Chapter 2 Diseases of the Abdomen Next

Instructions The following unit contains individual case studies which are based on the information learned in the pathophysiology review. Evaluate each case, review the signs and symptoms and determine the diagnosis of the disease from the provided options. Once you have determined the diagnosis, proceed to the next slide to receive the answer with the rationale. Next

Question 1 of 13 54 year old black / female had a sudden onset of a headache and poor coordination. She is oriented to person but confused to place and time. Her skin is pink, cool, pale and she has excessive sweating. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has a history of Diabetes. Her Blood pressure was 96/54, pulse 122 and regular, respirations 28. Her blood sugar is 43 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 1 of 13 54 year old black / female had a sudden onset of a headache and poor coordination. She is oriented to person but confused to place and time. Her skin is pink, cool, pale and she has excessive sweating. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has a history of Diabetes. Her Blood pressure was 96/54, pulse 122 and regular, respirations 28. Her blood sugar is 43 mg/dl. Oxygen saturation by pulse oximeter is 97%. Headache and poor coordination Confused to place and time. Skin is cool, pale and she has excessive sweating. History of Diabetes Blood sugar is 43 mg/dl. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 2 of 13 25 year old white / female states she has a burning pain in the upper abdomen, usually when eating Sometimes the pain occurs at night. The patient states she has occasional nausea and vomiting of material that looks like coffee grounds. She also has noted significant weight loss over the last several months. She is alert and oriented to person, place and time. His skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and slight tender in the upper abdomen; she moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 100/54, pulse 88 and regular, respirations 20. Her blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 99%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 2 of 13 25 year old white / female states she has a burning pain in the upper abdomen, usually when eating Sometimes the pain occurs at night. The patient states she has occasional nausea and vomiting of material that looks like coffee grounds. She also has noted significant weight loss over the last several months. She is alert and oriented to person, place and time. His skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and slight tender in the upper abdomen; she moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 100/54, pulse 88 and regular, respirations 20. Her blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 99%. Burning pain in the upper abdomen, usually when eating Pain occurs at night Nausea and vomiting of material that looks like coffee grounds. Significant weight loss Abdomen is soft and slight tender in the upper abdomen Key Indicators a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hypoglycemia Next

Question 3 of 13 17 year old white / male states he has a gradual onset of pinpoint pain in the lower right quadrant of the abdomen that increases on palpation. He has a loss of appetite, nausea and vomiting which started soon after abdominal pain began. He is alert and oriented to person, place and time. His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and extremely tender in the right abdominal quadrant; he moves all extremities with equal range of motion and strength. The patient has a medical history of Asthma. . His Blood pressure was 114/74, pulse 110 and regular, respirations 20. His blood sugar is 103 mg/dl. Oxygen saturation by pulse oximeter is 99%. Oral temperature is 102.0 degrees Fahrenheit. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 3 of 13 17 year old white / male states he has a gradual onset of pinpoint pain in the lower right quadrant of the abdomen that increases on palpation. He has a loss of appetite, nausea and vomiting which started soon after abdominal pain began. He is alert and oriented to person, place and time. His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and extremely tender in the right abdominal quadrant; he moves all extremities with equal range of motion and strength. The patient has a medical history of Asthma. . His Blood pressure was 114/74, pulse 110 and regular, respirations 20. His blood sugar is 103 mg/dl. Oxygen saturation by pulse oximeter is 99%. Oral temperature is 102.0 degrees Fahrenheit. Pinpoint pain in the lower right quadrant of the abdomen that increases on palpation Gradual onset of pain Loss of appetite Nausea and vomiting which started soon after abdominal pain began Fever - Temperature is 102.0 degrees Fahrenheit Key Indicators a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Next

