Monday, February 23, 2009


A 20 year old woman presents to student health complaining of several days of fatigue, nausea, and vomiting. The nausea is the worst after waking and has led to several episodes of bilious non-bloody emesis. She also complains of tingling and soreness of her breasts, urinary frequency, nocturia, lightheadedness, mild dyspnea, and nasal congestion.

Challenge: What is your next question?


Alex said...


deardoc said...

Next question could be: have you missed a menstrual cycle?
Would you like to take a pregnancy test?

I would rule out this possibility before proceeding with further investigations for her symptoms.

Unless I'm thinking in a totally wrong direction, wasn't Eileithyia the goddess of childbirth? And Rhea that of fertility?

Craig Chen said...


The Roman equivalent of Hera is of course Juno, referenced in the 2007 movie illustrating this case. These signs and symptoms are classic for early pregnancy, especially in this age group. She should be asked about her last menstrual period.

Source: UpToDate.