LCSE Med School

Question 1

Brief Summary

Answer 1

The patient is a 39-year-old male who presents with Left lower quadrant pain that began 4 days ago. The pain has worsened and is now associated with fever.

Question 2

where is the pain located

Answer 2

LLQ (left lower quadrant)

Question 3

Duration of the ongoing pain

Answer 3

4 days

Question 4

Characteristic of the pain

Answer 4

dull, constant and worsening

Question 5

Any fever monitored by the temperature

Answer 5

Temperature was monitored and it was 101 F

Question 6

Does the pain interfere with your work?

Answer 6

You are a laborer and the pain has prevented you from working for the past two days

Question 7

Opening Statement

Answer 7

I have pain on the left side (point toward LLQ)

Question 8

Characteristic of the pain

Answer 8

dull and present all the time

Question 9

gradual scale of the pain

Answer 9

3/10 but it is getting worse over the four days and currently a 8/10

Question 10

Any tachypnea

Answer 10

Yeah the patient is breathing rapidly by taking breath in middle of the sentence

Question 11

Current scale of the pain

Answer 11

8/10

Question 12

How long have the fever been going on?

Answer 12

For the past 24 hours

Question 13

Any attempted medications?

Answer 13

Took Tylenol and Motrin every 4 hours in alternating cycles

Question 14

Last time of the attempted medications

Answer 14

2 hours ago

Question 15

Effects from the medications

Answer 15

Decreased the fever but did not affect the pain

Question 16

Does the pain radiate?

Answer 16

The pain move to the left groin when straightening my left leg

Question 17

Any recent bowel movement

Answer 17

Usually have one bowel movement per day but haven’t experienced one for the past two days

Question 18

Have you experienced this type of pain before

Answer 18

Yes I have experienced this pain after I ate some popcorn

Question 19

Any recent weight gain or loss

Answer 19

No

Question 20

Any nausea or vomiting

Answer 20

No

Question 21

Have you been in recent contact with anyone with similar symptoms

Answer 21

No

Question 22

Have you traveled out of the immediate area for the past six months

Answer 22

No

Question 23

Past Medical/Surgical History

Answer 23

no chronic conditions and describe myself as healthy
Have no surgical history

Question 24

Past allergies

Answer 24

Allergic to bee stings (reaction: my throat closed up)

Question 25

Any medication

Answer 25

Not currently on long-term medications but the patient has taken Tylenol and Ibuprofen over the past few days

Question 26

Social Hx

Answer 26

single and have never been married
no children
have not had any unprotected sexual encounters in the past two years

Question 27

Substance Hx

Answer 27

drink one six-pack of beer per week on average since I was 21
Do not smoke
Do not use illicit drugs

Question 28

Family Medical Hx

Answer 28

Both of your parents are still living but neither have experienced symptoms of the pain you described today. Both are generally in good health. You have no siblings

Question 29

How old is the patient

Answer 29

39 years old

Question 30

Date of Birth

Answer 30

1/23/ 1984

Question 31

Pulmonary Exam Finding

Answer 31

Tachypneic with breath sounds bilaterally and clear without rales or rhonchi

Question 32

Differential diagnosis for the cause of the pain

Answer 32

Diverticulitis (inflammation of the wall of your large intestine)
Appendicitis (inflammation of the appendix)
Inflammatory bowel disease
pyelonephritis (inflammation of the kidney)

Question 33

Aggravating factors

Answer 33

Made worse by moving around, walking and straightening your left leg

Question 34

Alleviating factor

Answer 34

lying still, drawing left leg up to the abdomen

Question 35

Patient overall appearance

Answer 35

presence of fever, tachycardia, elevated RR, acute distress due to pain

Question 36

What is the type of diet?

Answer 36

Eat anything on the go fast food and food trucks

Question 37

Do you exercise?

Answer 37

No I work as a laborer

Question 38

Are you currently sexually active?

Answer 38

No