Journal 5

Abdominal and Genitourinary Exams and Diagnostics

Advanced physical assessment is used to address complaints generating from the abdominal area and genitourinary system. Additionally an understanding of a multisymptom assessment approach is often necessary for psychiatric and neurologic disorders. This may lead to a diagnosis from patient records, a subjective history and the physical exam using clinical reasoning. Additionally these complaints may require diagnostic labs to be performed for an accurate diagnosis.

Complete 2 scenarios. Choose one from each group.

Complete one of the three scenarios.

• Consider the chief complaint of lower abdominal pain in a 33-year-old female.
• or
• Consider the chief complaint of testicular pain in a 15-year-old male.
• or
• Consider the chief complaint of upper abdominal pain in a 55-year-old female.

Demonstrate clinical judgment with regards to the chief complaint in both cases by including this content for each.

• What pertinent information collected from the history would impact your assessment?
• What would be pertinent positives or pertinent negatives found in the exam?
• Include at least three differentials.
• Include which diagnostics you would order based on your differentials and why.
• How might a final diagnosis be determined?
• Address a possible brief management plan.
• Apply evidence-based support for your choices; including a clinical guideline for one of your differentials.
• Finally address how both ethics and policy relate to 1. genitourinary exams which are considered intimate in nature and 2. psychiatric care which carries a special level of confidentiality.