One of the patients that I had presented during my site visit was of a 20-year-old female presenting with severe abdominal pain. This patient had no PMH, G0, and her LMP was a week prior, complaining of intermittent, achy periumbilical pain that shifted towards her right lower quadrant. She rates the pain as a 6/10, but at its worst it is a 9/10. She also mentioned that she had 2 episodes of clear, non-bloody, non-bilious vomiting that morning.

Right away, based on the way that she had described her symptoms and how the pain had migrated from the periumbilical region to the RLQ, appendicitis had moved to the top of my differential. I quickly did a physical exam and palpated her abdomen, checking for a positive Rovsing sign or McBurney’s point. Sure enough, there was tenderness when I palpated the McBurney’s point. Because her symptoms and physical exam were highly suspicious of appendicitis, we quickly called an ambulance to transport her to the ER.

This experience taught me the importance of quickly recognizing serious and life-threatening diagnoses. It also highlighted the importance of a good physical exam and a thorough history and will definitely be something I keep in mind moving forward with my rotations.