In the process of interviewing Ms. Jones, a 50-year-old female, and discussing her dietary habits, she mentions consuming fried foods and ice cream regularly

QUESTION

You are interviewing Ms. Jones, a 50-year-old female. You ask about her diet, and she informs you that her diet often included fried foods and ice cream in her diet. When discussing the past 24-hour food intake with her, she recalls she felt nauseated and bad slight RUQ discomfort after eating fatty meals. Which of the following signs is most likely to be found on physical exam?

Group of answer choices

Murphy’s Sign

Cullens sign

Rosvigs sign

Psoa’s sign

ANSWER

In the process of interviewing Ms. Jones, a 50-year-old female, and discussing her dietary habits, she mentions consuming fried foods and ice cream regularly. Additionally, she recalls feeling nauseated and experiencing slight discomfort in the right upper quadrant (RUQ) after eating fatty meals. As a healthcare professional, it is essential to consider her symptoms and potential signs during the physical examination.

The most likely sign to be found on physical exam in this case is Murphy’s Sign. Murphy’s Sign is a clinical maneuver used to assess for inflammation of the gallbladder, which is often associated with gallstones or cholecystitis. During the examination, the healthcare provider palpates the RUQ while the patient takes a deep breath. If the patient experiences pain or abruptly stops inhaling due to pain during palpation, it is considered a positive Murphy’s Sign and may indicate acute cholecystitis.

Cullens sign, Rosvigs sign, and Psoa’s sign are not relevant signs for this specific case. Cullens sign is associated with periumbilical ecchymosis and is indicative of retroperitoneal bleeding, usually from pancreatitis or other intra-abdominal bleeding sources. Rosvigs sign is associated with left upper quadrant ecchymosis and is indicative of splenic rupture. Psoa’s sign is a test for appendicitis and involves assessing for tenderness in the right lower quadrant upon passive extension and internal rotation of the right hip.

In summary, based on Ms. Jones’ dietary history and her symptoms of nausea and RUQ discomfort after consuming fatty meals, the most relevant sign to be found on physical exam would be Murphy’s Sign, which could suggest acute cholecystitis or inflammation of the gallbladder. Proper assessment and evaluation of this sign can help guide further investigations and provide appropriate care for the patient.