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Male Patients 5-14 years old with RLQ  Pain and Tenderness with Various Associated Symptoms and Signs

 

Patient 1A: Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

Started in and confined to RLQ

Direct RLQ tenderness,

     NO rebound, NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  )  Others: 

_____________________________

(   ) Certain that I will proceed to

          treatment without requesting

          for  any ancillary diagnostic

          procedure.

 (   ) Uncertain that I will request  

        for an ancillary diagnostic

        procedure (observation

        included)

(  ) Observation without lab initially

(  ) CBC

(  ) Urinalysis

(  ) CBC and urinalysis

(  ) Ultrasound of lower abdomen

(  ) CT scan

Others:_______________________

 

Patient 1B: Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

With shifting pain -  epigastric or periumbilical to  RLQ

Direct RLQ tenderness,

     NO rebound, NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  )  Others: 

_____________________________

(   ) Certain that I will proceed to

          treatment without requesting

          for  any ancillary diagnostic

          procedure.

 (   ) Uncertain that I will request  

        for an ancillary diagnostic

        procedure (observation

        included)

(  ) Observation without lab initially

(  ) CBC

(  ) Urinalysis

(  ) CBC and urinalysis

(  ) Ultrasound of lower abdomen

(  ) CT scan

Others:______________________

 

Patient 1C: Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

With shifting pain -  LLQ  to  RLQ

Direct RLQ tenderness,

    NO rebound, NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  )  Others: 

_____________________________

(   ) Certain that I will proceed to

          treatment without requesting

          for  any ancillary diagnostic

          procedure.

 (   ) Uncertain that I will request  

        for an ancillary diagnostic

        procedure (observation

        included)

(  ) Observation without lab initially

(  ) CBC

(  ) Urinalysis

(  ) CBC and urinalysis

(  ) Ultrasound of lower abdomen

(  ) CT scan

Others:_______________________

 

Male Patients 5-14 years old with RLQ  Pain and Tenderness with Various Associated Symptoms and Signs

 

Patient 2A:  Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

Started in and confined to RLQ

Direct and REBOUND RLQ

      tenderness, NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  )  Others: 

_____________________________

(   ) Certain that I will proceed to

          treatment without requesting

          for  any ancillary diagnostic

          procedure.

 (   ) Uncertain that I will request  

        for an ancillary diagnostic

        procedure (observation

        included)

(  ) Observation without lab initially

(  ) CBC

(  ) Urinalysis

(  ) CBC and urinalysis

(  ) Ultrasound of lower abdomen

(  ) CT scan

Others:_______________________

 

Patient 2B: Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

With shifting pain -  epigastric or periumbilical to  RLQ

Direct and REBOUND RLQ

   tenderness,  NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  )  Others: 

_____________________________

(   ) Certain that I will proceed to

          treatment without requesting

          for  any ancillary diagnostic

          procedure.

 (   ) Uncertain that I will request  

        for an ancillary diagnostic

        procedure (observation

        included)

(  ) Observation without lab initially

(  ) CBC

(  ) Urinalysis

(  ) CBC and urinalysis

(  ) Ultrasound of lower abdomen

(  ) CT scan

Others:_______________________

 

Patient 2C: Sex: Male    Age: 5-14 years old

 

Clinical Findings and Data

(With 2 physical exams within 30min)

Primary Clinical Diagnosis

        (Tick one only)

Secondary Clinical Diagnosis

          (Tick one only)

Degree of Certainty of Clin. Diagnosis

                  (Tick one only)

Ancillary Diagnostic Procedure

              (Tick one only)

RLQ PAIN AND TENDERNESS

Onset: <7 days

With shifting pain -  LLQ  to  RLQ

Direct and REBOUND RLQ

      tenderness, NO guarding

No bowel movement disturbance

No urinary disturbance

No other associated symptoms/signs

(  ) Appendicitis

(  ) Urinary tract infection

(  ) Ureteral stone

(  ) Gastroenteritis

(  ) Nonspecific RLQ pain/tenderness

(  ) Others:

_____________________________

(  ) Appendicitis