Exam 2- abdominal pain

Question 1

34 y/o female, with no PMH, presents with acute RLQ pain and mild fever, associated with vomiting rebound tenderness.

Answer 1

provisional Dx: appendicitis

Question 2

56 y/o male, with history of diabetes and THN, presents with acute intermittent cramping pain to the LLQ, with a palpable mass in the LLQ on exam

Answer 2

provisional dx: diverticulitis

Question 3

Bowel sounds in obstruction

Answer 3

hyperactive

Question 4

Bowel sounds in perforation

Answer 4

hypoactive

Question 5

55 y/o female, with no PMH, presents with acute RUQ pain, associated with dark urine and tenderness to palpation and percussion

Answer 5

provisional dx: cholecystitis

Question 6

66 y/o male, with PMH of alcohol abuse and multiple CV risk factors, presents with complaint of intermittent silver-colored stools.

Answer 6

provisional dx: Carcinoma of the Ampulla of Vater

Question 7

45 y/o female, with PMH of alcohol abuse and multiple CV risk factors, presents with severe LUQ pain that worsens when lying supine and is alleviated by leaning forward, associated with NV and diaphoresis.

Answer 7

provisional dx: pancreatitis

Question 8

Rome II criteria for IBS

Answer 8

12 weeks of symptoms in the preceding year;

1: Recurrent dull/crampy pain    2: Bloating    3: Change in frequency/form of stool

Question 9

33 y/o female, with PMH of three vaginal births, presents with recurrent abdominal pain, associated with alternating periods of constipation and diarrhea and marble-like stools. The patient states sxs worsen in times of great stress

Answer 9

IBS

Question 10

Classic triad for acute diverticulitis

Answer 10

Fever, palpable mass in LLQ, abdominal tenderness

Question 11

42 y/o male, with no PMH, presents with hematuria and CVA tenderness.

Answer 11

provisional dx: Ureterolithiasis