I will give you the case and questions at the last explain the case naku case ni manchiga explain chei first and also questions ki answer text book nundi rayali Swartz text book nundi kindha questions ki answers ichi avi textbook lo ekkada vunnayo kuda cheppu ahh reference ni batti ivvu CASE 1: A 23-yo, male, medical student had a drinking spree after passing his final examination in Surgery. He was very drunk that he passed out after drinking. After several hours, he was awaken because of abdominal pain. The patient complained of stabbing abdominal pain in the epigastric area with radiation to the upper back area. He sought consult at DMSF Hospital. You are the clerk on duty. While performing physical examination, you noted that the patient appears diaphoretic, in severe abdominal pain, crying and holding his abdominal area. Vital signs revealed that the patient is tachycardic at 120 bpm, tachypneic at 27cpm, febrile at 39*C, normotensive at 130/90mmHg. Pertinent abdominal examination revealed that the patient is soft abdomen with tenderness on palpation at the epigastric and left upper quadrant area. 1. Give your initial impression on the case presented. Give 2 differential diagnoses. 2. Make an admitting notes for the patient: make sure to check possible/expected lab results and make sure to take note of the reason for requesting such test 3. Give the initial management for the patient -continuation- The patient was sent to the ward for monitoring. You were asked by your resident to monitor on the patient. You assessed the patient and noted the following: decrease in the abdominal pain, the patient is a little comfortable and has the following vital signs heart rate: 115bpm respiratory rate: 22 temperature: 38.5 BP: 100/80 Abdominal examination revealed persistence of abdominal tenderness at the epigastric area. Lab Results: CBC: Hgb 12.5, Hct 0.5, WBC 28, Plt 325, Neut 0.98, Lym 0.02 ABG: pH 7.33, pO2 98, pCO2 48, HCO3 12, BE -8.2 Lipase - 870 IU/L Amylase - 790 U/L Na - 132 K - 2.9 ECG - sinus tachycardia Urinalysis - unremarkable BUN - 45mg/dL Crea - 2.5mg/dL ALT - 30 U/L AST - 23 U/L LDH - 450 U/L CBG - 320 mg/dL CXR - normal 1. Classify the severity. 2. Interpret the laboratory results. 3. Create a new problem list according to the new data given. 4. Plan for the patient. 5. Make a SOAP charting for this one according to your plan.