All right, welcome. My name is Divine. This is episode 629 of the Divine Intervention Podcasts.

And in today's podcast, we're going to be addressing right, lower quadrant pain.

In fact, I'm going to call this the Clotch, Right Lower Quadrant Podcast for the USMLA exams.

This should be a pretty helpful podcast, and I think it's really going to help you with your with your exams all right so I think the very first thing I just want to say is this if a female

so very first thing if a female presents with sudden onset abdominal pain of any sort

especially even if it's in the right lower quadrant and they ask you for your next best step

on your exams please make sure you're checking if she's pregnant or not right that's in the right lower quadrant and they ask you for your next best step on your

exams please make sure you're checking if she's pregnant or not right that's like the right first thing to do

get a urine pregnancy test something you can do very quickly right just to make sure i'm not missing

like some pregnancy or ectopic or something like that all right so now let's go to number two so

what if they give you a question about a patient and they they tell you that this patient, you know, over the last like 12 hours, has been having progressively worsening abdominal pain, you know, started around the umbilicus. You know what I'm getting to here. I studied around the umbilicus, right? And then it's, you know, it's now becoming more and more pronounced towards the right lower quadrant. Right. So obviously this is going to be appendicitis, right? And the thing is the USML is these days, as I was telling people in my classes that are running now, the USML is these days, one thing they love to do is they don't like to ask you direct questions anymore. They like to ask

you derivatives. They like to ask you surrogates, right? So the thing is they actually give you a

question that you clearly know is appendicitis. And then you're like, okay, they ask you like,

what's the pathophysiology, right? Remember, there are many things that can cause appendicitis,

right? It can be from

a phycalaith that is occluding, the appendix, the lumen of the appendix. So bacterial infection

kind of sets up sharp. You get a lot of inflammation, right? You get a lot of inflammation and you

get in trouble. And remember that when the appendix is inflamed, right, he is going to irritates the pridal peritoneum, you know, near McBerney's point, and then you're going to get in trouble. You're going to get in trouble, right? Again, the pain usually is going to start off periambulical, right, and then it's going to migrate to the right lower quadrant, right? Again, that irritation that causes the pain is from irritation of the parietal

peritoneum, right? The inflamed appendix irritates the parietal peritoneum, right? Again, that's very important to know for your exams. You may be like, why does divine keep emphasizing parietal peritoneum is super high old to know that for your exams, right? So they're going to be vomiting, they're going to be nauseous, they're going to have fever, right?

And again, they're going to be ruling in pain.

They're going to be rolling in pain.

Okay?

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