Re-examining a painful abdominal area! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 2 CS Forum

USMLE Step 2 CS Forum USMLE Step 2 CS Discussion Forum: Let's talk about anything related to USMLE Step 2 CS exam

Thread Tools Search this Thread Display Modes
Old 07-05-2012
USMLE Forums Scout
Steps History: ---
Posts: 36
Threads: 10
Thanked 6 Times in 2 Posts
Reputation: 16
Question Re-examining a painful abdominal area!

Hey guys,

In case a patient with abdominal pain, suppose RLQ pain, during the examination, he will be in pain many times, one during superficial palpation, another one in deep palpation, another one during rebound tenderness, another one during Rovsing sign and lastly during performing psoas sign.
So how should we deal with all this. should we do all this maneuvers or not ? I am so confused because we should not repeat a painful maneuver..right ? so What is your advice? please I need your help. and the same thing if we have a RUQ pain !!!!
I really appreciate your input.
Reply With Quote Quick reply to this message

Old 07-05-2012
USMLE Forums Master
Steps History: 1+CK+CS+3
Posts: 3,263
Threads: 147
Thanked 4,954 Times in 1,563 Posts
Reputation: 5050

If the SP just moaned or just gave a scrambled face then you can go ahead and do all these tests but if he/she shouted and jumped out of bed and said that was very very painful, then you tell them sorry and that you wouldn't examine the area again and the in Patient Note you mention that deep palpation, rebound, Rovsing's, ...etc were not done because of exquisite tenderness.

Pretty much the case in real practice, if the pain and tenderness is so obvious and evident we don't insist on the other maneuvers. These maneuvers were made to confirm a suspicion of appendicitis (which means not too much tenderness in the initial palpation).

Reply With Quote Quick reply to this message



Quick Reply

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:
Please enter a password for your user account. Note that passwords are case-sensitive.
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.
Where you live. Leave blank if you don't want to tell.


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
Painful Area Examination in the CS GVVdoc USMLE Step 2 CS SP Challenges 9 01-22-2014 08:23 PM
Appropriate drape when examining the abdomen? chriledi USMLE Step 2 CS Forum 5 03-15-2012 08:04 PM
Examining painful areas in the CS exam? liquidreams USMLE Step 2 CS Forum 2 03-12-2012 06:34 PM
Examining the Heart in the CS encounter dempsey USMLE Step 2 CS Forum 1 06-20-2011 01:17 PM
examination of painful area in abdomen hedihav_x USMLE Step 2 CS Forum 1 01-26-2011 04:32 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2016 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)