03.09 Abdominal Pain in Adults

Question 1

Types of pain

Answer 1

Somatic
Visceral
Referred

Question 2

Site of disturbance located at the gallbladder, stomach or first or second portion of the duodenum

Answer 2

Epigastric pain

Question 3

Pain in the appendix or cecal area

Answer 3

Periumbilical

Question 4

Pain in the left side of the colon

Answer 4

Hypogastric

Question 5

Symptoms associated with abdominal pain

Answer 5

Fever
Inability to keep food down for more than 2 days
Any signs of dehydration
Inability to pass stool especially if you are vomiting
Painful or unusually frequent urination
Abdomen is tender to touch
Result of an injury to the abdomen
Lasts for more than a few hours

Question 6

General causes of acute abdominal pain

Answer 6

Inflammatory
Mechanical
Neoplastic
Vascular
Congenital
Traumatic

Question 7

Inflammatory causes of acute abdominal pain

Answer 7

Bacterial

Chemical

Question 8

Mechanical causes of acute abdominal pain

Answer 8

Incarcerated hernia (inguinal, diaphragmatic, umbilical)
Postoperative adhesions
Carcinoma

Question 9

Traumatic causes of acute abdominal pain

Answer 9

Penetrating abdominal injuries

Blunt abdominal injuries

Question 10

Conditions that require immediate medical care

Answer 10

Bloody vomitus
Bloody or black tarry tools
Difficulty in breathing
Pain occurring during pregnancy

Question 11

Most confirmed cause of abdominal pain <50 y/o

Answer 11

Nonspecific abdominal pain

Appendicitis

Question 12

Most confirmed cause of abdominal pain >50 y/o

Answer 12

Cholecystitis

Question 13

Type of onset

Answer 13

Gradual

Sudden

Question 14

Quality

Answer 14

Dull
Sharp
Tearing

Question 15

Intensity

Answer 15

Mild
Moderate
Severe

Question 16

Temporal features

Answer 16

Colicky
Pulsatile
Continuous

Question 17

Laboratory tests

Answer 17

CBC
Urinalysis
Pregnancy Test

Question 18

Likely to deceive as to inform
Often normal in patients with appendicitis
Often elevated in patients with AGE/nonspecific abdominal pain, menstruation

Answer 18

CBC (white blood cell count)

Question 19

Fairly sensitive to UTI in adults: WBC > 10/hpf

Answer 19

Urinalysis

Question 20

20-30% in urinalysis positive in ___

Answer 20

Appendicitis

Question 21

30-87% hematuria in urinalysis in _____

Answer 21

Ruptured aortic aneurysm

Question 22

Negative pregnancy test rules out

Answer 22

Ectopic pregnancy

Question 23

Air on the px’s right diaphragm

Air in the bowel

Answer 23

Pneumoperitoneum

Question 24

Air on the left side indicates ____

Answer 24

Gastric bubble (Magenblase)

Question 25

Potentially immediately life-threatening

Answer 25

Cardiac myocardial infarction
Intraabdominal (splenic rupture or hemorrhagic pancreatitis)
Pelvic (ectopic pregnancy)
Vascular (pulsatile masses)
Intraabdominal (splenic rupture, hemorrhagic pancreatitis)

Question 26

Potentially life-threatening within hours

Answer 26

Intraabdominal inflammatory conditions (acute appendicitis, acute cholecystitis, pancreatitis, AGE)
Allergic reactions or toxic conditions
Obstructive (malignancy, post-op adhesions)
Renal (uremic syndrome)
Cardio (congestion)
Hematologic (splenomegaly)
Infectious (AGE)
Metabolic or Toxic (electrolyte problems or poisoning)

Question 27

Assessment and management

Answer 27

Primary survey
Oxygenate
Vital signs
History and PE
ECG
Analgesics
NPO
Refer