Diagnosis of abdominal pain - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
GIT Diagnosis of abdominal pain

A 65 year man comes to the physician of abdominal pain. Initially the pain was epigastric, in this morning it has localized to the right lower quadrant. The man temperature is 38 degrees. Physical examination shows abdominal tenderness. Which of the following is the most likely diagnosis?

A- Acute appendicitis
B- Gallstones
C- Diverticulitis
D- Pancreatitis
E- Pyelonephritis
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message



  #2  
Old 05-03-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

age = diverticulitis

but the presentation = acute appendicits

answer A
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #3  
Old 05-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

Quote:
Originally Posted by DocSikorski View Post
age = diverticulitis

but the presentation = acute appendicits

answer A

Wrong answer
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
 
  #4  
Old 05-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 458 Times in 289 Posts
Reputation: 468
Default

A seems right
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #5  
Old 05-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 458 Times in 289 Posts
Reputation: 468
Default why?????

Quote:
Originally Posted by alfjof View Post
Wrong answer
Hows A wrong man......??????
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #6  
Old 05-03-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Quote:
Originally Posted by alfjof View Post
Wrong answer
well sure, than its ectopic pregnancy..........
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #7  
Old 05-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 458 Times in 289 Posts
Reputation: 468
Default are u kidding????

Quote:
Originally Posted by DocSikorski View Post
well sure, than its ectopic pregnancy..........

ectopic pregnancy in a MALE.......haha
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #8  
Old 05-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 458 Times in 289 Posts
Reputation: 468
Default pancreatitis

If I had an another chance i would tick pancreatitis .......its just a wild guess......!!!
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #9  
Old 05-03-2012
Hope2Pass's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,684
Threads: 213
Thanked 1,600 Times in 660 Posts
Reputation: 1610
Default

Could it be a gallstone getting lodged into the right ureter ? ... I would've gone with A but in appendicitis the pain doesn't relocate or does it ?
Reply With Quote Quick reply to this message
The above post was thanked by:
Dr. Mexito (05-03-2012)
  #10  
Old 05-03-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 39
Threads: 10
Thanked 47 Times in 9 Posts
Reputation: 57
Default

Quote:
Originally Posted by Hope2Pass View Post
... I would've gone with A but in appendicitis the pain doesn't relocate or does it ?
Yep. Kocher's sign = epigastric pain that shifts to the RLQ.
A
Reply With Quote Quick reply to this message
  #11  
Old 05-03-2012
Dr. Mexito's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS
Posts: 662
Threads: 72
Thanked 370 Times in 204 Posts
Reputation: 380
Default

Quote:
Originally Posted by Hope2Pass View Post
Could it be a gallstone getting lodged into the right ureter ? ... I would've gone with A but in appendicitis the pain doesn't relocate or does it ?
Pain moves... from umbilical region to LRQ... that is the progression.

I was also thinking about the gallstone...early presentation before development of a fistula.
__________________
"Disease is very old, and nothing about it has changed. It is we who change as we learn to recognize what was formerly imperceptible." JMC
Reply With Quote Quick reply to this message
The above post was thanked by:
Hope2Pass (05-03-2012)
  #12  
Old 05-03-2012
Teresa's Avatar
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 33
Threads: 0
Thanked 6 Times in 4 Posts
Reputation: 16
Show Teeth

I love the ectopic pregnancy!!!
Based on the info provided it has to be Accute Appendicitis
It's typical for the pain to move exactly the way it is described.
__________________
Don't take life too seriously. Nobody makes it alive
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #13  
Old 05-03-2012
alfjof's Avatar
USMLE Forums Veteran
 
Steps History: Step 1 Only
Posts: 251
Threads: 56
Thanked 105 Times in 63 Posts
Reputation: 115
Send a message via Yahoo to alfjof
Default

I LOVE THE ECTOPIC PREGNANCY . I found this question in Kaplan QB, my answer was A too then said I was wrong. So, the answer for them is DIVERTICULITIS, I tried to find an explication, all I was found, said: diverticulitis is not produced pain in RLQ. May be Kaplan is wrong, that is the reason I look for your help in this forum to clarify me
__________________
Happy to Learn New Concept and Mechanism each Day
Reply With Quote Quick reply to this message
The above post was thanked by:
one_destiny (05-04-2012)
  #14  
Old 05-03-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Quote:
Originally Posted by K06100 View Post
ectopic pregnancy in a MALE.......haha
it was supposed to be a joke...

I guess I am really bad in being funny
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #15  
Old 05-03-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Quote:
Originally Posted by alfjof View Post
I LOVE THE ECTOPIC PREGNANCY . I found this question in Kaplan QB, my answer was A too then said I was wrong. So, the answer for them is DIVERTICULITIS, I tried to find an explication, all I was found, said: diverticulitis is not produced pain in RLQ. May be Kaplan is wrong, that is the reason I look for your help in this forum to clarify me

Ye, that was my first guess...
But the thing is - diverticulitis is almost purely affects sigmoid (left side)
it can affect everywhere though, but sigmoid is more likely. It can get infected, it can get ruptured (as probably in this guy).
The most likely reason is 65 years of age...

But still the most common as the question says, will be acute appendicitis - right quadrant, especially this migrating pain (though it usually migrates from umbilicus... is it McBurney sight or point?)
============================================

but if he lucky with an ectopic pregnancy....
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message



  #16  
Old 05-03-2012
Teresa's Avatar
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 33
Threads: 0
Thanked 6 Times in 4 Posts
Reputation: 16
Default

We are talking about MC? Diverticulitis? On the left side maybe?
Or does the person have reversed organs?
__________________
Don't take life too seriously. Nobody makes it alive
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #17  
Old 05-03-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

Quote:
Originally Posted by Teresa View Post
We are talking about MC? Diverticulitis? On the left side maybe?
Or does the person have reversed organs?
Ha! That would be a hell-of-a-question about differentiation between appendicitis and diverticulitis in a pt with a kartagener syndrome!
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #18  
Old 05-03-2012
Teresa's Avatar
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 33
Threads: 0
Thanked 6 Times in 4 Posts
Reputation: 16
Default

Quote:
Originally Posted by DocSikorski View Post
it was supposed to be a joke...

I guess I am really bad in being funny
Actually it was a great joke!!!!!
There was no sarcasm at all
__________________
Don't take life too seriously. Nobody makes it alive
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #19  
Old 05-03-2012
K06100's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 730
Threads: 90
Thanked 458 Times in 289 Posts
Reputation: 468
Default

Quote:
Originally Posted by DocSikorski View Post
it was supposed to be a joke...

I guess I am really bad in being funny

there shud be fun while studying .....and u did good........!!
__________________
Try Not To Become A Man Of Success But A Man Of Value.
Reply With Quote Quick reply to this message
  #20  
Old 05-04-2012
ararat2552's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 17
Threads: 0
Thanked 2 Times in 2 Posts
Reputation: 12
Default

fever.........umbilicus.......
Reply With Quote Quick reply to this message



Reply

Tags
Gastrointestinal-Tract-, Pathology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
abdominal pain ricko335 USMLE Step 1 Forum 8 08-30-2011 12:12 PM
abdominal pain usmleman2020 USMLE Step 1 Forum 8 08-13-2011 09:55 PM
Abdominal CT Scan Diagnosis! USMLE-Syndrome USMLE Step 2 CK Forum 16 06-26-2011 01:12 PM
Diagnosis of Abdominal Aneurysm? Seetal USMLE Step 2 CK Forum 11 04-23-2011 06:28 PM
An old man with abdominal pain DrSeddik USMLE Step 1 Forum 11 12-28-2009 11:36 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)