CPC with Dr. Boyer vs. Dr. Steuerwald
16yoF with 4 days of bilateral lower quadrant abdominal pain and diarrhea that was tachy, dry, and with a diffusely tender abdomen and some right-sided discomfort on pelvic exam with a mild leukocytosis.
Dr. Steuerwald's approach to listening to patient presentations: Pick out the main symptoms, get a time course, and listen for any other true "weirdness" then build your own timeline of events.
- Don't forget about the "sexy numbers" in everyone, these include the vitals and also key aspects of a disease process (i.e. the EF in a patient with CHF)
- DDx included appendicitis, PID, TOA, Fitz-Hugh Curtis, Ovarian Torsion, Yersinia enterocolitis
- Dr. Steuerwald correctly identified the need to get a RLQ US to assess for appendicitis!