College of Dentistry

‫كليـــة طــب األســنان‬

Course Name: Internal Medicine, Skin and

Venereal Diseases (1)
Bachelor of Oral and Dental Surgery (BDS) Program Course Code: DIM322
sixth Semester
 Student Name:
Academic Year: 2023 -2024
 Student ID:
 Group:
 Date:

7th Week Assignment

 Answer All the following questions:
10
A . is 45 years old male came to the clinic complaining of
recurrent attacks of diarrhea (three times / day) every other
week with dark color offensive watery stool. He mentioned
he doesn’t have any medical problem .
He mentions he had frequent attacks of vomiting and diarrhea
which continued for 3 days following intake of this meal. He
received fluid, over counter medication for diarrhea in the
form of buscopan, flagyl, and antinal. He improved after that
event apart from attacks of abdominal distension, flatulence
and bloating and sometimes attacks of lower abdominal pain.
Few weeks later he had sever tooth ache, he received a lot of
analgesics. Yesterday he suffered from vomiting of blood.

1
College of Dentistry
‫كليـــة طــب األســنان‬

Question 1: do you want to ask any further questions in his

history?

Question 2: what is the best place to manage this patient?

Clinic, sending him home and come back after lab
investigation or sending him to the ER?

The following results have been detected:

HG 7.6 gm/dl, microcytic hypochromic indices,
FBG 80 mg/dl,
serum urea 70 mg/dl, serum creatinine 0.8 mg/dl.
Question 3: what is the further investigation you should do
for this patient?

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College of Dentistry
‫كليـــة طــب األســنان‬

Question 4: does this patient require nasogastric tune

insertion?

Question 5: do you need to start any medication while

waiting for upper endoscopy?

Diagnosis confirmed upper GIT bleeding 2ry to duodenal

ulcer with one clean based ulcer (Forest classification III) and
another ulcer Forrest class IIC
Question 6: what is the most probable causes of his ulcer?

GOOD LUCK