Abdo OSCE Exam Questions

Question 1

Cholecystitis

Answer 1

1. Inflamation of gall bladder
2. Assoc with gall stones
3. common in females, 30-50 yo
4. Nausea, vomiting
5. RUQ pain, tenderness
6. Fever
7. Trigger = fatty food

Question 2

Appendicititis

Answer 2

1. Pain begins periumbilicial then RLQ
2. Localised tenderness (abdo or pelvic)
3. Nausea, vomiting, anorexia
4. Fever
5. Raised white blood cells
6. Sudden relief of pain - possible perforation
7. Peritoneal signs

Question 3

Bowel obstruction

Answer 3

1. Causes = adhesions, hernias, fecal impaction, tumour
2. Crampy abdo pain
3. Nauasea, vomitting
4. Distended, firm abdo
5. Hypoactive / absent bowel sounds
6. High pitched tinkling sound if partial blockage

Question 4

7 Fs of distension

Answer 4

1. Fluid
2. Flatus (gas)
3. Faeces
4. Fat
5. Foetus
6. Fibroids (non-cancerous growths that develop in or around the womb (uterus)
7. Flaming big tumour

Question 5

Hyperactive ausc =

Answer 5

Dairrhoea, GI bleed

Question 6

Diverticulosis

Answer 6

1. Diverticulum - smalls sacs off colon that develop with age due to pressure (>50% of over60s in Western countries)
   
   • cramping, constipation, darrhoea, bloating
2. Diverticulitis - inflammation of a diverticulum, especially in the colon, causing pain and disturbance of bowel function

Question 7

Oesophogeal Varices

Answer 7

1. Dilated submucosal veins in lower oesophagus
   * Superficial vein lining oesophagus - drain into L gastric vein which drains into portal vein
2. Caused by portal hypertension
3. Risk of massive GI bleeding
4. heamatemesis, coffee ground emesis, melena

Question 8

Gastroenteritis

Answer 8

1. Inflamation of the stomach or intestine from bacterial or viral infection
2. flu like symptoms
3. vomiting likely before pain
4. Often profound diarrhoea
5. Tenderness and rgidity absent or minimal
6. Risk of dehydration

Question 9

Inflamatory bowel disease

Answer 9

1. Group of inflamatory conditions of large itnestine
   
   • Ulcerative colitis
   • Crohn’s disease
2. Diarrhoea, abdo cramping, visible bleeding more common in UC, nausea, vomiting, obstruction

Question 10

Intestinal ischeamia causes and signs

Answer 10

Acute

1. Blood clot, hypotenstion, vasoconsrtiction
2. Sudden pain, tenderness, distension, blood in stool, nausea, vomitting, fever

Chronic - many causes of hypoperfusion

cramps, increased pain after eating, weight loss, diarrhoea, bloating

Question 11

Irritable bowel syndrome (IBS)

Answer 11

1. Contractions in intestine stronger and last longer than normal
2. Food is forced through irregularly causing gas, blaoting, diarrhoea, and constipation
3. 20% of adults have IBS
4. Doesnt permanently harm intestines
5. Certain foods and stess can aggravate

Question 12

Kidney Stone

Answer 12

1. Mineral deposits develop in kidney and move to ureter
2. Assoc w recent UTI
3. Svere flank pain
4. Nausea, vomitting, haematuria
5. Extreme restlessness

Question 13

Pancreatitis

Answer 13

1. Inflamation fo the pancreas - acute/chronic
2. Causes = gall stones (50%), alcohol (25%), other 25% (infection, meds, trauma, ERCP)
3. N&V,
4. pain radiates from upper abdo to back
5. abdo tenderness
6. SIRS (tachycardia, tachypnoea, hypotension)

Question 14

Ruptured ectopic pregancy

Answer 14

1. Fertilised egg outside uterus
2. abdo pain
3. lower back pain
4. vaginal spottign/bleeding

if ruptures, can cause abdo bleeding and potential for hypovol shock

Question 15

Pelvic Inflammatory disease

Answer 15

1. Infection in femal reproductive organs from cervix exposed to STI (gonorrhea, chlamydia)
   
   • Uterus, fallopian tubes, ovaries
2. Dull pain and tenderness to lower abdo
3. vaginal discharge
4. irregular menstruation
5. chills, fever, nausea, vomitting

Question 16

Peptic Ulcer Disease

Answer 16

1. Ulcer in gastric or duodenal area
2. steady, localised, epigastric pain
3. burnign, gnawing, aching
4. Worsen: coffee, stress, spices, smoking
5. Improves: alkaline foods, antacids
6. May cuase GI bleed
7. Perforation - intense/steady pain, patients lies still, rigidity

Question 17

Rovsing’s sign

Answer 17

If palpation of the left lower quadrant of a person’s abdomen increases the pain felt in the right lower quadrant, the patient is said to have a positive Rovsing’s sign and may have appendicitis.

Question 18

McBurney’s sign

Answer 18

deep tenderness at McBurney’s point is a sign of acute appendicitis.

Rebound tenderness - If gentle pressure is applied at the McBurney’s point, it will feel tender. If the pressure is released suddenly appendicitis pain often will feel worse which is due to inflammation of the peritoneum overlying the appendix area.

Mcburney’s point = 1/3 distance from anterior superior iliac spine (ASIS) to umbilicus