55 year old physicist

PC: left lower back pain

HPC: sudden onset 3 days ago

stabbing pain in left loin, coming in waves

severe attacks lasting about 20-30 min but moderate pain in between

pain radiating down his left groin and left testicle

slightly better when moving about

started to have rigors yesterday x3

had loose stool x2 this morning, constant nausea

no dysuria, didn’t check his temperature

PMH: renal amyloidosis – not causing problems at present

gout

atrial septal defect, diagnosed in childhood

gynaecomastia - unkown cause

DHx: allopurinol od

aspirin od

loperamide prn

NKDA

FHx: mother: Grave’s disease

father: Marfan’s syndrome

grandmother: Alzheimer’s disease

brother: Hodgkin’s lymphoma

SHx: lives with 3 friends in shared flat

no alcohol, no smoking, vegetarian for 6 months