Undifferentiated Presentations Abdominal Pain — Written Clinical Reasoning · Phys Written Answers

Prompt

DCE-style written reasoning for Undifferentiated Presentations Abdominal Pain.

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Undifferentiated Presentations Abdominal Pain and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Leung E, Islam S, Van Wyk M, Ng ZQ, et al. Undifferentiated embryonal sarcoma of the liver presenting as a complex mixed solid-cystic hepatic lesion in a young adult: A case report Radiol Case Rep, 2026.PMID 42011342
[2]Fujii TY, Kimura T, Nakatsuka S Adult Primary Hepatic Sarcoma Presenting as a Chronic Expanding Hematoma Surg Case Rep, 2026.PMID 41859129
[3]Lugata J, Smith C, Nzota F, Mayengela A, et al. Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa Gynecol Oncol Rep, 2026.PMID 41704940
[4]Broder JS, Oliveira J E Silva L, Bellolio F, Freiermuth CE, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department 2 (GRACE-2): Low-risk, recurrent abdominal pain in the emergency department Acad Emerg Med, 2022.PMID 35543712
[5]Carpenter CR, Griffey RT, Mills A, Doering M, et al. Repeat computed tomography in recurrent abdominal pain: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department Acad Emerg Med, 2022.PMID 34897917
[6]Luria L, Nguyen J, Zhou J, Jaglal M, et al. Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review World J Gastroenterol, 2014.PMID 25206297
[7]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
[8]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005

SAQ 1 — Integrated plan (12 marks)

Prompt: Provide a prioritised problem list and management sequence for this presentation. [1] [2]

Model Answer

1. Frame and red flags (3 marks) [1]

State the working diagnosis/syndrome, acuity, and what would force emergency treatment now. [1] [2]

2. Discriminating assessment (3 marks) [2]

List the key history, examination and investigations that separate dangerous differentials from benign mimics. [1] [2]

3. Treatment sequence (4 marks) [1] [3]

Immediate stabilisation, disease-specific therapy, monitoring, and complications prevention. [1] [2] [3]

4. Follow-up and communication (2 marks) [2]

Disposition, safety-net advice, and who owns follow-up. [1] [2]

SAQ 2 — Exam trap defence (8 marks)

Prompt: Name two high-yield traps in Undifferentiated Presentations Abdominal Pain and how you avoid them. [1] [2]

Model Answer

Trap one: delayed escalation of a high-risk feature — avoid by explicit red-flag checklist. [1]

Trap two: therapy mismatched to mechanism — avoid by confirming the discriminating test before escalating treatment. [2] [3]

References

[1]Leung E, Islam S, Van Wyk M, Ng ZQ, et al. Undifferentiated embryonal sarcoma of the liver presenting as a complex mixed solid-cystic hepatic lesion in a young adult: A case report Radiol Case Rep, 2026.PMID 42011342
[2]Fujii TY, Kimura T, Nakatsuka S Adult Primary Hepatic Sarcoma Presenting as a Chronic Expanding Hematoma Surg Case Rep, 2026.PMID 41859129
[3]Lugata J, Smith C, Nzota F, Mayengela A, et al. Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa Gynecol Oncol Rep, 2026.PMID 41704940
[4]Broder JS, Oliveira J E Silva L, Bellolio F, Freiermuth CE, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department 2 (GRACE-2): Low-risk, recurrent abdominal pain in the emergency department Acad Emerg Med, 2022.PMID 35543712
[5]Carpenter CR, Griffey RT, Mills A, Doering M, et al. Repeat computed tomography in recurrent abdominal pain: An evidence synthesis for guidelines for reasonable and appropriate care in the emergency department Acad Emerg Med, 2022.PMID 34897917
[6]Luria L, Nguyen J, Zhou J, Jaglal M, et al. Manifestations of gastrointestinal plasmablastic lymphoma: a case series with literature review World J Gastroenterol, 2014.PMID 25206297
[7]Doan HN, Chang MC Comparative Effectiveness of Unstable Versus Stable Resistance Training on Lower Limb Strength, Mobility, and Fear of Falling in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials Am J Phys Med Rehabil, 2026.PMID 42468010
[8]Liu HW, Tsai TL Virtual Reality-assisted Physiotherapeutic Training for Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis Am J Phys Med Rehabil, 2026.PMID 42468005