A 40-Year-Old Man Comes to the Emergency Department Due to Worsening

question 323

Multiple Choice

A 40-year-old man comes to the emergency department due to worsening right lower abdominal pain that radiates to the right groin area.  He has had the pain for the past 7 days, and it is slowly increasing.  He also describes fever and anorexia.  Two weeks ago, he was treated for furunculosis of the right thigh.  The patient has a history of type 1 diabetes mellitus and takes insulin.  His temperature is 38.8 C (101.9 F) .  Abdominal examination shows tenderness on deep palpation in the right lower quadrant without rebound or guarding.  No masses are palpated.  Bowel sounds are present.  Extension of the right hip increases pain, and flexion decreases pain.  Rectal examination shows no abnormalities, and skin is normal.  Laboratory results are as follows: Which of the following is the best next step in management of this patient?

• A)Abdominal ultrasonogram
• B)Abdominal x-ray
• C)Colonoscopy
• D)CT scan of abdomen and pelvis
• E)Laparoscopic appendectomy
• F)Right hip joint aspiration

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Definitions:

Peripheral Vision

The part of vision that occurs outside the very center of gaze, allowing humans to perceive objects and movement outside the direct line of sight.

Major Highways

Principal arterial routes in a road network, designed for high-speed vehicular traffic and connecting major cities, regions, or countries.

Car Accident

An unintended collision involving one or more vehicles, often resulting in vehicle damage and potential personal injury.

Older Drivers

Individuals within an older age bracket, typically senior citizens, who are active drivers.