Assignment: diagnosing abdominal pain

Assignment: diagnosing abdominal pain

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Question 1. A 76-year-old retired farmer comes to your office complaining of abdominal pain, constipation, and a low-grade fever for about three 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, three 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 fifty 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.

What diagnosis for abdominal pain best describes his symptoms and signs?

Acute diverticulitis

Acute cholecystitis

Acute appendicitis

Mesenteric ischemia

Question 2. Question : Jim is a 60-year-old man who presents with vomiting. He denies seeing any blood with emesis, which has been occurring for two days. He does note a dark, granular substance resembling the coffee left in the filter after brewing. What do you suspect?

Bleeding from a diverticulum

Bleeding from a peptic ulcer

Bleeding from a colon cancer

Bleeding from cholecystitis

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