A、First in the right abdomen and then it went to the lower abdomen. B、First in the lower abdomen and then it shifted to the righ

W: Sit down, please, what’s your trouble?
M: I have got pain in my belly.
W: When did you get it?
M: It started the day before yesterday. So I just took two tablets of analgesics, and yesterday I went to work as usual. But the pain has become intolerable today, I think I have to come here to ask for an emergency treatment.
W: Is the pain continuous or does it come and go?
M: It is continuous, but sharpens at times, just like a needle prick. At first I had a pain in the upper abdomen and then it shifted to the right lower abdomen.
W: Have you got any diarrhea recently?
M: I don’t have diarrhea but I vomited twice a day.
W: Did you have any bowel movements or air expelled through the anus in the past few days?
M: I had once today.
W: Well, I am going to take your temperature. Roll up your sleeve, I shall take your blood pressure. Please lie on the table. Bend your legs to relax your abdominal muscles. Let me listen to your chest. Breathe deeply. Do you have any pain in the place where I press? Does it hurt in the exact place where I press?
M: Yes, it does. Yes it sure does.
W: Lie on the left side please, and I will do a rectal touch for you. Open your mouth and breathe deeply. O.K. put on your clothes. Get up. Take this bill to the laboratory.
M: Doctor, what disease have I got?
W: Judging from your case history and the results of physical examination and the laboratory test, I think you have got acute appendicitis, probably perforated. You should be admitted to hospital for an operation without delay.
M: Thank you, doctor.
Questions 16 - 20 are based on the conversation you have just heard.
16. Why did the man go to see an emergency doctor?
17. Why did he not go to see the doctor immediately after he felt unwell?
18. How did the pain spread to other parts of the body?
19. What disease has the man got?
20. What will the man do next after diagnosis?