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Ms Lee Jason is a 21 year old ward clerk. She presents to your clinic this am with about 10 hours of nausea with a gradual onset worsening abdominal pain. She stated it started around the umbilical region but now seems to be more symptomatic down her Right iliac fossa region. 

You examined her and found that she is febrile of 38.5 C, guarding with rebound tenderness in the RIF region. 

What is your most likely provisional diagnosis?

A. Acute pancreatitis
N. Herpes zoster
B. Appendicitis
O. Irritable bowel syndrome
C. Biliary colic
P. Large bowel obstruction
D. Carcinoma of the pancreas
Q. Ovarian cyst
E. Cholecystitis
R. Pelvic inflammatory disease
F. Coeliac disease
S. Peptic Ulcer
G. Constipation
T. Primary dysmenorrhoea
H. Crohn’s disease
U. Renal colic
I. Diverticulitis
V. Ruptured abdominal aortic aneurism
J. Ectopic pregnancy
W. Small bowel obstruction
K. Endometriosis
X. Ulcerative colitis
L. Gastroenteritis
Y. Urinary tract infection
M. Gastro-oesophageal reflux
Z. Viral hepatitis

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