Medical Student Teaching #4
GS is a 24 year-old female beach volleyball player who is referred to you, the on-call F1 in the Surgical Admissions Unit. She has been sent in by her GP, who writes “Dear Doctor, thank you for seeing this young lady.” Unfortunately, that’s all his letter says. He’s a pretty shit GP if one is to be honest. So, none the wiser, you go to see her and can immediately see she is hot, indeed the nurse tells you her temperature is ‘up’. She’s a pretty shit nurse if one is to be honest.
From her brief history, you learn that she recently had a belly-button piercing performed, after which her symptoms began. She has a chronic history of injuries sustained whilst playing beach volleyball, such as getting tanned and developing a toned body. She has no other significant medical history.
On examination, GS is a young lady wearing a bikini and is comfortable at rest. Cardiovascular and neurological exam are unremarkable, although you do notice she has a good pair of lungs on her. The abdomen is soft and non-tender and is Stefani’s sign positive. She’s is in no pain, but as her abdomen is so unlike any you ever saw whilst practicing with friends in medical school, you realise something is definitely amiss. Your doctey sense is tingling.
You recall the influx of acute pancake-itis that came in soon after Shrove Tuesday…but it doesn’t seem like that. As usual, you’re completely flummoxed. But just then, yes just then, Christopher Lloyd tells you the diagnosis. You’re about to ask him if the flux capacitor is real, when you realise that he’s right.
What’s the diagnosis?
A Cute Abdomen.
That’s right, GS has a cute abdomen. Be sure to remember this case as you will encounter it incredibly rarely if you practice medicine in Britain. The classic triad of a cute abdomen is a lack of distension, a waist:hip ratio of less than 0.7 and very often a cute pairitonice-tits. Management for this condition is very, very close observation, with conservative treatment. You know the Daily Rhino loves steroids, but this is probably one instance that you definitely, positively should NOT give them.
Previous teaching sessions:
Medical Student Teaching #1
Medical Student Teaching #2
Medical Student Teaching #3
Originally published in Medical Student Newspaper.
Technorati tags: Medicine medical school medical students medical student
Labels: Medical Student Teaching, medical students
Permanent link action