Question 4 of 13 21 year old white / female states dull pain and tenderness in the lower abdominal area which increases when having a bowel movement. Patient states she has also noted abnormal vaginal discharge that is green in color and has an unusual odor. She also complains of chills, fever, nausea and vomiting. She is alert and oriented to person, place and time. Her skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and the pain increases on palpation. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 112/76, pulse 102 and regular, respirations 20. Her blood sugar is 112 mg/dl. Temperature is 102.2 degrees Fahrenheit. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 4 of 13 21 year old white / female states dull pain and tenderness in the lower abdominal area which increases when having a bowel movement. Patient states she has also noted abnormal vaginal discharge that is green in color and has an unusual odor. She also complains of chills, fever, nausea and vomiting. She is alert and oriented to person, place and time. Her skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and the pain increases on palpation. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 112/76, pulse 102 and regular, respirations 20. Her blood sugar is 112 mg/dl. Temperature is 102.2 degrees Fahrenheit. Oxygen saturation by pulse oximeter is 97%. Dull pain and tenderness in the lower abdominal area Pain increases when having a bowel movement Abnormal vaginal discharge that is green in color and has an unusual odor Chills, fever - Temperature is 102.2 degrees Fahrenheit Nausea and vomiting Key Indicators a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hypoglycemia Next

