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RUQ pain

  • Common ddx

    • gallstone
  • Serious ddx

    • trauma, hepatitis, hepatic abscess, hepatobiliary cancer, metastatic cancer
  • Labs

    • Murphy's test
    • LFTs
    • CBC, Chem
    • CXR if suspect pneumonia
    • US if suspect gallstone
    • CT if suspect abscess or trauma
  • Other ddx

    • PBC, PSC, Wilson's disease, hemochromatosis, pneumonia, pleural effusion
  • ROS

    • pain quality, quantity, alleviation, aggravation
    • jaundice
    • fever
    • dyspnea
    • nausea, vomiting, diarrhea, steatorrhea, acholic stool
    • tremors
    • trauma
    • foreign travel, sick contacts
    • PMH of cancer: colorectal cancer, melanoma
  • Px

    • vitals: fever, BP
    • jaundice, icterus
    • pulm: crackles
    • palpation: Murphy sign, tenderness, rebound, hepatomegaly, mass
    • asterixis

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