Young man with worsening abdominal pain
AMC Clinical practice station

The task

You are the doctor in an emergency department. Jordan Whitaker, aged 23, has come in with abdominal pain. He is alone. Take a focused history. Then tell him what you think the possible causes are, what you will do next and why, and answer his questions. There is no need to examine him. The examiner will not take part in the conversation.

What this station tests

• The classic appendicitis story is periumbilical pain that migrates to the right iliac fossa with anorexia and low fever.
• Do not forget testicular torsion in young men with lower abdominal pain.
• Treat pain early, keep the patient fasting and call the surgical team without waiting for imaging.
• Record the allergy before any antibiotic is chosen and use eTG for the choice.
• Acknowledge the patient's non-medical worries, such as work, and offer practical help.

Sources for the clinical content

• healthdirect: Appendicitis
• Australian Commission on Safety and Quality in Health Care: Antimicrobial Stewardship Clinical Care Standard
• Medical Board of Australia: Good medical practice, a code of conduct for doctors in Australia

An original practice scenario with invented patients. Not an exam question.

Practise next

• Chest tightness that is not settling
• Shortness of breath building over months
• Bleeding when opening the bowels
• Vaginal bleeding and lower abdominal pain
• Persistent fever in a three-year-old