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The Four F's


command5

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I don't think it is for abdominal pain.

The four F's that I'm familiar with:

Fat

Forty

Flatulent

Female

For cholecystitis

Hmmm... I would have to say that it IS for abdomial pain, since that is how cholecystitis generally presents. Using that mnemonic is part of the evaluation of abd pain patients to narrow down your diagnosis.

There are actually six F's for cholecystitis, however four of them are demographics (fair [skinned], fat, forty, female), and two of them are signs (flatulent, fever). Generally when you hear somebody speaking of the four Fs, they are referring to the demographic terms, and not the signs.

If you find somebody with all six Fs and a positive Murphy, you can pretty well stop looking for your abdominal pain diagnosis.

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I may be way off base here ( wouldnt be the first time) but I was also taught those four Fs as mneonics for cholecystitis. And as Dust said, along with poisitive Murphys sign (which i was taught to do by haveing the patient exhale and the pushing my fingers under the rib cage.) Dust-

I have also hurd this called McBUrney's sign...or is that something else?

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And as Dust said, along with poisitive Murphys sign (which i was taught to do by haveing the patient exhale and the pushing my fingers under the rib cage.)

I too have seen that method, and I use it as part of my differential, but a true Murphy's Sign is actually elicited during inspiration, not expiration. A true positive Murphy's is when the patient abruptly stops his deep inspiration because of the pain elicited by the palpation. I suspect the other method considers that, depending upon the patient's style of breathing, his belly may be expanding on expiration instead of inspiration.

I have also hurd this called McBUrney's sign...or is that something else?

McBurney's is a different sign. McBurney's Sign is simply point tenderness at McBurney's Point, which is the usual location of the appendix. It is one sign of appendicitis, although not a terribly reliable one.

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I had to think about that one for a moment. When I worked at the State Pirson down the road as a Corrections Officer/EMT I often told my inmates I had 4 rules, 4 Fs, that they could not violate.

1-No Fighing

2-No F...ummm...let me think...Fornicating, yeah No Fornicating

3-No starting Fires

and

4-No Fleeing over the fence.

Follow the 4 Fs and I don't have to cuff or shoot anybody and we all have a quiet 12 hours.

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