[Expert Solution]: 2 diagnoses and 3 differential…

2 diagnoses and 3 differential diagnosesChief Complaint “Vaginal bleeding.” History of Present Illness A 28-year-old woman presents to her PCP with a 3-day history of dizziness, fatigue, and headache. She is mother of two girls, ages 5 and 2 . She and her husband want another child, hopefully a boy, and have planned accordingly. She missed her last period and suspects she is pregnant; a home pregnancy test last week was positive. Until 3 days ago, she felt fine, other than some fatigue and mild nausea. Over the last 2 days, she began experiencing abdominal cramping and irregular vaginal bleeding. She points to both lower and upper quadrants as the main location of the pain. She describes her abdominal pain as 7 of 10 . She has not used over-the-counter pain medication because she wants to avoid medication if pregnant. Additionally, she states, “When changing positions, I get lightheaded.” When the PCP asks about her bleeding, she states she has had similar bleeding during her other pregnancies. “All my pregnancies are like that, it’s normal.” Review of Systems A ROS is positive for fatigue, nausea, abdominal pain, and vaginal bleeding. The patient reports headache and dizziness. The ROS is negative for fever, chills, vomiting, diarrhea, constipation, shortness of breath, or chest pain. Relevant History The patient’s medical history is significant for cholecystectomy (age 27) and chlamydia infection (age 17). Her social history includes drinking one glass of wine per weekend since age 18. She had a few male sex partners prior to her marriage. She lives with her husband and children and describes her marriage as happy. Both children were full-term babies and the pregnancies were normal. Her family history is unknown as she was adopted.