In this assignment, you will demonstrate your ability to analyze and synthesize patient information from a case study, create a list of preliminary differential diagnoses, and further delineate and refine your differentials through risk factor identification and incorporation of relevant epidemiological data. Be sure to provide rationale for your decisions and choices and always reference your sources. You must utilize the most current evidenced based clinical resources available – these include treatment guidelines (provincial and national where appropriate), systematic review evidence and other scholarly resources. Do NOT rely solely on course textbooks. Do not use websites, etc. meant for the public (e.g., Mayo Clinic, WebMD, canoe.com, news articles, disease-specific foundations, and the like). Hint: Public info sites usually use the pronoun “you” in the text. *You will answer both Case Study A and Case Study B to complete this assignment Scholarly Writing and Critical Thinking (20% of the assignment mark) Twenty percent (20%) of the marks for your assignment will be awarded for appropriate writing style. Your paper should create a coherent progression through the diagnostic process. Answer the assignment questions in the body of the paper, and not in appendices. Do not restate the entire case anywhere in your paper– the reader is familiar with the case study. You must use APA format to accurately cite and reference all information used to assist you in developing the case study (e.g., cite and reference the sources that you used in developing your list of differential diagnoses, and the diagnostics ordered). The following criteria will be used: The paper is structured according to APA format, with a title page, references and appendices if needed. Do not include an abstract. Spelling and grammar are correct Patient: Ms. Elsa Age: 29 Ms. Elsa is a 29-year old primigravida and works as a licensed practical nurse (LPN). At 21 weeks gestation she presents to a Collaborative Emergency Centre (Health Centre with NP, MD, DI and Lab) with complaints of right sided abdomen pain. When you take her history, she reveals she has abdominal pain, nausea, vomiting, and has felt “hot” for approximately 24 hours. She describes the pain as steady and cramping for the last several hours. At times the pain radiates to her right subscapular area. She has had no vaginal bleeding/spotting. She tells you that prior to the pain starting she was out for dinner where she treated herself to hot wings and a Pepsi. She is currently taking no medications other than prenatal vitamins. Physical examination reveals a woman who appears uncomfortable. Her vital signs are P – 98, BP – 110/50, RR – 12, and Temp – 38.7 C. Her abdomen is tender in the right upper quadrant, especially on deep inspiration. Her liver is slightly enlarged on percussion. Bowel sounds could be heard. A strong fetal heart beat is auscultated on Doppler at 120 bpm. Cardiac, respiratory, and all other parts of the examination are normal. Case Study B Questions: 1. Describe the differences in your acute abdominal physical assessment given the physiologic and anatomic changes that occur during pregnancy. (10 marks) 2. When considering further evaluation for an acute abdomen in pregnancy, discuss how you will interpret a CBC differently in a pregnant versus a non-pregnant female. (10 marks) 3. Describe the physical examination special tests you would perform, indicating what disease processes you are looking to rule in/out, and how the test will assist you with this. Include information related to the sensitivity and specificity of the test. (20 marks) 4. Given the limited information provided, provide a diagnosis that you would be working at ruling in with your diagnostic testing. Indicate what your priority diagnostic test would be. (10 marks)