Hello, med students. My name is Zach Olson, and thank you for downloading this week's

episode of the EM Clerkship Podcast. So let's pick up where we left off last week. Remember,

we're doing presentation-based learning, and we were talking about the single most high-yield

complaint that you could study for your clerkship.

Abdominal pain. So I'm going to give you our presentation again.

Hello, Dr. Olson, in bed 20, I have a 48-year-old female with a past medical history of insulin-dependent diabetes, no history of abdominal surgeries who

comes in with abdominal pain. She describes it as a severe, generalized abdominal pain that

started last night and has been gradually worsening since then. She's had some subjective

fevers, but no history of a-fib, and no vomiting, dark-tartary stools, urinary symptoms, or vaginal bleeding or vaginal

discharge. Vitals in triage showed a mild tachycardia, which she still does have in the room,

afebrile here, otherwise stable. Focused abdominal exam shows non-specific tenderness throughout,

no focal guarding or rigidity, no masses,

no CVA tenderness. Honestly, I don't have any particular diagnosis that I think is most likely,

but we do need to rule out the life threats. Ectopic pregnancy, DCA, and appendicitis,

or a few that came to mind. So for my testing plan, I would like to get a pregnancy test, electrolytes, a CBC, a lipase,

a liver function test, and a CT scan with IV contrast.

And for my treatment plan, I would like to get her some Zophran, 4 milligrams of

zofran, and some morphine and some fluids.

I think that if everything returns normal,

she should be safe for outpatient follow-up within the next 24 hours as long as she's looking

okay. So picking up where we left off last week with step four. You've already spent a few

minutes talking to your patient so that you can give the first few steps of your presentation,

...