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Repeated: A 40-year-old man with a 2-month history of intermittent upper abdominal pain

40 years old | Male

Vignette:

A 40-year-old man presents to his primary care physician with a 2-month history of intermittent upper abdominal pain. He describes the pain as a dull, gnawing ache. The pain sometimes wakes him at night, is relieved by food and drinking milk, and is helped partially by ranitidine. He had a similar but milder episode about 5 years ago, which was treated with omeprazole. Physical examination reveals a fit, apparently healthy man in no distress. The only abnormal finding is mild epigastric tenderness on palpation of the abdomen.

Summary:

2 month | intermittent upper abdominal pain | dulling | gnawing ache | wakes at night | relieved by food | relieved by drinking milk | relieved by ranitidine | episode | epigastric tenderness

Dx:

Peptic Ulcer

Ref:

Evaluation of symptom checkers for self diagnosis and triage: audit study Summary terms just inserted from paper at all

Rank

Disease

Weight
1 Duodenal Ulcer 270.0
2 Peptic Ulcer 269.0
3 Acute peptic ulcer 264.0
4 Gastric Ulcer 260.0
5 Endometriosis 187.0
6 Acute Appendicitis 177.0
7 Gastric Volvulus 175.0
8 Diverticulitis 169.0
9 Gastroparesis 162.0
10 pancreatic cancer 160.0
11 Mesenteric ischemia 155.0
12 Biliary cyst 154.0
13 Sigmoid volvulus 149.0
14 Zollinger-Ellison Syndrome 148.0
15 Choledochal Cyst 146.0
16 Intussusception 146.0
17 Bacterial gastroenteritis 143.0
18 Listerial gastroenteritis 143.0
19 Acute perforated appendicitis 137.0
20 pancreatic SOD 130.0
21 Crohn Disease 128.0
22 Acute Pancreatitis 126.0
23 Gallstone pancreatitis 126.0
24 Primary sclerosing cholangitis 119.0
25 biliary SOD 119.0
26 biliary colic 119.0
27 Ectopic Pregnancy 118.0
28 Fibromyalgia 118.0
29 Panic disorder in adults 117.0
30 Acute Cholecystitis 113.0
31 Gastroesophageal reflux disease 110.0
32 Ovarian and fallopian tube torsion 109.0
33 Irritable Bowel Syndrome 109.0
34 Acute Bacterial Prostatitis 106.0
35 Acute intermittent porphyria 105.0
36 Dyspepsia 105.0
37 Primary biliary cirrhosis 103.0
38 Tuberculous Peritonitis 101.0
39 Amebic Liver Abscess 100.0
40 Peritoneal dialysis associated peritonitis 100.0
41 Ruptured ectopic pregnancy 99.0
42 Multiple Sclerosis 99.0
43 Chronic prostatitis 99.0
44 Prostatitis 99.0
45 Chronic bacterial prostatitis 99.0
46 Globus Sensation 98.0
47 Toxic Megacolon 98.0
48 Shigellosis 98.0
49 Autosomal Dominant Polycystic Kidney Disease 97.0
50 Chronic Pancreatitis 96.0
51 Intestinal malrotation 96.0
52 Familial Mediterranean fever 94.0
53 mucosal Eosinophilic gastroenteritis 94.0
54 Muscle Layer Eosinophilic gastroenteritis 93.0
55 Acalculous Cholecystitis 92.0
56 Annular pancreas 91.0
57 Analgesic nephropathy 90.0
58 COPD Exacerbation 90.0
59 Leiomyomas 89.0