Question 5 of 13 57 year old white / male states he has recently noted dark, tarry stools, cramping and diarrhea over the last several weeks. He feels generally weak all over and gets very dizzy when he stands up. He is alert and oriented to person, place and time. His skin is pale, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and slightly tender in all four quadrants; he moves all extremities with equal range of motion and strength. The patient has a history of colitis. His Blood pressure was 97/544, pulse 112 and regular, respirations 24. His blood sugar is 121 mg/dl. Oxygen saturation by pulse oximeter is 95%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 5 of 13 57 year old white / male states he has recently noted dark, tarry stools, cramping and diarrhea over the last several weeks. He feels generally weak all over and gets very dizzy when he stands up. He is alert and oriented to person, place and time. His skin is pale, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and slightly tender in all four quadrants; he moves all extremities with equal range of motion and strength. The patient has a history of colitis. His Blood pressure was 97/544, pulse 112 and regular, respirations 24. His blood sugar is 121 mg/dl. Oxygen saturation by pulse oximeter is 95%. Dark, tarry stools Cramping and diarrhea over the last several weeks Weak all over, gets very dizzy when standing up Skin is pale, warm and dry Abdomen is soft and slightly tender in all four quadrants a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 6 of 13 68 year old white/ male had a gradual onset of general weakness and altered level of consciousness. The patient has a fever and a fruity smell on his breath is noted. He is confused to person, place and time His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. A deep and labored breathing pattern is noted. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength. The patient has a history of Diabetes. His Blood pressure was 144/84, pulse 112 and regular, respirations 18. His blood sugar is 443 mg/dl. Oxygen saturation by pulse oximeter is 97%. Temperature is 103.1 degrees Fahrenheit a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 6 of 13 68 year old white/ male had a gradual onset of general weakness and altered level of consciousness. The patient has a fever and a fruity smell on his breath is noted. He is confused to person, place and time His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. A deep and labored breathing pattern is noted. The abdomen is soft, and non-tender. He moves all extremities with equal range of motion and strength. The patient has a history of Diabetes. His Blood pressure was 144/84, pulse 112 and regular, respirations 18. His blood sugar is 443 mg/dl. Oxygen saturation by pulse oximeter is 97%. Temperature is 103.1 degrees Fahrenheit Gradual onset of general weakness and altered level of consciousness Skin is pink, hot and dry Confused to person, place and time Fever - Temperature is 103.1 degrees Fahrenheit Fruity smell on breath Deep and labored breathing pattern History of Diabetes Blood sugar is 443 mg/dl. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 7 of 13 66 year old black / male states he has had itchy skin, loss of appetite and a lack of energy. He has noted fever for several months as well as swelling in the ankles, legs, and abdomen. Patent states he has recently noted orange tint to the urine and light colored stools. He is alert and oriented to person, place and time. His skin has a yellow tint to it, is warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; he moves all extremities with equal range of motion and strength. The patient has a history of alcohol and drug abuse, hypertension and diabetes. His Blood pressure was 166/94, pulse 74 and regular, respirations 20. His blood sugar is 201 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 7 of 13 66 year old black / male states he has had itchy skin, loss of appetite and a lack of energy. He has noted fever for several months as well as swelling in the ankles, legs, and abdomen. Patent states he has recently noted orange tint to the urine and light colored stools. He is alert and oriented to person, place and time. His skin has a yellow tint to it, is warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; he moves all extremities with equal range of motion and strength. The patient has a history of alcohol and drug abuse, hypertension and diabetes. His Blood pressure was 166/94, pulse 74 and regular, respirations 20. His blood sugar is 201 mg/dl. Oxygen saturation by pulse oximeter is 97%. Itchy skin Loss of appetite and lack of energy Swelling in the ankles, legs, and abdomen Skin has a yellow tint, orange urine, light colored stool History of alcohol and drug abuse a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 8 of 13 45 year old white / female states she has pain in the upper right abdomen that radiates to the right shoulder and upper back; the patient states the pain lasts for several hours and usually occurs not long after eating. The patient also complains of nausea and vomiting, indigestion and heartburn. She is alert and oriented to person, place and time. Her skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; she moves all extremities with equal range of motion and strength. The patient has history diabetes and hypertension. Her Blood pressure was 156/99, pulse 88 and regular, respirations 20. Her blood sugar is 212 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 8 of 13 45 year old white / female states she has pain in the upper right abdomen that radiates to the right shoulder and upper back; the patient states the pain lasts for several hours and usually occurs not long after eating. The patient also complains of nausea and vomiting, indigestion and heartburn. She is alert and oriented to person, place and time. Her skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; she moves all extremities with equal range of motion and strength. The patient has history diabetes and hypertension. Her Blood pressure was 156/99, pulse 88 and regular, respirations 20. Her blood sugar is 212 mg/dl. Oxygen saturation by pulse oximeter is 97%. Pain in the upper right abdomen that radiates to the right shoulder and upper back Lasts for several hours and usually occurs not long after eating Nausea and vomiting Indigestion and heartburn a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 9 of 13 44 year old black / male states he has a burning sensation in his chest, accompanied by sharp chest pain, when he is eating. This has been going on for the last several months. He has difficulty swallowing his food, a dry cough and hoarse throat. He has also noted that occasionally he regurgitates a sour liquid sometimes after he eats. He is alert and oriented to person, place and time. His skin is warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; he moves all extremities with equal range of motion and strength. The patient has no medical history. His Blood pressure was 112/64, pulse 74 and regular, respirations 20. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 9 of 13 44 year old black / male states he has a burning sensation in his chest, accompanied by sharp chest pain, when he is eating. This has been going on for the last several months. He has difficulty swallowing his food, a dry cough and hoarse throat. He has also noted that occasionally he regurgitates a sour liquid sometimes after he eats. He is alert and oriented to person, place and time. His skin is warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft and non-tender; he moves all extremities with equal range of motion and strength. The patient has no medical history. His Blood pressure was 112/64, pulse 74 and regular, respirations 20. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 97%. Burning sensation in his chest, accompanied by sharp pain, when eating Difficulty swallowing food Dry cough and hoarse throat Regurgitates a sour liquid sometimes after eating a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 10 of 13 45 year old white / male states sudden onset of upper left abdominal pain that radiates into the back, severe nausea, vomiting and fever. He is alert and oriented to person, place and time. His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, swollen and tender especially on the left side; he moves all extremities with equal range of motion and strength. The patient has history of diabetes. His Blood pressure was 176/89, pulse 108 and regular, respirations 24. His blood sugar is 224 mg/dl. Oxygen saturation by pulse oximeter is 97%. Temperature is 101.8 degrees Fahrenheit. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 10 of 13 45 year old white / male states sudden onset of upper left abdominal pain that radiates into the back, severe nausea, vomiting and fever. He is alert and oriented to person, place and time. His skin is pink, hot and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, swollen and tender especially on the left side; he moves all extremities with equal range of motion and strength. The patient has history of diabetes. His Blood pressure was 176/89, pulse 108 and regular, respirations 24. His blood sugar is 224 mg/dl. Oxygen saturation by pulse oximeter is 97%. Temperature is 101.8 degrees Fahrenheit. Upper left abdominal pain that radiates to the back Severe nausea and vomiting Fever - Temperature is 101.8 degrees Fahrenheit Abdomen is swollen and tender especially on the left side a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Next

