Abdominal pain induction

A 68-year-old man is brought in by ambulance. He has been complaining of abdominal pain for the last 4 days. Pain has gradually been getting worse and his GP prescribed him senna yesterday. Today he started vomiting profusely and is unable to keep any food down. He has not opened his bowels for 5 days.

PMH–hypertension, mild arthritis, he had a Laparotomy 30 years ago following a motorcycle accident, which left him with a limp. DH-atenolol, thiazide diuretics and enalapril His HR is 80 with a BP of 100/75, he looks sweaty and pale. His abdomen is distended and generally tender with no guarding with loud bowel sounds

Which if the following is the most likely diagnosis:

A 70-year-old woman presents to the ED with a two-hour history of severe abdominal pain which developed suddenly while she was at rest. The pain is diffuse and radiates to her back. On examination she has generalised abdominal tenderness but no guarding; does not have an abdominal aortic aneurysm clinically and is in AF with a rate of approximately 100bpm. She deteriorates during her stay in the department and becomes clinically shocked. You request an VBG which shows the following results:

• pH 7.1
• BE -12
• lactate 5
• Na+132
• K+4.0

What is the next appropriate course of action?

A 36-year-old woman presents to the ED with RUQ pain for the past 5 hours. She has associated vomiting. She has previously been diagnosed with gallstones and is on the waiting list for cholecystectomy. You give her fluids, antiemetics and analgesia

When reviewing the patient which of the following features would reassure you, she is suitable for discharge:

A 17-year old girl presents with RIF pain, temp and vomiting. You examine her and find there is tenderness and guarding in RIF.

Appropriate next steps would include (select all that apply)