2. Patient Information
• 32 years old Lady
• Known Asthmatic for 7 years.
• No known Drug Allergy.
• Single daughter 10 years old.
• Appendectomy and Salpingoplasty.
• Passive Smoker.
4. History Of Present Illness
• One year ago the patient had single attack of hematemesis one
month later progressed with multiple attacks of hematemesis
associated with epigastric pain.
• These attacks weren't precipitated by certain stimuli , not
associated with change in bowel habit, melena or hematochazia .
• The epigastric pain wasn't related to meal.
• The patient isn't known Analagesic abuser.
5. History Of Present Illness – Cont'd
• OTC medications were given and didn't relieve the symptoms
• April 2016 – an UGI endoscopy:
Superficial duodenal > gastric erosions .
• Biopsy : H.Pylori associated gastritis and duodenitis.
• Triple Therapy was given : epigastric pain improved but recur later
6. History Of Present Illness – Cont'd
• One month ago, the patient noticed :
Significant weight loss " around 23 Kgs " .
Night Sweating.
Night Fever.
Productive Cough " Greenish Sputum " .
7. Examination
• Vital Data : Vitally Stable , recently has increased Temperature "38"
• General : Cachexia – Hair Loss – Oral Moniliasis –
NO Lymphadenopathy .
• Chest : Rhonchi – Whezzes.
• Heart : Normal Heart Sounds – No murmurs.
• Abdomen : Lax – No Organomegaly –
Moderate Epigastric tenderness.
• Limbs : No L.L Edema – No skin Pigmentation.