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Asclepius1
12-01-2004, 10:48 PM
Can some one come up with a case for abdomen pain. Here is the information.

25 year old white female came in to your office with complain of abdominal pain for 5 hours. Here is her vital signs:

Temp= 102
Pulse = 110
RR =20
BP = 154/90

Asclepius1
12-02-2004, 09:26 AM
Can some one come up with a case for abdomen pain. Here is the information.

25 year old white female came in to your office with complain of abdominal pain for 5 hours. Here is her vital signs:

Temp= 102
Pulse = 110
RR =20
BP = 154/90

Think of the differential diagnosis so you can ask appropriate questions regarding the diagnosis.

Here are some causes of abdomen pain in a woman.

What is in the abdmonen pelvis area?

Kidneys:
UTI
Pyelonephritis
Interstitial cystitis

Bowel:
Appendicitis
Irritable Bowel Syndrome
Crohn's Disease
Ulcerative Colitis

Gall bladder:
Cholecysticis
Cholelithiasis
Choledole cholelithiasis

Splene:
Mononucleosis
Splenic rupture

Liver:
Hepatitis

Vaginal area:
Cervicitis
Ectopic Pregnancy or pregnancy
Pelvic Inflammatory Disease
Menstrual cramps

What questions should you ask?

Asclepius1
12-02-2004, 10:10 PM
Rupture/torsion of ovarian cyst
Acute gastroenteritis
Endometritis

Not that they care. I think all you need to come up with only 3-5 differential diagnosis based on the patient's questions.

Asclepius1
12-02-2004, 10:20 PM
I use LIQOR AAA (Location, Intensity, Quality, Onset, Radiation, Associated symptoms, Alleviating, Aggrevating factor)

Where is the pain. Point to it.

Please rate your pain from 1 to 10. 1 is nothing and 10 is the most severe.

When did the pain start?

How long did it last? Is it getting better or worse?

Does it radiate anywhere? To your back, your leg?

Does anything make it worse or better?

Do you have nausea or vomitng?

Any trauma to your abdomen area?

Do you have fever or chill?

Do you have burning on urination? Do you have to go to the bathroom more frequently? Did you see blood in your urine?

Do you have constipation or diarrhea? If yes, how many bowel movements a day? What is the consistency of your stool? Any blood in your stool?

When was your last menstrual period?

Did you have vaginal discharge or vaginal bleeding?

Did you have unprotected sex? What is your method of contraception?

Social History:

Do you smoke? If yes, how much do you smoke a day and how long have you been smoking?

Do you drink? If yes, when was your last drink? Do you have DT or seizure related to your alcohol?

Do you do IV drugs or illicit drugs? If yes, what are they?

Have you ever had blood transfusion? If yes, when?

FH:
Any diabetes, cancer, or heart probelems in your family?

Allergy:

Are you allergic to anything

Meds:

Are you taking any medications right now?

Asclepius1
12-02-2004, 10:37 PM
You missed the Past medical history and past surgical history part. I will add to it. Nice job, though.

PMH:
Do you have any significant medical history such as high blood pressure, diabetes?

Did you have any hospitalization in the past?

Did you have similar episodes in the past?

PSH:

Did you have surgeries in the past?

Asclepius1
12-04-2004, 07:55 PM
Physical Exam


1. If you still have your hands, make sure you wash them... or cut them off and throw them away.
2 Aucultate the abdomen at least 3 quadrants
3. Superficial palpation of the abdomen
4. Deep palpation of the abdomen
5. Illicit guarding and rebound tenderness
6. Check CVA tenderness with gently tapping the flanks of the patient.
7. Tell the patient you want to do a rectal exam DO NOT FORCE THE PATEINT.
8. Illicit Murphy sign, Psoas sign, and Mcburny point.

After you have done the exam, explain to the patient the findings. Explain what you are going to do; what test you are going to order.

Counsel the patient to have safe sex.

Workup:

Pelvic Exam
Rectal Exam
CBC with differentials
CMP
Urine analysis
Pregnancy test
Ultrasound abdomen or CT scan of the abdomen
Abdomen x ray (KUB)

step2csguru
12-06-2004, 07:55 PM
This is the check list of abdomen pain I gathered in this post.

Case Presentation:

25 year old white female came in to your office with complain of abdominal pain for 5 hours. Here is her vital signs:

Temp= 102
Pulse = 110
RR =20
BP = 154/90

Think of the differential diagnosis so you can ask appropriate questions regarding the diagnosis.

