What diagnosis for abdominal pain best describes his symptoms and signs?
A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about 3 days. He denies any nausea, vomiting, or diarrhea. The only unusual thing he remembers eating is two bags of popcorn at the movies with his grandson, 3 days before his symptoms began. He denies any other recent illnesses. His past medical history is significant for coronary artery disease and high blood pressure. He has been married for over 50 years. He denies any tobacco, alcohol, or drug use. His mother died of colon cancer and his father had a stroke. On examination he appears his stated age and is in no acute distress. His temperature is 100.9 degrees and his other vital signs are unremarkable. His head, cardiac, and pulmonary examinations are normal. He has normal bowel sounds and is tender over the left lower quadrant. He has no rebound or guarding. His rectal examination is unremarkable and his fecal occult blood test is negative. His prostate is slightly enlarged but his testicular, penile, and inguinal examinations are all normal. Blood work is pending.
A) Acute diverticulitis
B) Acute cholecystitis
C) Acute appendicitis
D) Mesenteric ischemia
A) Acute diverticulitis
Diverticulitis is caused by localized infections within the colonic diverticula. Constipation, fever, and abdominal pain are common. Mesenteric ischemia classically presents in older people with a history of vascular disease elsewhere. The typical pain is unusual in that it is not made worse by examination despite being severe. Some mistake this feature to indicate malingering, with bad results.
You might also like to view...
The nurse is assessing a 7-year-old boy with pharyngitis. Which of the following symptoms would be least likely to be observed?
A) Working hard to breathe B) Difficulty swallowing C) Rash on the abdomen D) Sore throat and headache
Which finding 12 hours after birth would require further assessment? The fundus is palpable __________ the umbilicus
a. Two finger-breadths above b. At the level of c. One finger-breadth below d. Two finger-breadths below
Which of the following topics most closely conforms to the priorities that have been suggested for future nursing research?
A) Attitudes of nursing students toward smoking B) Nursing staff morale and turnover C) Effectiveness of nurse-managed centers D) Number of doctorate-prepared nurses in various clinical specialties
Which of the following is not initially seen in children 12-18 months old?
a. speak four to six words b. know the major body parts c. can open doors d. understand cause and effect