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Sara is a healthy 11½-year-old girl who has come to see you for minor illnesses throughout the
years, but she has never been diagnosed with any chronic illness. Her last exam was a year ago
and she was found to be in good health. Her mother brought her in today because over the past
month, she has missed several days of school due to stomachaches. Her mother states that she
has not had a fever, vomiting, diarrhea, or any other concerning symptoms.
1. What information will you need to determine if the stomachaches have a physical etiology?
2. What diagnostic testing might you consider?
3. Based on Sara’s age, what developmental factors should you consider?
4. What additional questions should you ask Sara and her mother to evaluate the possibility of
school refusal related to psychosocial etiology?
5. What additional information should you collect from Sara and her mother at this visit?
6. What additional education and/or follow up should you recommend?