Here are some causes of abdomen pain in a woman.

What is in the abdmonen pelvis area?

Kidneys:
UTI
Pyelonephritis
Interstitial cystitis

Bowel:
Appendicitis
Irritable Bowel Syndrome
Crohn's Disease
Ulcerative Colitis

Gall bladder:
Cholecysticis
Cholelithiasis
Choledole cholelithiasis

Splene:
Mononucleosis
Splenic rupture


Liver:
Hepatitis

Vaginal area:
Cervicitis
Ectopic Pregnancy or pregnancy
Pelvic Inflammatory Disease
Menstrual cramps

Rupture/torsion of ovarian cyst
Acute gastroenteritis
Endometritis

HPI

Open ended question:
Mrs. John, please tell me about your abdomen pain.

Now closed end questions:
I use LIQOR AAA (Location, Intensity, Quality, Onset, Radiation, Associated symptoms, Alleviating, Aggrevating factor)

Where is the pain. Point to it.

Please rate your pain from 1 to 10. 1 is nothing and 10 is the most severe.

When did the pain start?

How long did it last? Is it getting better or worse?

Does it radiate anywhere? To your back, your leg?

Does anything make it worse or better?

Do you have nausea or vomitng?

Any trauma to your abdomen area?

Do you have fever or chill?

Do you have burning on urination? Do you have to go to the bathroom more frequently? Did you see blood in your urine?

Do you have constipation or diarrhea? If yes, how many bowel movements a day? What is the consistency of your stool? Any blood in your stool?

When was your last menstrual period?

Did you have vaginal discharge or vaginal bleeding?

Did you have unprotected sex? What is your method of contraception?

Social History:

Do you smoke? If yes, how much do you smoke a day and how long have you been smoking?

Do you drink? If yes, when was your last drink? Do you have DT or seizure related to your alcohol?

Do you do IV drugs or illicit drugs? If yes, what are they?

Have you ever had blood transfusion? If yes, when?

FH:
Any diabetes, cancer, or heart probelems in your family?

Allergy:

Are you allergic to anything

Meds:

Are you taking any medications right now?

PMH:
Do you have any significant medical history such as high blood pressure, diabetes?

Did you have any hospitalization in the past?

Did you have similar episodes in the past?

PSH:

Did you have surgeries in the past?

Physical Exam


1. If you still have your hands, make sure you wash them... or cut them off and throw them away.
2 Aucultate the abdomen at least 3 quadrants
3. Superficial palpation of the abdomen
4. Deep palpation of the abdomen
5. Illicit guarding and rebound tenderness
6. Check CVA tenderness with gently tapping the flanks of the patient.
7. Tell the patient you want to do a rectal exam DO NOT FORCE THE PATEINT.
8. Illicit Murphy sign, Psoas sign, and Mcburny point.

After you have done the exam, explain to the patient the findings. Explain what you are going to do; what test you are going to order.

Counsel the patient to have safe sex.

Workup:

Pelvic Exam
Rectal Exam
CBC with differentials
CMP
Urine analysis
Pregnancy test
Ultrasound abdomen or CT scan of the abdomen
Abdomen x ray (KUB)

Asclepius1
06-07-2005, 07:39 PM
I RECENTLY HAD A CAT SCAN AND ULTRA SOUND AND THEY SAY I HAVE A MASS ON MY SPLENE, WHAT DOES THIS MEAN AND WHAT IS THE TREATMENT.

Asclepius1
06-07-2005, 07:53 PM
I RECENTLY HAD A CAT SCAN AND ULTRA SOUND AND THEY SAY I HAVE A MASS ON MY SPLENE, WHAT DOES THIS MEAN AND WHAT IS THE TREATMENT.

Unregistered
11-14-2005, 03:13 PM
I RECENTLY HAD A CAT SCAN AND ULTRA SOUND AND THEY SAY I HAVE A MASS ON MY SPLENE, WHAT DOES THIS MEAN AND WHAT IS THE TREATMENT.
spleen you mean,i don't really know,Talk to your doctor please.

alimari
01-02-2006, 05:28 PM
This patient is in hemodynamic shock!, Right?!

Check first:

1. Explore chief complaint.
2- Volume status assessment.
3- Full Gyn/OB history.
4- THEN the above listed questions.

See more of how to prepare for the ***** at ******

Unregistered
01-08-2006, 04:54 PM
Did you mean "***** Home" site?







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