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The pain was on the upper abdomen and the upper back. According to the patient, the painworsened whenever she coughed, sneezed or did any jarring activity. The patient experienced relentless steady pain in her abdomen at the beginning but after some time, the pain moved to right the lower abdomen. The pain, however, lasted for almost one week, and she had a mild fever.

Physical examination techniques applied

1. The intestines should be checked for obstruction by listening to any sounds coming from the inside.

2. With the art of special maneuvers, the doctor can detect the presence of any inflammation.

3. Gentle messaging of the abdomen enables the doctor to identify the tender location

4. Scrutiny of the stool will determine whether or not it is bloody. This could be a sign of intestinal problems.

Finally, a lab test conducted determines the blood count, the liver enzymes, urinalysis and an analysis of the pancreatic enzymes.

The patient is a 23year old woman who was experiencing some genitourinary symptoms.

History associated with the condition and her symptoms

The patient started experiencing the symptoms three months after she had an IUD inserted. She stated experiencing foul smelling discharge accompanied by pelvic pains, back ache, nausea and fever and occasional chills. Menorrhagia, Dyspareunia and Dysmenorrhea, were also experienced.

Questions asked to the patient.

1. For how long has the discharge been appearing?

2. When was your last menstrual period?

3. Do you have a history with any sexually transmitted infection?

4. Do you have multiple sexual partners?

5. Are you under any medication, including family planning? If so, which one ?

Physical examination and diagnosis

1. Touching and gently pressing the affected area will help to determine the exact location of the pain.

2. A wet pap smear

3. Ultra sound

4. Culture and sensitivity of vaginal discharge

Physical education

1. The doctor advised the patient to maintain one sexual partner

2. Both partners need to complete taking their medication

3. Sexual intercourse should be done using a condom until both parties get cured

4. In case of an IUD, the doctor should recommend alternative family planning.

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