60 Carpal Tunnel Syndrome 88.0
61 Adrenal crisis 88.0
62 Chronic pelvic pain in women 87.0
63 Biliary cirrhosis 86.0
64 Diabetic Ketoacidosis 86.0
65 Gallbladder Dyskinesia 85.0
66 Inguinal hernia 83.0
67 Ovarian Cancer 83.0
68 Non-small cell lung cancer 83.0
69 Cholecystitis 81.0
70 Diabetes Mellitus 80.0
71 Type 2 Diabetes mellitus 80.0
72 Type 1 Diabetes mellitus 80.0
73 Intestinal Obstruction 80.0
74 Chronic Cholecystitis 77.0
75 subserosal eosinophilic gastroenteritis 77.0
76 Bladder Cancer 76.0
77 Chronic Hepatitis 76.0
78 Systemic sclerosis 74.0
79 Spontaneous bacterial peritonitis 73.0
80 Polyarteritis nodosa 71.0
81 Esophagitis 69.0
82 Pyogenic Liver Abscess 69.0
83 Rumination Syndrome 68.0
84 Ileus 68.0
85 Meckel diverticulum 67.0
86 Gallstones 67.0
87 Choledocholithiasis 67.0
88 Sphincter of Oddi Dysfunction 65.0
89 Adrenocortical carcinoma 65.0
90 Abdominal compartment syndrome 65.0
91 Acute heart failure 64.0
92 Hepatocellular carcinoma 64.0
93 Sarcoidosis 63.0
94 Gastric cancer 62.0
95 Amyloidosis 62.0
96 Autoimmune hepatitis 62.0
97 Autoimmune Pancreatitis 61.0
98 Klebsiella pneumoniae liver abscess 61.0
99 Ankylosing spondylitis 60.0
100 Tinnitus 60.0
101 Emphysematous cholecystitis 59.0
102 Chronic heart failure 59.0
103 Hyperparathyroidism 58.0
104 Menopause 58.0
105 Eosinophilic gastroenteritis 58.0
106 Hereditary Angioedema 58.0
107 Non-ST-elevation myocardial infarction 58.0
108 Lactose intolerance 57.0
109 Viral Gastroenteritis 56.0
110 Hiatus hernia 54.0
111 chronic acalculous cholecystitis 54.0
112 Foreign body ingestion 53.0
113 Anthrax 53.0
114 Graves Disease 52.0
115 Cholangiocarcinoma 52.0
116 Liver Cirrhosis 52.0
117 Dubin-Johnson syndrome 52.0
118 Foodborne E coli infection 52.0
119 Acute pericarditis 51.0
120 Campylobacter infection 51.0
121 Gastrointestinal Hemorrhage 51.0
122 Lower gastrointestinal hemorrhage 51.0
123 Upper gastrointestinal hemorrhage 51.0
124 Acute peritonitis 51.0
125 Acromegaly 50.0
126 Obstructive Sleep Apnea 50.0
127 Hyperprolactinemia 50.0
128 Atopic dermatitis 50.0
129 Churg-Strauss Syndrome 50.0
130 Infectious mononucleosis 49.0
131 Cholera 49.0
132 Pneumonia 49.0
133 Acute Cholangitis 48.0
134 Intestinal Pseudo Obstruction 48.0
135 Colorectal cancer 47.0
136 Kawasaki disease 47.0
137 Giardiasis 47.0
138 Common cutaneous drug reactions 47.0
139 Familial adenomatous polyposis syndrome 46.0
140 Optic neuritis 46.0
141 Neuropapillitis 46.0
142 Acute Clonorchiasis 46.0
143 Aortic Dissection 46.0
144 Hereditary hemochromatosis 46.0
145 Lung Cancer 46.0
146 Osteoarthritis 45.0
147 Gastritis 45.0
148 Gallbladder cancer 45.0
149 Alcoholic hepatitis 45.0
150 Budd Chiari Syndrome 45.0
151 Pheochromocytoma 45.0
152 Hemolytic uremic syndrome 45.0
153 Pelvic inflammatory disease 45.0
154 Acute pelvic inflammatory disease 45.0
155 Inflammatory Bowel Diseases 44.0
