Lower abdominal pain in a 24-year-old woman
Emergency DepartmentMaya Lin · 24yo female · CC: Right lower abdominal pain and dizziness
History
0/6 key findingsAsk the questions your differential demands — not just the ones the case volunteers. Every diagnosis you intend to list owes you one discriminating question.
CASE SETTING: EMERGENCY DEPARTMENT
Maya Lin, a 24-year-old woman with acute right lower quadrant pain, spotting, and orthostatic dizziness
Vitals
Opening
Maya Lin, a 24-year-old architectural designer, presents to the Emergency Department with sudden-onset sharp right lower quadrant abdominal pain that began 2 hours ago at work, followed by dark vaginal spotting and nearly fainting when she stood up. She is pale, tachycardic at 118 bpm with a blood pressure of 92/56 mmHg, and winces when the stretcher bumps.
Triage note
24-year-old female with 2 hours of sudden severe RLQ pain, dark brown vaginal spotting, and orthostatic presyncope. BP 92/56, HR 118, afebrile.
From the patient
"I was sitting at my desk two hours ago when a sharp tearing pain hit my right lower belly out of nowhere. When I stood up to go to the bathroom my vision went black, and since they laid me flat here my right shoulder hurts too."
Maya Lin · 24yo female
Pale, diaphoretic young woman lying supine on the stretcher, guarding her right lower abdomen