Hello, residents. My name is Maddie Watts. Thank you for downloading this month's episode of the EM Clerkship podcast.

This month's episode is sponsored by Pearson Rabbit's Insurance, who is my personal independent disability insurance agent.

We will talk more about Pearson Rabbit's later in the episode. Today, I'm back with Isabel Tweet, who you guys met in case two. Isbel, are you ready to go at it again?

Let's do it. All right. So today is round number four of the game 3.0.

Isabel will need to perform today's case in real ABEM oral boards format. She will have 15 minutes to complete the case and

she does not know what it is ahead of time. If she hits all of the critical actions that I've

listed out beforehand, she wins. If she doesn't or if she performs a dangerous action, then I win.

These cases were created by me. They are not derived from actual boards cases

because I have not taken my boards yet, and they are not real patient cases. Dr. Tweet, take out a

piece of paper and a pencil. Place the paper sideways in front of you and outline a human body on the

left side. Let me know when you are ready. Let's do it. All right, this will be a

single patient encounter and you will have 15 minutes. Before we begin, do you have any questions?

Nope, me and my stick figure are ready to go. All right. I'm going to get our timer started for 15 minutes, and the timer has started.

Isabel, you are working an afternoon shift at ABEM General. You notice that another room has been filled with a new patient.

It's a 54-year-old male who is here for abdominal pain. Okay, I'm going to walk up to the room.

Hi, sir, I'm Dr. Tweet. What brings you in today? So as you walk in, you see a well-dressed middle-aged male sitting on the bed. He is in no acute distress. And he says, well, Doc, I've been having this abdominal pain kind of on the right lower side for a little while. At first,

it was kind of coming and going, so I didn't make much of it. You know, I work a pretty manual job. I do a lot of physical labor, so I thought maybe I'd just strain a muscle. But, gosh, since last night, it's been really intense and it hasn't been going away. So I don't think this is a muscle strain anymore.

I'm so glad you came in. I'm going to ask you a few more questions in just a second,

but first I'm going to turn to my nurse, ask them to get him hooked up on a monitor,

undressed and into a gown, including underwear off so we can take a look and do a genitalia exam later,

and then get two large bore IVs placed.

I'll turn back to the patient.

...