[33F] With nausea, vomiting, abdominal pain, and pelvic symptoms

Patient Description

A 33-year-old female presents with nausea and vomiting occurring several times a day over the past three days, reporting that she seems to vomit more than she consumes. All food exacerbates the nausea, and no relief methods have been identified. The patient also reports abdominal pain, rated as 5 out of 10 in severity, which has gradually worsened over the same period. Additionally, she experiences sharp pelvic pains and a thick, chunky brown vaginal discharge without any noticeable odor. The patient notes random episodes of dizziness and chills, but denies fever, changes in bowel movements, or urinary symptoms. Her menstrual cycles are very irregular, with the last period starting on the 21st of last month. She has not taken a pregnancy test recently. The patient's medical history includes asthma diagnosed at age 15 and fibromyalgia diagnosed at age 17. Current medications include lithium, venlafaxine, propranolol, trazodone, montelukast, and Strattera. She has not traveled recently and reports no known allergies.

Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few potential concerns that need immediate attention:

Ectopic Pregnancy: Given your irregular periods, recent spotting, and pelvic pain, an ectopic pregnancy is a serious condition where a fertilized egg implants outside the uterus, often in a fallopian tube. This can cause severe abdominal pain and is a medical emergency. A pregnancy test and ultrasound are typically used to diagnose this condition.
Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs, often caused by sexually transmitted bacteria. Symptoms can include pelvic pain, abnormal discharge, and fever. It requires prompt treatment with antibiotics to prevent complications.
Ovarian Cyst or Torsion: A cyst on the ovary can cause pain and discomfort, and if it twists (torsion), it can cut off blood supply, leading to severe pain and nausea. An ultrasound can help diagnose this condition.
Gastrointestinal Issues: Severe nausea, vomiting, and abdominal pain could also indicate a gastrointestinal issue, such as a blockage or severe infection, which would require immediate medical evaluation.

What you can do

Given the potential seriousness of these conditions, it is crucial to seek medical attention immediately. Here are some steps you can take:

Visit the Emergency Room: Due to the possibility of an ectopic pregnancy or other serious conditions, you should go to the emergency room as soon as possible. If you are unable to drive, please call for an ambulance or have someone take you.
Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, dizziness, or any new symptoms like fever or heavy bleeding, and report these to the healthcare provider.
Avoid Eating or Drinking: Until you are evaluated by a healthcare professional, it may be best to avoid eating or drinking, especially if you are experiencing severe nausea and vomiting.
Stay Calm and Rest: While waiting for medical care, try to stay calm and rest as much as possible to conserve your energy.

Please remember that while I can provide information based on your symptoms, only a healthcare professional can provide a formal diagnosis and appropriate treatment. Your health and safety are the top priority, so please seek care immediately.

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1 mo ago

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[33F] With nausea, vomiting, abdominal pain, and pelvic symptoms

What might be happening

What you can do

Experiencing symptoms?