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USMLE Step 1 Classic Clues Classic clues seen in clinical case scenarios in USMLE Step 1 questions.

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Old 01-24-2010
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ObGyn Vaginal discharge + RUQ pain

One of the classic case scenarios seen in USMLE is the description of the a premenopausal female with h/o multiple sexual partners, vaginal discharge, fever, and suprisingly an right upper abdominal pain.
This is a classic presentation of Fitz Hugh Curtis Syndrome in which the infection ascends from a PID (typically salpingitis) to involve the capsule of the liver and therefore pain may sometimes refer to the right scapula and tip of shoulder.
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Old 07-30-2011
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And also

And also...upper right-quadrant abdominal pain and tenderness aggravated by breathing, coughing or movement, and referred to the right shoulder following an episode of PID. Laparoscopy may reveal "violin string" adhesions.
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Old 03-29-2016
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Thank You
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Old 05-19-2016
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Thank you
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ObGyn-, Pathology-, Syndromes-Acronyms

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