How to Answer Year Male Presents Questions (Complete Guide)

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Original Question

A 75-year-old male presents to the emergency department with abdominal pain and constipation. The abdominal pain started one week ago and has gotten progressively worse. He complains of nausea, but no fever or weight loss. He has had intermittent abdominal pain and bloating in that past that has resolved on its own. He has type 2 diabetes and chronic low back pain and takes 10 mg of oxycodone each morning. He is afebrile with a heart rate of 95 beats/min and blood pressure of 146/93 mmHg. Physical examination is remarkable for mild diffuse abdominal tenderness, abdominal distension, hypoactive bowel sounds and hyperresonance to percussion, but no rebound tenderness or guarding. Abdominal x-ray reveals a U-shaped distended colon (see image below). Which of the following is the most appropriate next step in the management of this patient? (A) Surgical repair (B) Endoscopic detorsion (C) Neostigmine (D) Oral antibiotics (E) Discontinue oxycodone

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