h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Just thought we'd localise the medic-speak to here to avoid topic drift over in the 'Ask h2g2' threads

So - I take it you're in a medic-related field?

just a little... or i was.

the renal failure bit... you were right with the pre-renal though its more gomerular than tubular...

Ah!

Glomerulonephritis!

Or summat spelt along the same lines...

So... what were/are you in

Pain questions - location, radiation and exacerbating/relieving factors, severity of pain on a scale of 1-100, colicky/constant, had the pain before or not.

Is she pyrexial, and what's the amylase like?

(just a small note - I've posted a Hello! to your personal space here:

pain 80 - constant - no doctor never like this!!!

you didnt ask for an amylase and the biomedical scientist is pissed off that you just got her out of bed AGAIN but its normal.

slightly pyrexial

any other questions

Upper abdo pain or lower abdo pain? (constant pain is a bit worrying...)

Itching anywhere at all?

no itching... her eyes are white and clear

lower adbo pain

How's passing motions?

Rebound tenderness/guarding/rigidity at all?

motions normal, rigid and guarded no rebound tenderness...

pain is increasing...

any more tests before the biomedical scientist goes back to bed?

you didn`t reply to m analsys of what liking the colour lilac says about you.Oh sorry to butt in.

it says b***** all about me and the patient is slipping into shock

keep them warm.look out for any other signs of sleepyness

LFTs are the only ones I can think off the top of my head...

(BTW - not that this is an excuse or anything - but I'm 3rd year, so that may explain my apparent uselessness...)

A bit of peritonism there... hmm, my differential at the moment is:

Acute cholecystisis (atypical location of pain, but it can happen)
Appendicitis (the vomiting is atypical, but the location and increasing pain suggests more urgency in this matter)

Was she doing anything at the time to kick this all off, or was she in bed?

Patient slipping into shock - Ok - pH?

suffering from major signs of sleepyness here...

ok not bad but start with the obvious and work outwards

front line test for a 37 year old female with abdo pain.

fbc
u&e (lft if you can get it but take blood to follow if not poss stat)
amylase
msu
PREG TEST (most do hcg not lh/fsh)

things to ask... LMP???

be careful about patient discriptions of vomit... if she has been throwing up for any length of time bile is what she will say she has been vomiting

i can see iam not welcome here,adios

not a bad stab for a 3rd year...

night night

see ya on the other side.

Eyethink_eyethink:

Cheers - just one question, LMP? I've never been one for abbvs. apart from the old LKKS, JACCOL and MJTHREADS... never seen that one... Not a ileus or volvus as no AXR signs, so intestinal obstruction is out, amylase is normal, but can be normal in severe pancreatitis...

It's pointing to more of an appendix thing I feel, but I'm not entirely confident of that

Frankie:

Sorry mate , there's something about the vignettes which make me get all focused etc - I'll be over to the nightwear thread in a flash

errr last menstral period.

its an ectopic pregnancy

Ah - that would explain my ignorance... Obs and gynae firm not until next year either, although I should know that too...

Blindingly obvious come to think of it...

Lower abdo pain=pelvic cause of the acute abdomen

Problem is, I clerked a woman of a similar age in with a similar pain (though she wasn't critical enough to go into shock, thank god), who had an exacerbation of Crohn's mixed in with pelvic pain, so my first instinct was 'oooh, Crohn's...'

Never seen last menstrual period as LMP actually - but probably best for me to ask the silly questions now rather than cock it up much further down the line...

Anyhow - I'd best not keep you up - nighty night