Clare
Forum Asst. Chief
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You are sent to a 37 year old Asian female who is complaining of abdominal pain. The call has been categorised as "urgent/potentially serious".
O/A she is sitting up on the master bed with her husband and doesn't look sick (passes the "end-of-the-bed-oscopy")
C/O 4/24 generalised abdominal pain in all quadrants and some nausea but no vomiting
Previous history NAD, smoker (but trying to quit), gynae history is G1 P1, vaginal birth, menstural NAD - last +/- 3/52 ago, IUD
O/E ABC OK, BP 140/100 PR 80 RR 12 SpO2 99% RA T 37.5 ECG SR
Abdo generalised tenderness, no distention, no guarding, no organomegaly, bowel sounds present, no discolouration (Greys sign), some mild pain upon percussion.
GUI, CVS, Resp NAD, pedal pulses present, some light vaginal discharge but this is said to not be anything different from her normal period.
The patient states the pain is (again) generalised to all quadrants, it is not a tearing pain, does not radiate to the back, is 3/10, does not get worse or better with movement or rest and is not cardiac pain.
Most recent meal was this morning and before that the family ate at a Mexican restaurant the previous evening where she had chicken enchiladas.
Questions
(1) Do you see any "red flags" in the information presented? What? Why?
(2) What is your provisional diagnosis?
(3) Can this patient be safely left at home? Why or why not?
This is my first time doing this so I hope I have given you the information you need, if anything is missing please ask.
O/A she is sitting up on the master bed with her husband and doesn't look sick (passes the "end-of-the-bed-oscopy")
C/O 4/24 generalised abdominal pain in all quadrants and some nausea but no vomiting
Previous history NAD, smoker (but trying to quit), gynae history is G1 P1, vaginal birth, menstural NAD - last +/- 3/52 ago, IUD
O/E ABC OK, BP 140/100 PR 80 RR 12 SpO2 99% RA T 37.5 ECG SR
Abdo generalised tenderness, no distention, no guarding, no organomegaly, bowel sounds present, no discolouration (Greys sign), some mild pain upon percussion.
GUI, CVS, Resp NAD, pedal pulses present, some light vaginal discharge but this is said to not be anything different from her normal period.
The patient states the pain is (again) generalised to all quadrants, it is not a tearing pain, does not radiate to the back, is 3/10, does not get worse or better with movement or rest and is not cardiac pain.
Most recent meal was this morning and before that the family ate at a Mexican restaurant the previous evening where she had chicken enchiladas.
Questions
(1) Do you see any "red flags" in the information presented? What? Why?
(2) What is your provisional diagnosis?
(3) Can this patient be safely left at home? Why or why not?
This is my first time doing this so I hope I have given you the information you need, if anything is missing please ask.