Author Question: A 22-year-old female enters the emergency room with complaints of right lower quadrant abdominal ... (Read 101 times)

mikaylakyoung · **on:** Jun 25, 2018

A 22-year-old female enters the emergency room with complaints of right lower quadrant abdominal pain, which has been worsening over the last 24 hours.

On examination of the abdomen, there is a palpable mass and rebound tenderness over the right lower quadrant. The clinician should recognize the importance of:
A. Digital rectal examination
B. Endoscopy
C. Ultrasound
D. Pelvic examination

Question 2

Your patient complains of lower abdominal pain, anorexia, extreme fatigue, unintentional weight loss of 10 pounds in last 3 weeks, and you find a positive hemoccult on digital rectal examination. Laboratory tests show iron deficiency anemia.

The clinician needs to consider:
A. Diverticulitis
B. Appendicitis
C. Colon cancer
D. Peptic ulcer disease

akpaschal · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
A female with abdominal pain can have a GI or GU disorder or gynecologic problem. It is imperative to ask about the last menstrual period (LMP) and about birth control methods in order to rule out ectopic pregnancy. A history of miscarriages and/or sexually transmitted diseases (STDs) can give more clues for the risk of ectopic pregnancy. Safe sex practices and the number of sexual partners can alert the practitioner to the risk for pelvic inflammatory disease. No complaint of lower abdominal pain in a female should be evaluated without performing a pelvic examination.

Answer to Question 2

ANS: C
A positive hemoccult on rectal examination may indicate an upper GI bleed or malignancy. Malignancy should also be suspected if there is weight loss and/or a palpable abdominal mass.