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Toronto Notes - Case 1: Acute Abdominal Pain

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General OSCE Tips Respirology Cardiovascular Gastroenterology Case 1: Acute Abdominal Pain Case 2: GI Bleeding Case 3: Vomiting Case 4: Recurrent Abdominal Pain Case 5: Jaundice Musculoskeletal Urology Pediatrics Peripheral Vascular Women's Health Neurology Psychiatry Ophthalmology and Otolaryngology Geriatrics

Case 1: Acute Abdominal Pain

You are seeing Ms. Cox, a 21 year old female, in the ER for a 24 hour history of abdominal pain. Please take an appropriate history and perform pertinent physical maneuvers.

History
Onset and duration of abdominal pain Location of pain Alleviating factors Aggravating factors Progression of pain Quality of pain Radiation of pain Severity of pain Associated nausea and vomiting Fever Changes in bowel habit Blood in stools Menstruation history Urinary symptoms Sexual history and use of contraception Previous pregnancies Previous abdominal surgery Recent changes in diet Travel history Infectious contacts

Physical Examination
Inspection/Auscultation Comments on patients position on the examination table and drapes patient appropriately Inspects the abdomen for masses, scars Auscultates in all four quadrants of the abdomen
My Account Suggestions/Feedback

Percussion/Palpation

Note Pad

Info

Uses light and deep palpation to examine for tenderness Monitors patients reaction to palpation, comments on guarding Assesses for rebound tenderness in the right lower quadrant Notes tenderness at McBurneys point States that they would perform a digital rectal examination as part of the abdominal examination Special Maneuvers Assesses for Murphys Sign Assesses for Rosvings sign Assesses for Psoas sign

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