156 Blepharitis 44.0
157 Nephrogenic diabetes insipidus 44.0
158 Addison Disease 43.0
159 Liver disease 42.0
160 Thrombotic thrombocytopenic purpura 42.0
161 Tinea versicolor 41.0
162 Intraperitoneal bleeding 41.0
163 Parkinson disease 40.0
164 Wilson disease 40.0
165 Acute viral meningitis 40.0
166 Secondary Peritonitis 40.0
167 Alcoholic Liver Cirrhosis 39.0
168 Ruptured Tuboovarian abscess 39.0
169 Anaphylaxis 39.0
170 Bacterial pharyngitis 39.0
171 Breast Cancer 39.0
172 Hypertriglyceridemia 39.0
173 Celiac Disease 39.0
174 Hyperglycemia 39.0
175 Ovarian Hyperstimulation Syndrome 38.0
176 Malaria 38.0
177 Brucellosis 38.0
178 Hypercalcemia 37.0
179 Cushing syndrome 37.0
180 Henoch-Schonlein purpura 37.0
181 Meniere disease 36.0
182 Intestinal Entamoeba histolytica amebiasis 36.0
183 Gastroenteritis 36.0
184 Chronic Myeloid Leukemia 36.0
185 Central diabetes insipidus 36.0
186 Common cold(adults) 35.0
187 Malt lymphoma 35.0
188 Typhoid infection 35.0
189 Short bowel syndrome 34.0
190 Pancreatic Pseudocyst 34.0
191 Hyperosmolar Hyperglycemic state 34.0
192 Adrenal Suppression 34.0
193 Bullous pemphigoid 34.0
194 Ascites 34.0
195 Non-alcoholic Fatty Liver Disease 33.0
196 Chronic fatigue syndrome 32.0
197 Hyperthyroidism 32.0
198 Mirizzi Syndrome 32.0
199 Alcoholic Liver Disease 32.0
200 Epiploic appendagitis 32.0
201 Intra-abdominal abscess 32.0
202 Ulcerative Colitis 31.0
203 Alopecia areata 31.0
204 Benign Prostatic Hyperplasia 31.0
205 Insomnia in adults 30.0
206 Diabetic Neuropathy 30.0
207 Achilles tendon rupture 30.0
208 Achilles tendinopathy 30.0
209 Ruptured ovarian cyst 30.0
210 Chronic Clonorchiasis 29.0
211 Acute Liver Failure 29.0
212 Insect bites and stings 29.0
213 Food poisoning 28.0
214 Gastric Outlet Obstruction 28.0
215 Hypothyroidism 27.0
216 Acute fatty liver of pregnancy 27.0
217 Acute Cystitis(Men) 27.0
218 Salmonella infection 27.0
219 Acute Lymphoblastic leukemia in children 27.0
220 Anemia of chronic disease 27.0
221 Graves ophthalmopathy 26.0
222 Primary Myelofibrosis 26.0
223 COVID19 26.0
224 Rocky Mountain spotted fever 26.0
225 Acetaminophen overdose 26.0
226 Hyperaldosteronism 26.0
227 Hepatic Encephalopathy 25.0
228 Alzheimer disease 25.0
229 Peutz-Jeghers Syndrome 25.0
230 Gilbert syndrome 25.0
231 Clonorchiasis 25.0
232 Multiple Myeloma 24.0
233 Prostate cancer 24.0
234 Autosomal Recessive Polycystic Kidney Disease 23.0
235 Cystic Fibrosis 22.0
236 Heparin-induced thrombocytopenia 22.0
237 Empyema 22.0
238 Urinary Tract Obstruction 22.0
239 Diabetic Kidney Disease 21.0
240 Limited cutaneous systemic sclerosis 21.0
241 Extraintestinal Entamoeba histolytica amebiasis 21.0
242 Congenital Myasthenic Syndromes 20.0
243 Acute bacterial meningitis in children 20.0
244 Morton neuroma 20.0
245 Splenic Rupture 19.0
246 Achalasia 19.0
247 Migraine headache in adults 18.0
