Example Cases von Charles Vega, MD

A mom brings in her 7-year-old boy for frequent "bellyaches" that have sent him home from school several times a week for the past 2 weeks. When at home and after a couples hours, he seems more comfortable and playful. However, by the next day his discomfort appears to reoccur. He has less of an appetite in the mornings, but snacks well when brought home from school and usually eats his dinner. He typically has daily or every-other-day bowel movements that appear normal. What is the best next step in diagnosis?

A previously healthy 31-year-old woman presents to your office because of stiffness in both her hands, fingers, wrists, and ankles for several weeks. Her symptoms are worse in the morning but improve significantly by noon. She also complains of dry eyes and mouth without any changes to her diet or water intake. She feels tired with little daily activity and cannot complete her work as she used to. She is single and is not in any new relationships. She has a strong family history of rheumatoid arthritis. Which of the following is the most appropriate next step?

A 26-year-old woman comes to the physician because of frequent diarrhea and abdominal cramps over the past six months. She denies blood or mucous in her stools, changes in her diet or appetite, or weight loss. She has not traveled over the past year. She has no history of a serious illness and takes no medications. Physical examination shows no abnormalities. Which of the following is the most likely diagnosis?