Postprandial RUQ Pain
Diagnosis History and physical Symptomatic cholelithiasis RUQ pain radiating around right back after fatty meals, resolves after a few hours, female, multigravida, obese Acute cholangitis Persistent RUQ pain, fever, jaundice…
Nausea, Vomiting, and Left Groin Mass
Type Examples Comments Malformation Undescended testicle, varicocele, hydrocele, hernias Hernias will protrude with straining and may reduce with pressure Infectious/inflammatory Lymphadenopathy (reactive), mononucleosis (EBV), abscess, sarcoidosis, lymphogranuloma venereum “Shotty,” tender…
Chest Pain After Vomiting
Diagnosis Comments Myocardial infarction Chest pain, more on the left side, left arm and jaw pain, diaphoresis, ST segment elevation, and elevated troponins Pericarditis Substernal, pleuritic chest pain, worse supine,…
Scrotal Mass
Etiology Features Epidermoid or pilar cysts Develop from epidermis or hair follicle and present as painless, slow growing, mobile, fluid-filled nodules; they occur most commonly in areas that have a…
Incidentally Discovered Adrenal Mass on CT Scan
Diagnosis Clinical presentation Hypercortisolism (Cushing’s syndrome) Weight gain, central obesity, muscle weakness, poor wound healing, hirsutism, amenorrhea, depression, hypertension, diabetes mellitus Hyperaldosteronism (Conn’s syndrome) Muscle cramps, weakness, hypertension Catecholamine hypersecretion…
Pedestrian Struck by Motor Vehicle
Hard signs Soft signs Arterial/pulsatile bleeding History of hemorrhage in the field Persistent hemorrhage with shock Small, stable, non-pulsatile hematoma Expanding or pulsatile hematoma Unexplained hypotension Palpable thrill Penetrating wounds…
Immediate Swelling After Trauma to the Knee
Diagnosis Comments Hemarthrosis, bone infarct History of hemophilia or sickle cell disease Septic arthritis Fever, unwillingness to bear weight or range a knee held constantly around 30° of flexion. Neisseria…
Sudden Onset of Severe Left-Sided Abdominal Pain
Diagnosis History and physical examination Ruptured AAA Elderly; Caucasian; male; smoker with sudden onset of severe abdominal, left flank, left groin, and/or lower back pain; pulsatile abdominal mass; tachycardia; and…
Infant with Bilious Emesis
Diagnosis Specific findings Adhesions Prior abdominal surgery, dilated loops of bowel with transition point to decompressed bowel on contrast study Enteric duplication cyst Fluid-filled structure not contiguous with stomach or…
Right Calf Pain with Walking
Disease Pathophysiology Symptoms Claudication Atherosclerotic plaque obstructing blood flow Pain with walking Relieved with a few minutes of rest Reproducible at the same walking distance Osteoarthritis of the hip or…
