VIDEO PANDUAN OSCE SEMESTER 2 : Pemeriksaan Abdomen OSCE FK Undip

Summary

Dr. Hasan conducts a thorough physical examination on a 20-year-old patient, Mr. Rizki, who presents with severe lower abdominal pain. The doctor performs a series of tests, including inspection, auscultation, percussion, and palpation, to assess the patient's condition. Following these assessments, Dr. Hasan suspects the patient may have appendicitis, as indicated by positive signs in the abdominal area. The doctor refers the patient for further radiological tests and prescribes temporary pain relief. The diagnosis will be confirmed after the radiology results, and further treatment will follow accordingly.

Takeaways

• 😀 The doctor introduces himself as Dr. Hasan and identifies the patient, Bapak Rizki, who is 20 years old.
• 😀 The patient presents with lower abdominal pain, which has been persistent since the previous night.
• 😀 The pain is described as severe and worsens with movement, but it improves when lying down.
• 😀 The patient has no other symptoms such as fever or vomiting and has not sought previous treatment for this issue.
• 😀 The doctor performs a thorough physical examination, including inspection, auscultation, percussion, and palpation of the abdomen.
• 😀 Normal findings during inspection include no redness, scars, or visible masses on the abdomen.
• 😀 The auscultation reveals normal bowel sounds (5-20 per minute) and no abnormal aortic bruits.
• 😀 Percussion results are normal, with typical tympanic sounds over the abdomen.
• 😀 Special tests for ascites and liver/spleen enlargement come back normal, indicating no significant issues in those areas.
• 😀 Positive findings on physical examination, including tenderness in the lower right abdomen and positive psoas and obturator signs, suggest possible appendicitis.
• 😀 The doctor diagnoses the patient with appendicitis and refers him for further radiological tests to confirm the diagnosis.
• 😀 The patient is prescribed pain relief medication, with the plan to return after radiology results for further treatment decisions.

Q & A

What is the patient's main complaint during the consultation?

The patient, Rizki, complains of severe pain in the lower abdomen since the previous night. The pain is persistent but sometimes subsides.

Has Rizki experienced any other symptoms besides abdominal pain?

No, Rizki has not reported any other symptoms, and there were no other notable signs of illness.

How does the pain affect Rizki's daily activities?

The pain intensifies when Rizki is walking, making movement very difficult and painful. However, lying down seems to alleviate the pain somewhat.

What physical examinations did the doctor perform?

The doctor conducted a thorough physical examination, including inspection, auscultation, percussion, palpation, and specific tests like the shifting dullness test and the psoas and obturator signs.

What did the doctor find during the abdominal inspection?

The inspection revealed that Rizki's abdomen had a normal shape, no redness, no surgical scars, and no visible masses or enlarged blood vessels.

What is the significance of the psoas and obturator signs in the examination?

The psoas and obturator signs help in diagnosing conditions like appendicitis. A positive result, such as pain during the psoas test, could suggest appendicitis or peritonitis.

What was the result of the physical tests, and what condition did the doctor suspect?

The doctor found tenderness in the lower right abdomen and positive results for the psoas and obturator signs, leading to the suspicion of appendicitis.

What did the doctor recommend for further diagnosis?

The doctor recommended that Rizki undergo further radiological tests to confirm the diagnosis of appendicitis.

What treatment did the doctor provide for Rizki's condition?

The doctor prescribed pain relief medication as a temporary measure but emphasized that further treatment or surgery might be necessary depending on the radiological findings.

What follow-up action did the doctor suggest for Rizki after the radiological test?

Once the radiological test results are available, Rizki should return to the clinic for further consultation and potential treatment based on the findings.