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want to discuss it.
45 yr old policeman comes to ur office complains of tiredness and sleepiness his job seems tiring to him recently it is difficult for him to get up in d morning and go to work . He goes to bed early as he feels tired and sleepy 2 months ago he was investigating a massive murder case he slipped on the blood on the floor fell and hit his head.He also describes recent abdominal pain that is constant and gnawing interfering with his sleep His apetite is poor and lost 15 pounds over the last month PE is significant only for tenderness and fullness in epigastrium
Which of following is the most likely diagnosis?
a-duodenal ulcer
b-major depressive disorder
c-pancreatic cancer
d-PTSD
e-chronic subdural hematoma

C.

cc? not sensible but danger thing always comesd in mind......wt loss , poor appetite..........
tendernessl and fullnesss in epi

cc
wt loss,fatigue,middle aged person with dull abd pain...alwys think of pan cancer

y not E pt comes to ur clinic with complaints of chronic subdural hematoma?

whats the relationship of tiredness and sleepiness to his abdominal complaints
or there r 2 problems at a time in this pt?

I think tiredness and sleepiness is due to metastasis of panc cancer to the brain

abd pain not letting him sleep may be responsible for his tiredness and day time sleepiness

To thrombo....Bingo again...

ccc

thanx aaz
dep
for eg he has pancreatic cancer as well as chronic subdural hematoma which 1 as a dx u,ll choose?