NUR250 Medical Surgical Nursing 1


HPB Assignment: Patient Case Study

Mr Bob Jackson is a 55 year old man admitted to ED with a presenting complaint of diarrhoea, nausea and malaise. His Subjective and Objective examinations are as follows:

History of presenting complaint:

1 week history of increasing Left Lower Quadrant (LLQ) abdominal pain and diarrhoea

Medical History:




Seasonal rhinitis

Osteoarthritis Right knee




Surgical History:

  • Appendicectomy as a child
  • Knee arthroscopy 2005


  • NKA



•  Metoprolol




Review of Systems


  • Currently not on antidepressants, describes normal mood in last year
  • No dizziness, headache, vision change noted, except some headache during last few days


  • Recurrent bronchitis and colds over last year
  • CXR NAD 12 months ago
  • Recent haemoptysis and persistent cough with mild pleuritic pain over 1/12


  • Regular antihypertensives (Ramipril)
  • No central chest pain/ palpitations/dizziness reported


  • 3/12 Hx of occasional loose stools and frank blood in bowl.
  • States that over the years that he has often had runs of watery diarrhoea that he treats with ‘gastro-stop’
  • States a history of ‘piles’


  • No retention/hesitancy/pain


  • Nocturnal bone pain in hips and back noted last 2/12 – treated with OTC Ibuprofen
  • Hx of knee and lumbar pain

Social History

  • Sheep farmer at Patersons Plains, a rural community 100 km Northwest of Melbourne. Married with 2 adult children.


  • Currently smokes – pack a day for the last 35 years
  • Alcohol: 6 stubbies of heavy beer a week
  • Denies illicit drug use

Answer the following questions in regards to Mr Jackson’s presentation.

  1. Hypothesise the most likely chronic disease process that fits Mr Jackson’s symptoms and history. Your hypothesis must be justified by aetiology and pathophysiology relevant to MrJackson’s presentation.
  1. Name one other chronic disease that explains Mr Jackson’s symptoms. Justify what further data, such as diagnostic tests and/or further history, which would enable a clinician to discriminate between these two diseases.
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