Instruction
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 a 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?