Differential Diagnosis
- Single most likely diagnosis
- E) Substance use disorder: The patient's symptoms of stomach pain and vomiting, combined with the discovery of model airplane glue in her room, suggest the possibility of inhalant abuse, which is a form of substance use disorder. The fact that she becomes nervous when her parents are asked to leave the room may indicate that she is hiding something, further supporting this diagnosis.
- Other Likely diagnoses
- D) Separation anxiety disorder: The patient's symptoms occur only on weekdays, causing her to miss school, which could suggest a pattern of anxiety related to separation from her parents or home environment.
- C) Oppositional defiant disorder: Although less directly related to the physical symptoms, the pattern of missing school and the potential for secretive behavior (given the glue incident) might also suggest oppositional behavior, especially if the vomiting and stomach pain are being used as an excuse to avoid school.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- B) Hepatic failure: While less likely given the lack of other symptoms such as jaundice, hepatic failure can cause vomiting and abdominal pain. It's crucial to consider and rule out serious conditions like hepatic failure due to the potential for severe consequences if left untreated.
- Rare diagnoses
- A) Celiac disease: This is an autoimmune disorder that can cause abdominal pain and vomiting after consuming gluten. However, the symptoms described do not strongly suggest celiac disease, especially given the lack of mention of dietary correlations or other typical symptoms like diarrhea. It's considered here because it's a condition that could potentially cause some of the symptoms described, albeit less likely than other options.