Evita Alonso iHuman - 48-year-old Hispanic female CC: Abdominal pain. The pain is in the right upper quadrant of her abdomen

Evita Alonso is a 48-year-old Hispanic female who presents to the clinic today with complaints of

abdominal pain. The pain is in the right upper quadrant of her abdomen, under the ribs, and radiates to

the right shoulder. The pain has been intermittent for many months now. About 2 weeks ago she started

having the pain again but over the past two days the pain is constant. The pain gradually increases

starting at a 2-3 and can get up to a 6-7. Pain is characterized as a cramping, gnawing, achiness and is

currently rated at a 3-4 on a scale of 0-10. E. A. believes that eating makes the pain worse, especially fast

food. Of note, she has been trying to stick to a weight loss program but sometimes she must eat fast

food due to busy schedule. Pain is persistent at rest and not worsened with dairy or wheat products. She

is also experiencing nausea and vomiting as well as a subjective fever. Home use of antacids and

ibuprofen have not provided relief. Reports 3 episodes of emesis over the past 2 days, and only drinking

water and Gatorade. Her emesis is clear and liquid with no evidence of coffee ground or dark tarry

stools.