"Flank Pain"
HPI:
A 31 year old African American female with history significant for a 21 week IUP presents to the ED with a chief complaint of right flank pain which started 3 days prior to presentation. She described the pain as severe (10/10), constant and aching in nature with radiation to her ipsilateral groin. She states that her pain worsens with movement and improves while lying still. The patient denied any vaginal discharge, dysuria, hematuria, fever, nausea, vomiting or anorexia.
Physical Exam:
Vital signs:
General: Well developed, gravid African-American female in NAD
CV:
Pulm:
Abdo: mild tenderness to palpation in the right flank, appropriately sized uterus, no peritoneal signs.
PE:
GEN: Well-developed, gravid African-American female in NAD.
LUNGS: CTAB, no wheeze ronchin rales
CV: RRR without MRG
ABD: soft, NT, no rebound or guarding, some mild CVA tenderness in the R flank
EXT: Without cyanosis, clubbing or edema
OB: Gravid uterus, appropriate for dates
DATA:
WBC 6,700 with a normal differential
Hgb 14.1
Platelets 275,000
Electrolytes – normal
BUN/Cr – 23/0.9
Urinalysis – 10 RBC
2 WBC
1+ Bacteria
No casts
Leukocyte negative
Nitrite negative
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