Provide the most likely diagnosis based on the hpi and pe

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Reference no: EM133529214

Case Study: Heartburn in a 46-Year-Old MaleHPI: Patient complains of pain in his mid-chest for the past couple of months that has progressively worsened over the last couple of weeks. He states it is worse when he goes to bed at night or when he eats a large meal. He has been eating out a lot more over the past couple of months because he has been traveling a lot for work. He denies any nausea or vomiting. He has been taking OTC Tums for the past few weeks, but he has to take 10-12 a day and only gets minimal relief. He denies any unusual weight gain or loss.PE: Exam reveals an obese, Caucasian male with mild epigastric tenderness. No hepatosplenomegaly. Bowel sounds normoactive in all four quadrants.

Questions:

  1. Provide the most likely diagnosis based on the HPI and PE. In addition, provide your interpretation of the cues found in the assessment.
  2. List possible differential diagnoses and justify your rationale.
  3. Develop therapeutic plan options based on quality, evidence-based clinical guidelines. Plan must include cost-effective and least-invasive techniques, counseling and patient education, pharmacological and nonpharmacological treatments, and additional diagnostic testing as needed.

 

Reference no: EM133529214

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