medicine q - raheem

[ArchivalUser]

A 34-year old man presents to the emergency department in excruciating abdominal pain. It woke him from sleep about one hour ago and he now has severe right lower quadrant pain radiating into his testicle. He is nauseated and has vomited twice in the past hour. The pain is not relieved in any position, and he has never experienced anything like this before. He has type 1 diabetes but claims it is well controlled. His only medication is insulin, and he has no allergies.

Physical exam:
T 37.8C, HR 108, RR 25, BP 140/83
General: weighs 75kg, in obvious distress
Abdomen: soft, bowel sounds present, right-sided tenderness worse in upper quadrant
Genitalia: uncircumcised phallus, nonbloody meatus, nontender descended testis
Rectal: normal

At this stage what is your differential diagnosis (choose the one most likely diagnosis):

a- acute appendicitis
b- abdominal aortic aneurysm
c- acute renal colic
d- bowel obstruction
e- pancreatitis
f- muskuloskeletal etiology
g-cholecystitis
h- diverticulitis
i- testicular torsion

[ArchivalUser]

cc

[ArchivalUser]

c,

[ArchivalUser]

Dont know but i think C because of the radiation of pain, my second guess would be A coz
the right lower quadrant, nausea vomiting and the degree of pain suggests that to me. I did however think that renal colic is more of a lumbar pain, guess the radiation gives away in this one.