Question

Now…look at the following case scenarios and determine which diagnosis is most likely to be applicable to the patient.  

1. A 32-year-old female presents to the emergency room with complaints of abdominal pain. She describes generalized pain that started yesterday and worsened overnight. She indicates that the pain is now located in the RLQ. Upon auscultation, bowel sounds are hypoactive. Guarding noted with palpation, reports tenderness in RLQ, positive McBurney sign. Low grade fever noted, nausea with 2 episodes of vomiting since onset of pain.

This patient most likely has:

Why did you make this conclusion:

2. A 72-year-old male presents to the emergency room with complaints of colicky abdominal pain in his abdomen. He reports episodes of vomiting that is green in color and states that he feels better after vomiting. Upon assessment, his abdomen is rounded, distended and tympanic. Bowel sounds are hyperactive in the upper quadrants and high pitched. He denies passing flatus. Last bowel movement was 3 days ago.  

This patient most likely has:

Why did you make this conclusion:

3. A male patient presents to the emergency room with complaints of abdominal pain. He states the pain is constant and burning and points to his midepigastric area. States it has been present for “about 1 week”. He denies vomiting but does state he has some nausea after meals. Abdomen is not tender to palpation, non-distended, patient reports passing flatus. He reports having taken corticosteroids for the past 2 weeks for an asthma exacerbation.  

This patient is most likely experiencing:

Why did you make this conclusion:

Answer 1

Answer Part 1:

This patient most likely has acute appendicitis. Reason- It started with generalized pain and got localized into RLQ. McBurney sign is positive. Tenderness in RLQ. Low grade fever with nausea and vomiting are present.

Answer Part 2:

This patient most likely has intestinal obstruction. Reason- No flatus passed, abdominal distension, bilious vomiting.

Answer Part 3:

The patient is most likely having peptic ulcer. Reason-Midepigastric pain, nausea after meals,aggravated by NSAIDs and corticosteroids.