Your patient complains of left upper quadrant pain, fever, ...

[yoroshambo]

Your patient complains of left upper quadrant pain, fever, extreme fatigue, and spontaneous bruising. The clinician should recognize that these symptoms are often related to:
 
  A. Hematopoetic disorders
  B. Hepatomegaly
  C. Esophageal varices
  D. Pleural effusion

Question 2

Your patient demonstrates positive shifting dullness on percussion of the abdomen. This is indicative of:
 
  A. Cholecystitis
  B. Appendicitis
  C. Ascites
  D. Hepatitis

[Chou]

Answer to Question 1

ANS: A
LUQ pain can be associated with stomach or spleen disorders; however, it is often associated with causes that are outside the abdomen. Hematopoietic malignancies, such as lymphomas and leukemias, and other hematologic disorders, such as thrombocytopenia, polycythemia, myelofibrosis, and hemolyticanemia, often cause enlargement of the spleen, leading to LUQ pain. In addition to questions about the specific characteristics of the pain, it is important to ask the patient about fever, unusual bleeding or bruising, recent diagnosis of mononucleosis, fatigue, malaise, lymphadenopathy, cough, arthralgias, anorexia, weight loss, jaundice, high blood pressure, and headache.

Answer to Question 2

ANS: C
To assess the patient for ascites, test for shifting of the peritoneal fluid to the dependent side by rolling the patient side to side and percussing for dullness on the dependent side of the abdomen.

[yoroshambo]

TYSM

[skipfourms123]

Excellent