Dr. Jones was tired, but glad to be seeing his last Patient of the day. The Patient was a 50 year old woman, Emily Brown, who had never been to the office before. On reviewing the Chart Dr. Jones saw that the Patient had a history of Keratic causing severe vision problems. She had Oculopathy abnormalities requiring cornea surgery of the left eye, 5 years ago. She presented today complaining of vomiting, swelling and Pain in the abdomen and swelling of her left big Toe and lower extremity. Ms. Brown stated she had severe Febrile, Emesis and pain for a week and the Symptoms were getting worse. She explained to Dr. Jones that she was frightened that she might have a Cancer as the underlying cause of the symptoms, and wonders if she should see an Oncologist for evaluation. Dr. Jones attempted to reassure the Patient and advised her that whatever the reason, she had done the right thing by seeing a doctor and he would determine the reason for her Febrile, Emesis and pain. If he believed she needed to see an Oncologist, he would refer her. First, he wanted to schedule some tests, including a Biopsy to obtain some tissue from the abdomen. Dr. Jones explained to Ms. Brown, that sometimes the Swelling can be inflamed and irritated without any indication of cancer. This could cause the symptoms she was having in the abdomen. As for the Swelling of the Toe, and the left lower extremity, this might be from two different sources. After Examination of her lower extremities, Dr. Jones informed her that her veins looked as if she had Phlebitis a painful condition from inflammation of her veins. The edema and Pain of the Hallux, however, looked as if it was from some fungal problem or Mycosis. Dr. Jones assured Ms. Brown that he would prescribe medication for the Pain and phlebitis that would improve the Symptoms and start to reduce the edema and pain. He also advised her that for the Biopsy, the test to obtain tissue to determine the reasons for the edema and pain of the abdomen, she would be Sedate and would not ex
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