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Clinical scenario: Patient complaining of epigastric pain

You are dispatched to a report of a female patient at the gym complaining of abdominal pain


Engine 2441, respond Code 2 to the fitness center at 2474 University Way. The caller is at the front desk reporting that she is with a female patient complaining of abdominal pain.

You arrive at the driveway in front of the fitness center on the local college campus and walk up to the front desk. The student working behind the reception desk points out a female patient lying on a bench alongside the counter. He states she walked up and asked him to call for an ambulance.

You walk over to the bench and introduce yourself. Your patient, Gina, states that she finished her workout, showered and was walking to the front entrance to go to class when she experienced a sudden onset of left lower quadrant abdominal pain. She states that she tried to walk it off but could not continue walking due to the pain.

Gina states that she tried to walk it off but could not continue walking due to the pain. (Photo/WomensHealth.gov)
Gina states that she tried to walk it off but could not continue walking due to the pain. (Photo/WomensHealth.gov)

Gina has no medical history and takes birth control regularly. She states that she has no allergies to medications. When asked about the possibility of pregnancy, Gina states that she just finished her period.

Gina denies any recent trauma or illness. She also reports normal urination and bowel movements.

What are the next steps in your assessment? Consider the following questions:

  • What type of physical exam should you perform? Why?
  • What are some of the differential diagnoses you must consider for Gina?
  • Should Gina be transported to a specialty facility?

Post your answers in the comments and view the solution for this scenario.

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