Sevena


HPI Mrs. Alfonso is a 48-year-old female patient who presented to the clinic with a progressive, intermittent right upper quadrant pain for the past 2 weeks and which has increased in severity in the past 2 days. The pain radiates to the right shoulder. She also complains of associated symptoms like nausea, vomiting, anorexia since the past 2 days. She has had previous recurrent self-resolving symptoms over the last one year. Pain used to be precipitated by fast food but not occurs with all foods and unresponsive with antacids and NSAIDS. . Patients diagnosis is  Choledocholithiasis .

3 Differential Diagnosis relating to patients illness . with 3 APA references.