Bates’ Guide to Physical Examination and History Taking Practice Test

The location of the abdominal pain described, specifically being medial and inferior to the right iliac crest, is highly indicative of appendicitis. The appendix is located in the right lower quadrant of the abdomen, and pain associated with appendicitis often begins as vague, periumbilical discomfort that then migrates to the right lower quadrant as the condition progresses. This migration of pain combined with tenderness in that specific area is a classic presentation for appendicitis.

In contrast, conditions such as peptic ulcer and pancreatitis typically present with pain in different areas. Peptic ulcers often cause pain in the epigastric region, while pancreatitis presents with pain in the upper abdomen that may radiate to the back. Cholecystitis, which involves inflammation of the gallbladder, often leads to pain in the right upper quadrant, particularly after meals. The specific localization of pain is crucial in narrowing down the diagnosis, and in this case, the characteristics strongly support appendicitis.