Abdominal examination with a painful groin lump
PLAB 2 practice station

The task

You are a doctor in an emergency department. Mr Kofi Boateng, aged 62, has had abdominal discomfort and pain from a lump in his right groin since this morning. He is lying on the couch. Perform an abdominal examination, including the groins. Say aloud what you are doing at each step. The examiner will report the findings when you say what you are doing, so describe each step as you go. At the end, summarise your findings and say what you think is going on and what you would do next.

What this station tests

• Examine the groin lump for cough impulse, reducibility and tenderness, and do not use force to reduce a tender hernia.
• An irreducible painful hernia with vomiting and constipation is a surgical emergency.
• Palpate from the area furthest from pain and watch the patient's face.
• Offer a chaperone and maintain dignity during abdominal and groin examination.
• State vital signs and act on tachycardia and dehydration found during the examination.

Sources for the clinical content

• NHS: Hernia
• NHS: Inguinal hernia repair

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

Practise next

• Cardiovascular examination in a breathless man
• Respiratory examination in a woman with cough and fever
• Neurological examination of the legs after back pain
• Examination of a swollen painful knee
• Thyroid examination in a woman with weight loss