PAEA Surgery End Of Rotation (EOR) Practice Exam

What could flank pain and CVA tenderness indicate in a patient presenting symptoms?

1. Chronic renal failure

2. Nephrolithiasis

3. Acute pancreatitis

4. Liver cirrhosis

The correct answer is: Nephrolithiasis

Flank pain and costovertebral angle (CVA) tenderness are classic signs associated with nephrolithiasis, or kidney stones. The renal system is closely linked to the anatomy of the flank, and when kidney stones are present, they can cause irritation and inflammation of the renal structures. This often leads to pain that is described as severe and can radiate to the lower abdomen or groin. CVA tenderness occurs when there is pressure applied to the area where the kidney is located, and a positive sign can often indicate inflammation or irritation of the kidney, which is frequently seen in cases of kidney stones. In this context, the combination of flank pain and CVA tenderness helps to strongly indicate the presence of nephrolithiasis, as this condition not only produces pain in the flank region but also tends to present with tenderness when the renal area is palpated. Other conditions listed, while may present with abdominal or flank discomfort, typically do not correlate with both flank pain and acute CVA tenderness in the same manner as nephrolithiasis. Each has its own presentations and associated symptoms, making this option the most appropriate choice for the symptoms described.