248 Multiple endocrine neoplasia 2B 18.0
249 Rotor syndrome 18.0
250 Allergic rhinitis 18.0
251 Chlamydia pneumoniae infection 18.0
252 Chronic Kidney Diseases 18.0
253 Systemic lupus erythematosus 17.0
254 Alcoholic Fatty Liver 17.0
255 Cholestasis 17.0
256 Intrahepatic Cholestasis 17.0
257 Secondary hyperparathyroidism 17.0
258 Splenic Infarction 17.0
259 Diabetic Amyotrophy 17.0
260 Amebiasis 16.0
261 Multiple endocrine neoplasia 2A 16.0
262 Influenza 16.0
263 Acute Hepatitis 15.0
264 Clostridium difficile infection 15.0
265 Splenic abscess 15.0
266 Rosacea 14.0
267 Exocrine pancreatic insufficiency 14.0
268 Endometrial cancer 14.0
269 Premature labor 14.0
270 Renal vein thrombosis 14.0
271 Chronic Renal vein thrombosis 14.0
272 Acute Renal vein thrombosis 14.0
273 Chronic Lymphocytic Leukemia 14.0
274 Hepatorenal Syndrome 14.0
275 Hemorrhagic stroke 14.0
276 Ischemic stroke 14.0
277 Cryptorchidism 13.0
278 Asthma 13.0
279 Tetanus 13.0
280 ST-elevation myocardial infarction 13.0
281 Varicose veins 13.0
282 Substernal goiter 12.0
283 Obstructive cervical goiters 12.0
284 Acute Lymphocytic Leukemia in Adults 12.0
285 Chronic liver disease 12.0
286 Portal hypertension 12.0
287 Chronic Mitral regurgitation 12.0
288 Premenstrual syndrome 11.0
289 Aortic coarctation 11.0
290 Renal and perinephric abscess 10.0
291 Mallory-Weiss syndrome 10.0
292 Intrahepatic cholestasis of pregnancy 10.0
293 Liver Abscess 9.0
294 Umbilical hernia 9.0
295 Guillain-Barre syndrome 9.0
296 Acute bacterial meningitis in neonates 9.0
297 Extrahepatic Cholestasis 8.0
298 Ramsay Hunt syndrome 8.0
299 Anaplastic thyroid cancer 8.0
300 Eclampsia 8.0
301 Primary ciliary dyskinesia 7.0
302 Kartagener syndrome 7.0
303 Mitral Stenosis 7.0
304 Renal Artery Stenosis 7.0
305 Testicular cancer 7.0
306 Unstable angina 7.0
307 Painless thyroiditis 7.0
308 Erectile dysfunction 7.0
309 Acute otitis media 6.0
310 Psychogenic polydipsia 6.0
311 Kidney stones 6.0
312 Simple kidney cyst 6.0
313 Glomerulonephritis 6.0
314 Stable angina 6.0
315 Goiter 6.0
316 Diffuse nontoxic goiter 6.0
317 Toxic multinodular goiter 6.0
318 Cervical goiter 6.0
319 Chronic pyelonephritis 6.0
320 Animal bites 5.0
321 Acute Rhinosinusitis 5.0
322 Acute viral rhinosinusitis 5.0
323 Acute bacterial rhinosinusitis 5.0
324 Acute pyelonephritis in adults 5.0
325 Pyelonephritis 5.0
326 Renal Cell Carcinoma 5.0
327 Migraine 4.0
328 Medullary thyroid cancer 4.0
329 Rheumatoid Arthritis 2.0
330 Thyroid lymphoma 2.0
331 Drowning 2.0
332 Acute disseminated encephalomyelitis 0.0
333 Bell palsy 0.0
334 Myoclonus 0.0
335 Hemorrhoids 0.0
336 Chalazion 0.0
337 Abetalipoproteinemia 0.0
338 Immune thrombocytopenia 0.0
339 Phenylketonuria 0.0
340 Stable ischemic heart disease 0.0
341 Gout 0.0
342 Acute Bronchitis 0.0
343 Granulomatosis with polyangiitis 0.0
344 Discogenic low back pain 0.0