Anna, a 78-year-old overweight but active white female presents to the office with complaints of
left lower quadrant abdominal pain which she describes as dull and "gripey". Anna is a farmer
and she comes to see you only once a year when she needs to get her routine care, including her
well-woman care and refills, so you suspect that this must be bothering her enough that she came
in today even though she downplays the pain. She has a history of hypertension which is well
controlled and mild hyperlipidemia but she declines statins. Anna also has a history of
diverticulitis. On exam, Anna is afebrile and she does not show peritoneal signs or signs of
toxicity. You believe that her diverticulitis is causing her pain. include a prescription.
78-Year-Old Farmer with Left Lower Quadrant Abdominal Pain
1. Anna, a 78-year-old overweight but active white female presents to the office with complaints of
left lower quadrant abdominal pain which she describes as dull and "gripey". Anna is a farmer
and she comes to see you only once a year when she needs to get her routine care, including her
well-woman care and refills, so you suspect that this must be bothering her enough that she came
in today even though she downplays the pain. She has a history of hypertension which is well
controlled and mild hyperlipidemia but she declines statins. Anna also has a history of
diverticulitis. On exam, Anna is afebrile and she does not show peritoneal signs or signs of
toxicity. You believe that her diverticulitis is causing her pain. include a prescription
