Location: You are a Medical Student on the Surgical assessment unit
Patient: 75 year old patient presents with vomiting and abdominal pain
Task: – Take a focused history from the patient – After 6 minutes you will be asked a series of questions by the examiner. – Answer any questions that the patient may have
You’re a 75 year old patient who’s had abdominal pain for the past 2 days, it has been getting worse and nothing really seems to make it better. If asked, the pain had previously been coming and going in waves ‘colicky’ but is now constant.
If specifically asked you have not opened your bowels for the past 7 days, or passed any wind (flatus) either.
Your abdomen is more distended and you feel nauseated. If asked, you have no appetite.
If asked, you’ve noticed some weight loss as your clothes are a lot looser although you have not weighed yourself, so you do not know how much weight you have lost.
In general, you have been more tired recently but you have put this down to old age.
PMH – Hypertension – Asthma
DH – Amlodipine – Blue inhaler when needed – Simvastatin
SH – You do not smoke at the moment. If asked you have smoked 15 a day for 20 years – You are retired – You live at home with your wife
FH – Father died of a heart attack
ICEF – You do not like all this fuss, you really just want to go home after the pain stops.