Question

Case 45: 20F presents to ED w/ sudden onset sharp RLQ pain worsening over the last 3 hours. Pain associated w/ nausea & vomiting. Denies fever, diarrhea, constipation, urinary sx, or vaginal discharge. LMP 2 weeks ago, only medication is OCPs. Vitals show tachycardia and are otherwise normal.

1. Emergency orders
2. Physical Exam
3. Diagnostic tests
4. Therapy
5. Location
6. Final order
7. Dx

Answer 1

The patient's symptoms of sudden sharp RLQ pain with associated nausea and vomiting require further investigation to determine the cause. Emergency diagnostic tests should be ordered to confirm the diagnosis and determine appropriate therapy.

Step-by-step explanation:

The patient presents with sudden sharp right lower quadrant (RLQ) pain, worsening over the last 3 hours, associated with nausea and vomiting. Given the symptoms and the absence of other signs such as fever, diarrhea, constipation, urinary symptoms, or vaginal discharge, the doctor considers a few possibilities.

Appendicitis, urinary tract infection (UTI), and pelvic inflammatory disease (PID) are considered, but each typically presents with additional symptoms. Given the patient's history of compressed spinal cord and the absence of abdominal pain associated with it, other causes are explored. The doctor needs to order emergency tests to confirm the diagnosis and ascertain the best course of therapy for the patient.