Approach to acute abdominal pain (pediatrics) Quiz: Ace Your Exams

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A 16-year-old girl gave presents to the pediatrician for abdominal painThe patient reports bloating, increased burpingand burning epigastric pain. Thsymptoms worsen when the patient is hungry and improves after eating. The patient denies blood or mucus in the stools, mouth sores, rashes, or joint pain. She has experienced a 5 lb. weight loss over the last few months, that is unintentional. The patient does not have systemic symptoms. There is no significant family history of gastrointestinal disorders. Temperature is 37°C (98.6°F), pulse is 92/min, blood pressure is 111/66 mm Hg, respirations are 14/min, and oxygen saturation is 99% on room air. On physical examination, the patient appears well. Cardiopulmonary examinations are normal. The abdomen is soft and nondistended with normoactive bowel sounds. There is tenderness to palpation in the epigastriumWithout rebound or guarding. No hepatosplenomegaly is appreciated. Which of the following additional factors would be expected given the most likely diagnosis? 

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