Last updated on: November 26th, 2020



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A 71-year-old woman presents with severe epigastric pain for 6 hours. The pain was near-instantaneous in onset, dull in nature, exacerbated by movement, without radiation, and associated with nausea. No other symptoms are present.

Her medical history is significant for well controlled hypertension for 10 years. She is currently on ramipril. She is not on any other drugs, including over-the-counter medications, or herbal supplements. Her family history is unremarkable. She only drinks socially, and does not smoke.

A full blood count is significant for a leukocyte count of 15,000/mm3 (normal: 4,600-11,000), with 90% neutrophils. C-reactive protein levels are 20.0 mg/L (normal: <6). Serum amylase and lipase levels are within the normal range. A liver profile and renal profile are also within normal parameters.

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