Condition History and physical Gastroenteritis Nausea, extensive vomiting, diarrhea, myalgia, fever, mild abdominal tenderness Acute gastritis Burning/gnawing epigastric pain, NSAIDa use, mild abdominal tenderness Acute cholecystitis Right upper quadrant/epigastric 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…
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…
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,…
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…
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…
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…
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…
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…
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…
