Diminished radial pulses assignment

Diminished radial pulses assignment

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Question 3 Question : A 26-year-old sports store manager comes to your clinic, complaining of severe right-sided abdominal pain for twelve hours He began having a stomachache yesterday, with a decreased appetite, but today the pain seems to be just on the lower right side He has had some nausea and vomiting but no constipation or diarrhea His last bowel movement was the night before and was normal He has had no fever or chills He denies any recent illnesses or injuries His past medical history is unremarkable He is engaged He denies any tobacco or drug use and drinks four to six beers per week His mother has breast cancer and his father has coronary artery disease On examination, he appears ill and is lying on his right side His temperature is 1004 degrees and his heart rate is 110 His bowel sounds are decreased and he has rebound and involuntary guarding, one-third of the way between the anterior superior iliac spine and the umbilicus in the right lower quadrant (RLQ) His rectal, inguinal, prostate, penile, and testicular examinations are normal

What is the most likely cause of his pain?

Acute appendicitis

Acute mechanical intestinal obstruction

Acute cholecystitis

Mesenteric ischemia

Question 4 Question : Josh is a 14-year-old boy who presents with a sore throat On examination, you notice dullness in the last intercostal space in the anterior axillary line on his left side with a deep breath What does this indicate?

His spleen is definitely enlarged and further workup is warranted

His spleen is possibly enlarged and close attention should be paid to further examination

His spleen is possibly enlarged and further workup is warranted

His spleen is definitely normal

Question 5 Question : Diminished radial pulses may be seen in patients with which of the following?

Aortic insufficiency

Hyperthyroidism

Arterial emboli

Early “warm” septic shock