Question 11 of 13 18 year old white / female states gradual onset of burning on urination, also states passing frequent, small amounts of urine. The patient complains of the presence of blood in the urine and a strong-smell. She is alert and oriented to person, place and time. Skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 112/74, pulse 112 and regular, respirations 20. Her blood sugar is 113 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 11 of 13 18 year old white / female states gradual onset of burning on urination, also states passing frequent, small amounts of urine. The patient complains of the presence of blood in the urine and a strong-smell. She is alert and oriented to person, place and time. Skin is pink, warm and dry. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and non-tender. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 112/74, pulse 112 and regular, respirations 20. Her blood sugar is 113 mg/dl. Oxygen saturation by pulse oximeter is 97%. A burning sensation when urinating Passing frequent, small amounts of urine Blood in the urine Strong-smelling urine a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 12 of 13 25 year old Hispanic / male states sudden onset of sharp, severe, pinpoint abdominal pain that gets worse in waves. The patient states the pain radiates to the flank and groin. The patient is unable to find a position of comfort. He has severe nausea and vomiting and his skin is pale, cool, clammy and he is sweating excessively. He is alert and oriented to person, place and time. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and there is no change in pain quality on palpation. He moves all extremities with equal range of motion and strength. The patient has no medical history. His Blood pressure was 122/78, pulse 112 and regular, respirations 24. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 12 of 13 25 year old Hispanic / male states sudden onset of sharp, severe, pinpoint abdominal pain that gets worse in waves. The patient states the pain radiates to the flank and groin. The patient is unable to find a position of comfort. He has severe nausea and vomiting and his skin is pale, cool, clammy and he is sweating excessively. He is alert and oriented to person, place and time. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and there is no change in pain quality on palpation. He moves all extremities with equal range of motion and strength. The patient has no medical history. His Blood pressure was 122/78, pulse 112 and regular, respirations 24. His blood sugar is 101 mg/dl. Oxygen saturation by pulse oximeter is 97%. Sudden onset of sharp, severe, pinpoint abdominal pain that gets worse in wave Pain radiates to the flank and groin Unable to find a position of comfort Severe nausea and vomiting Skin is pale, cool, clammy and sweating excessively No change in pain quality on palpation. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Key Indicators Next

Question 13 of 13 16 year old Hispanic / female states sudden onset of a severe sharp pain in the pelvic area that radiates to the lower back and thighs. She states the pain is worse during bowel movements. She also complains of nausea, vomiting, heaviness in the abdomen and vaginal spotting that is heavier than her normal menstrual period. She states her menstrual cycle started two days ago. She is alert and oriented to person, place and time. Her skin is pale, cool and clammy. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and the pain increases on palpation. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 102/66, pulse 112 and regular, respirations 20. Her blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 97%. a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Answer

Question 13 of 13 16 year old Hispanic / female states sudden onset of a severe sharp pain in the pelvic area that radiates to the lower back and thighs. She states the pain is worse during bowel movements. She also complains of nausea, vomiting, heaviness in the abdomen and vaginal spotting that is heavier than her normal menstrual period. She states her menstrual cycle started two days ago. She is alert and oriented to person, place and time. Her skin is pale, cool and clammy. Pupils are equal and reactive to light. Lung sounds are clear in all lung fields. The abdomen is soft, and the pain increases on palpation. She moves all extremities with equal range of motion and strength. The patient has no medical history. Her Blood pressure was 102/66, pulse 112 and regular, respirations 20. Her blood sugar is 98 mg/dl. Oxygen saturation by pulse oximeter is 97%. Sudden onset of a severe sharp pain in the pelvic area that radiates to the lower back and thighs Pain is worse during bowel movements Nausea and vomiting Heaviness in the abdomen Vaginal spotting that is heavier than normal menstrual period Menstrual cycle started two days ago Skin is pale, cool and clammy Abdominal pain increases on palpation Key Indicators a. Appendicitis h. Kidney stones b. Cirrhosis of the Liver i. Ovarian Cyst c. Hypoglycemia j. Pancreatitis d. Gastro Esophageal Reflux Disease k. Pelvic Inflammatory Disease Gall Stones l. Peptic Ulcers Gastrointestinal Bleeding m. Urinary Tract Infection Hyperglycemia Next

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