MCC Objectives

Abdominal distension may indicate the presence of serious intra-abdominal or systemic disease, but it is also a common symptom of benign disease, such as irritable bowel syndrome.

Abdominal injuries are common and may be life-threatening. Assessment of patients with an abdominal injury may be difficult because it may produce few clinical signs. Interpretation of abdominal physical examination findings may also be difficult in unconscious patients with multiple injuries.

Abdominal masses and pelvic masses may be noted on physical examination or discovered incidentally on imaging. It is imperative for a physician to determine which masses require immediate investigation and treatment, and which can be safely monitored.

Abdominal pain is a common presentation in children. While the symptoms may result from serious abdominal pathology, in a large proportion of cases, an identifiable organic cause is not found. When a cause is identified, the cause is often age dependent.

Murmurs and abnormal heart sounds may be detected on physical examination. Although systolic murmurs are often “innocent” or physiologic, diastolic murmurs are virtually always pathologic. A thorough history and physical examination almost always identify which patient cases require further investigation and management.

Hypercholesterolemia is a common and important modifiable risk factor for ischemic heart disease, cerebrovascular disease, and peripheral vascular disease. Determination of levels is usually based on concomitant risk factors.

Abnormal liver function tests are common in clinical practice. Appropriate investigation can distinguish benign reversible liver disease from potentially life-threatening conditions.

Puberty is the physiologic and psychosocial transition from childhood to adolescence. Questions about typical and atypical pubertal development are a common reason for presentation to primary care clinics. Abnormalities in pubertal development can be indicators of severe underlying disorders and can be a cause of significant anxiety for patients and families. They require careful investigation and follow-up.

Abuse of older adults is action or neglect causing harm or distress to an older person where there is an expectation of trust.

Abnormally high or low hydrogen ion concentration—acidemia and alkalemia, respectively—is encountered relatively frequently, particularly in hospital-based practice. Acidemia may be caused by an underlying life-threatening condition. Several acid-base abnormalities can coexist in a single patient.

Acute abdominal pain is common in adults, leading to frequent physician visits in both Emergency Department and office settings. Acute abdominal pain may result from serious intra-abdominal, intrathoracic, or retroperitoneal processes.

Acute diarrhea (lasting less than 1 week) is defined as a disturbance of stool frequency and/or consistency. Diarrheal diseases are extremely common worldwide, including in North America, where morbidity and mortality are significant.