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A 36-Year-Old Woman Comes to a New Primary Care Provider

question 545

Multiple Choice

A 36-year-old woman comes to a new primary care provider due to diffuse abdominal pain and poor appetite. The patient has worked as an administrative assistant but recently quit her job "because I always felt uncomfortable. I couldn't get my work done because the pain was bothering me so much." She has difficulty describing the pain in detail and cannot identify any precipitants. Nothing appears to bring relief, although she has felt a little better since leaving her job.
The patient does not use tobacco or alcohol. Family history is noncontributory. Over the past several years, the patient has seen 3 different physicians and had several hospitalizations for similar symptoms; previous workups, including endoscopic studies and an exploratory laparotomy, have revealed no etiology for the pain.
Recent abdominal CT scan and abdominal ultrasound were normal. Physical examination and laboratory tests, including comprehensive metabolic panel, complete blood count, and urinalysis, are within normal limits.
In addition to explaining that serious illness has been ruled out, which of the following is the most appropriate next step in management of this patient?

Definitions:

Project Members

Individuals who are part of a group tasked with achieving specific goals within a project, contributing their skills and efforts towards its completion.

Knowing-Doing Gap

The disconnect between knowing what needs to be done and actually doing it, often hindering organizational performance and outcomes.

Toyota Production System

A manufacturing methodology developed by Toyota that emphasizes efficiency, quality, and continuous improvement, focusing on eliminating waste.

Web-Enabled Input

Data or information input methods that are facilitated through web technologies, allowing for interaction or data entry via the internet.