[37F] Experiencing nausea, headache, and diarrhea

Nausea and Diarrhea

Differential diagnosis

• Gastroenteritis (A09), food poisoning (A05.9), and irritable bowel syndrome (K58.9) are more likely given the symptoms.
• Less likely but possible are peptic ulcer disease (K27.9), gallstones (K80.20), and pancreatitis (K85.9).

Plan

Order stool culture and sensitivity to rule out bacterial or parasitic infection. Recommend BRAT diet (bananas, rice, applesauce, toast) and hydration with electrolyte solution. If symptoms persist, consider abdominal ultrasound to rule out gallstones and pancreatitis.

Headache

Differential diagnosis

• Given the patient's description and history, tension headache (G44.2), migraine (G43.9), and cluster headache (G44.0) are more likely.
• Less likely but possible are sinusitis (J32.9), glaucoma (H40.9), and brain tumor (C71.9).

Plan

Perform a neurological exam and eye exam. If the headache persists or worsens, consider ordering a CT or MRI scan. Recommend over-the-counter pain relievers and relaxation techniques. If these measures are ineffective, consider prescription medications.

Overheating

Differential diagnosis

• Given the patient's history of hypothyroidism and current medications, drug-induced hyperthyroidism (T38.3X5A) and menopause (N95.1) are more likely.
• Less likely but possible are hyperthyroidism (E05.90), pheochromocytoma (D35.0), and carcinoid syndrome (E34.0).

Plan

Check thyroid function tests to assess for drug-induced hyperthyroidism. If the patient is of appropriate age, consider checking FSH levels to assess for menopause. If these tests are negative and symptoms persist, consider further endocrine evaluation.