Your 54-year-old male patient complains of a painless lump in his ...

[savannahhooper]

Your 54-year-old male patient complains of a painless lump in his lower left abdomen that comes and goes for the past couple of weeks. When examining the abdomen, you should have the patient:
 
  A. Lie flat and take a deep breath
  B. Stand and bear down against your hand
  C. Prepare for a digital rectal examination
  D. Lie in a left lateral recumbent position

Question 2

A patient presents to the emergency department with nausea and severe, colicky back pain that radiates into the groin. When asked to locate the pain, he points to the right costovertebral angle region.
 
  His physical examination is unremarkable. Which of the following lab tests is most important for the diagnosis?
  A. Urinalysis
  B. Serum electrolyte levels
  C. Digital rectal exam
  D. Lumbar x-ray

[apple]

Answer to Question 1

ANS: B
In the majority of hernia cases, a history of heavy physical labor or heavy lifting can be elicited. Right or left lower quadrant pain that may radiate into the groin or testicle is typical. The pain is usually dull or aching unless strangulated, in which case the pain is more severe. The pain increases with straining, lifting, or movement of the lower extremities. Physical examination includes palpating the femoral area and inguinal ring for bulging or tenderness. Ask the patient to bear down against your hand.

Answer to Question 2

ANS: A
Urinary calculi can occur anywhere in the urinary tract; therefore, pain can originate in the flank or kidney area and radiate into the RLQ or LLQ and then to the suprapubic area as the stone attempts to move down the tract. The pain is severe, acute, and colicky and may be accompanied by nausea and vomiting. If the stone becomes lodged at the ureterovesical junction, the patient will complain of urgency and frequency. Blood will be present in the urine.

[savannahhooper]

Thank you

[apple]

No problemo