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Further Questions:Have you had dark colored urine? (Hepatitis)Any clay colored stools? (Hepatitis)When did you notice your skin changing colors? (Hepatitis)Any black stools? Blood in your stools? (Gastric carcinoma)When you eat do you get full fast? (Gastric carcinoma)Any recent tattoos? (Hepatitis)Any IV drug use or cocaine use? (Hepatitis)Any heart burn, epigastric pain, burning, or acid reflux? (PUD, gastric carcimoma)Where is your abdominal pain? (PUD)How often do you take Ibuprofen? What is the dosage you take? (PUD)How much caffeine do you consume? (PUD)Are you under a lot of stress? (PUD)Any nausea and pain after eating? (PUD)Differential Diagnosis:Hepatitis-hepatitis is inflammation of the liver, causes include; viruses, alcohol, medications, autoimmune disease, and metabolic defects. Viral hepatitis is caused by 5 different viruses that attack the liver; A(HAV), B(HBV), C(HCV), D(HDV), and E(HEV). Hepatitis B and C are common in incarcerated populations, with drug use, high-risk sexual behavior and tattoos. HAV is transmitted via oral-fecal route, person-to-person contact, and ingestion of contaminated food and water. HCV has been transmitted through blood transfusions before 1992, chronic hemodialysis, injection of drugs, high risk sexual activity, and snorting cocaine. HDV requires coinfection with HBV for replication; it is transmitted through drug use and rarely via sexual contact. HEV outbreaks have only been seen in developing countries usually through contaminated water (Buttaro, Trybulski, Bailey, Sandburg-Cook, 2013). Rational- She has been dating multiple partners, 2 in the past 6 months and does not use a condom. Nausea is a symptom of all viral strands of hepatitis. Ibuprofen should not be used in anyone with hepatic impairment, may cause hepatotoxicity.
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Human sexual behavior, Helicobacter pylori
, Nr 603