Abdominal and Pelvic
Pain
Questions
74.An 81-year-old diabetic woman with a history of atrial fibrillation is
transferred to your emergency department (ED) from the local nursing home.
The note from the facility states that the patient is complaining of abdominal
pain, having already vomited once. Her vital signs in the ED are temperature
100.1°F, blood pressure (BP) 105/75 mm Hg, heart rate (HR) 95 beats per
minute, and respiratory rate (RR) 18 breaths per minute. You examine the
patient and focus on her abdomen. Considering that the patient has not
stopped moaning in pain since arriving to the ED, you are surprised to find
that her abdomen is soft on palpation. You decide to order an abdominal radi-
ographic series. Which of the findings on plain abdominal film is strongly
suggestive of mesenteric infarction?
a. Sentinel loop of bowel
b. No gas in the rectum
c. Presence of an ileus
d. Pneumatosis intestinalis
e. Air-fluid levels
75.A husband and wife present to the ED with 1 day of subjective fever,
vomiting, watery diarrhea, and abdominal cramps. They were at a restaurant
a day before for dinner and both ate the seafood special, which consisted of
raw shellfish. In the ED, they are both tachycardic with temperatures of
99.8°F and 99.6°F for him and her, respectively. Which of the following is
responsible for the majority of acute episodes of diarrhea?
a. Parasites
b. Viruses
c. Enterotoxin-producing bacteria
d. Anaerobic bacteria
e. Invasive bacteria
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