Quote:
Originally posted by NousDefionsDoc
LOL - Check 6 SACA! Me and Doc T are on you and your ass is out now!
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LOL... I am alright, my six is covered.. you guys took the path that
I wanted
you to follow in this thread. Are you sure
you haven't walked into a SACA ambush? LOL
Quick note for Tuuka-
Doc T has of course covered most of this info. For you medics to be, here is a brief diagram that covers what Doc T said about Mcburney's sign... (
see diagram at the end of this post)
In our case we are working:
palpation/percussion exam reveal the following:- pt has moderate tenderness to direct palpation around umbilicus
- pt's abdomen is rigid in RLQ w/associated severe tenderness upon palpation of RLQ.
- "Mcburney's point", however, is not specifically more tender than any other are within the RLQ
- Quick note about potential palpation/percussion exam findings:
------Rovsing sign (ie, RLQ pain with palpation of the LLQ), obturator sign (ie, RLQ pain with internal rotation of the flexed right hip), and psoas sign (ie, RLQ pain with hyperextension of the right hip) are present in a minority of patients with "our TS's condition".
***None of these findings were observed when we examined our patient.
- guarding present upon exam
- no rebound tenderness noted upon exam
Other items/info requested:- Patients pain seems to increase when standing/walking
- pt was taking IBU 800, TID prn for sprained ankle beginning two days prior.
- stools regular and WNL per patient's recollection. Last known bowel movement 24 hours ago.
- Pain getting worse compared to when first noticed
- no radiating of pain described by patient, however, as it has worsened , he states it could hurt in his back as it hurts all over and is giving him worse nausea.
- Pain is worsened by walking/standing verses supine
- WBC?? You don't have access to this info in the jungle NDD., however, your jedi powers indicate that the count is elevated though. (ONLY NDD can use this info... none of you would have this ability except him) LOL
- Pt reports similar pain in the past, not as severe, and resolved in its own after an hour or so.
- Pt states his nausea came before pain, and that his appetite has been minimal for the last 48 hours for unknown reason.
Alright.. I think that covers all the wanted exam techniques and questions to ask the patient. Now that you have this info... Any more questions? Do you have a guess as to Diagnosis? What have you now ruled out ( which is just as important since you must do this before you can make a legit Dx)?