Image IQ: 18-Year-Old With Abdominal Pain, Nausea, and Weakness

How good are your diagnostic skills?  Test them here with this month's Visual Dx quiz!

Photo Credit: Visual DX

An 18-year-old freshman college student was brought to the ED by 2 dormmates because she wasn’t acting like herself. They reported that she had been very stressed as her first papers were due in a few classes. They had also just gone to several campus parties and been drinking the weekend before. The patient told them it was her first time doing much drinking and she’d been drunk, but her friends had made sure she didn’t overdo it. The patient complained of abdominal pain and nausea and had vomited in the car on the way to the hospital. Her dormmates knew she hadn’t had diarrhea because she’d actually been complaining to them earlier that she felt constipated. She seemed agitated, but also exhibited weakness in her extremities, needing help to move around. The doctor noted tachycardia and dark urine output.

A. Acute intermittent porphyria

B. Generalized anxiety disorder

C. Appendicitis

D. Peritonitis

Can you diagnose the patient? Use the Differential Builder in VisualDx to help you.

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Learn more about this diagnosis on the VisualDx site.

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The correct answer is A. Acute intermittent porphyria.