LCSE Med School Flashcards

1
Q

Brief Summary

A

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.

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2
Q

where is the pain located

A

LLQ (left lower quadrant)

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3
Q

Duration of the ongoing pain

A

4 days

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4
Q

Characteristic of the pain

A

dull, constant and worsening

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5
Q

Any fever monitored by the temperature

A

Temperature was monitored and it was 101 F

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6
Q

Does the pain interfere with your work?

A

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

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7
Q

Opening Statement

A

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

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8
Q

Characteristic of the pain

A

dull and present all the time

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9
Q

gradual scale of the pain

A

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

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10
Q

Any tachypnea

A

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

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11
Q

Current scale of the pain

A

8/10

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12
Q

How long have the fever been going on?

A

For the past 24 hours

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13
Q

Any attempted medications?

A

Took Tylenol and Motrin every 4 hours in alternating cycles

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14
Q

Last time of the attempted medications

A

2 hours ago

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15
Q

Effects from the medications

A

Decreased the fever but did not affect the pain

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16
Q

Does the pain radiate?

A

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

17
Q

Any recent bowel movement

A

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

18
Q

Have you experienced this type of pain before

A

Yes I have experienced this pain after I ate some popcorn

19
Q

Any recent weight gain or loss

20
Q

Any nausea or vomiting

21
Q

Have you been in recent contact with anyone with similar symptoms

22
Q

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

23
Q

Past Medical/Surgical History

A

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

24
Q

Past allergies

A

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

25
Any medication
Not currently on long-term medications but the patient has taken Tylenol and Ibuprofen over the past few days
26
Social Hx
single and have never been married no children have not had any unprotected sexual encounters in the past two years
27
Substance Hx
drink one six-pack of beer per week on average since I was 21 Do not smoke Do not use illicit drugs
28
Family Medical Hx
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
29
How old is the patient
39 years old
30
Date of Birth
1/23/ 1984
31
Pulmonary Exam Finding
Tachypneic with breath sounds bilaterally and clear without rales or rhonchi
32
Differential diagnosis for the cause of the pain
Diverticulitis (inflammation of the wall of your large intestine) Appendicitis (inflammation of the appendix) Inflammatory bowel disease pyelonephritis (inflammation of the kidney)
33
Aggravating factors
Made worse by moving around, walking and straightening your left leg
34
Alleviating factor
lying still, drawing left leg up to the abdomen
35
Patient overall appearance
presence of fever, tachycardia, elevated RR, acute distress due to pain
36
What is the type of diet?
Eat anything on the go fast food and food trucks
37
Do you exercise?
No I work as a laborer
38
Are you currently sexually active?
No