs of the patient: heart rate 97, blood pressure 120/90 mmHg and
breathing frequency 19 breathings per minute.
The diagnosis of apendicitis was made on the basis of clinical picture and physical
examination. The presumptive diagnosis of appendicitis was confirmed with a
laparoscopy test. The patient was paged to the surgical room for appendectomy
and further medication so as to avoid complication.

Case report Peptic Ulcer Diseasse

A 55-year-old women whose name is Kate Moss, lawyer that living alone and since
3 years his husband death. He was admitted to the Militar hospital complaing of
sudden onset, acute localized epigastric pain. This pain had burning nature. It was
accompanied by belching and bloating. The BMs is normal. On claser questioning,
she mentions she slipped on a wet floor and truisted her wrist, so she had been
taking recommended dosis of ibuprofen to control the pain. The patient had a some
years history of several Bronchial Asthma. When she was 28 years she was
operated by appendicectomy: There was no family history of Peptic Ulcer. The
patient doesn´t drink alcohol.
The physical examination is normal. Only mild, localized epigastric tenderness to
deep palpation is present. The vital signs of the patient: heart rate 80, blood
pressure 110/80 mmHg and breathing frequency 16 breathings per minute.
The emergency department (ED) physician orders an endoscopy to confirm the
diagnosis of what seems to be a peptic ulcer. When results arrive, the physician
recommends avoid spicy food, stop taking ibuprofen and take cimetidine 400mg
bid (twice a day).