WEEK #9: I-HUMAN CASE – 3O YEAR-OLD WITH
LOWER ABDOMINAL PAIN AND SPOTTING,90+
SCORE GURANTEED ABOVE
6512,6531,6541,6550,6560.
1
, PATIENT DETAILS
Age: 30 years
Gender: Female
Height: 5’3’’ (160 cm)
Weight: 136 lbs (61.8 kg)
Location: Emergency Department
Reason for Encounter: Lower abdominal pain and vaginal spotting
CHIEF COMPLAINT
"Lower abdominal pain with vaginal spotting."
HISTORY OF PRESENT ILLNESS (HPI)
The patient is a 30-year-old female presenting to the emergency department with complaints of
lower abdominal pain accompanied by vaginal spotting. The pain is localized to the lower
abdomen and is associated with abnormal vaginal bleeding. The patient denies trauma. Further
evaluation is required to rule out gynecologic, obstetric, and abdominal causes.
REVIEW OF SYSTEMS (ROS)
General: Denies fever, chills, or weight loss
HEENT: Denies headache, vision changes, ear pain, nasal congestion
Cardiovascular: Denies chest pain, palpitations
Respiratory: Denies shortness of breath or cough
Gastrointestinal: Positive for lower abdominal pain; denies nausea, vomiting, diarrhea
Genitourinary: Positive for vaginal spotting; denies dysuria or urinary frequency
Musculoskeletal: Denies joint pain or swelling
Neurological: Denies dizziness, weakness, numbness
Psychiatric: Denies anxiety or depression
PAST MEDICAL HISTORY
No chronic medical conditions reported
2
LOWER ABDOMINAL PAIN AND SPOTTING,90+
SCORE GURANTEED ABOVE
6512,6531,6541,6550,6560.
1
, PATIENT DETAILS
Age: 30 years
Gender: Female
Height: 5’3’’ (160 cm)
Weight: 136 lbs (61.8 kg)
Location: Emergency Department
Reason for Encounter: Lower abdominal pain and vaginal spotting
CHIEF COMPLAINT
"Lower abdominal pain with vaginal spotting."
HISTORY OF PRESENT ILLNESS (HPI)
The patient is a 30-year-old female presenting to the emergency department with complaints of
lower abdominal pain accompanied by vaginal spotting. The pain is localized to the lower
abdomen and is associated with abnormal vaginal bleeding. The patient denies trauma. Further
evaluation is required to rule out gynecologic, obstetric, and abdominal causes.
REVIEW OF SYSTEMS (ROS)
General: Denies fever, chills, or weight loss
HEENT: Denies headache, vision changes, ear pain, nasal congestion
Cardiovascular: Denies chest pain, palpitations
Respiratory: Denies shortness of breath or cough
Gastrointestinal: Positive for lower abdominal pain; denies nausea, vomiting, diarrhea
Genitourinary: Positive for vaginal spotting; denies dysuria or urinary frequency
Musculoskeletal: Denies joint pain or swelling
Neurological: Denies dizziness, weakness, numbness
Psychiatric: Denies anxiety or depression
PAST MEDICAL HISTORY
No chronic medical conditions reported
2
