Above is a current first year resident rotating through general internal medicine seen drawing the abdominal anatomy when considering a case of a patient with generalised abdominal pain, reduced bowel sounds and guarding.
Using an anatomical and aetiological approach when considering the causes of disease is important when constructing a differential diagnosis based on history and physical examination.
By establishing a differential diagnosis, it allows one to consider which laboratory data and radiological tests should be performed and hence, which potential treatments are going to be required.
Problem Based Learning is essential to allow medical students and residents to learn how to work out the various problems and thereby teaching us not to forget to review all the problems no matter how innocuous they may at first seem.
It can also be fun too!
This excellent resident got the diagnosis from history and physical examination-- ischaemic bowel from a small bowel volvulus. Well done!