Abdo pain Flashcards
What might cause RUQ?
Hepatitis Gallstones/Biliary colic Acute cholecystitis Acute cholangitis Duodenal Ulcer Right basal pneumonia Appendicitis Pyelonephritis Congestive hepatomegaly
Causes of hepatitis
Viral
Autoimmune
Alcoholic
What are the symptoms of hepatitis?
Nausea Vomiting Fever weightloss Jaundice Ascites Itchiness
When do you get biliary colic?
Worse after eating fatty foods
Risk factors for gallstones (6Fs)
Female Fat Forty Family history Fertile Fair (Caucasian)
What is cholecystitis + what is the sign?
Cystic duct obstruction
Murphy’s sign
What is cholangitis
INFECTION of the cystic duct as well as the biliary tree
What is charcot’s triad?
RUQ pain
Fever
Jaundice
What is cholangitis and what signs does it present with?
INFECTION of the cystic duct as well as the biliary tree
Charcot’s triad
Reynold’s pentad
Left hypochondriac region pain can be due to?
Aortic aneurysm Gastric ulcer Perforated colon Ruptured spleen Left basal pneumonia Pyelonephritis
Reynold’s pentad
Mental confusion
Symptoms of septic shock (hYPOtension)
What can cause
Ischaemic bowel - acute (trauma) or chronic (intermittent gut claudication after eating, therefore you get weight loss)
Symptoms of ischaemic bowel
Fever
Nausea
Vomiting
Bloody diarrhoea
How would you describe an AAA?
Expansile
Pulsatile
What can cause generalised abdo pain?
Ischaemic bowel
Peritonitis
Gastroenteritis
DKA
How would someone with peritonitis appear?
Pt will be lying v still as movement causes extreme pain
What might you need to ask regarding gastroenteritis?
If anyone around them experienced the same
Travel hx
How can you classify ischaemic bowel and what are these different types due to?
Acute (trauma) or chronic (intermittent gut claudication after eating, therefore you get weight loss)
Epigastric pain can be caused by?
Give gastro causes
Acute/chronic pancreatitis Perforated peptic ulcer Gastroenteritis Peptic ulcer disease Biliary colic Acute cholecystitis Ascending cholangitis Oesphagitis due to GORD Incomplete bowel obstruction Gastric cnacer Pancreatic cancer
Give cardiac causes of epigastric pain
MI
Ruptured AAA
Mesenteric ischaemia
Give respiratory causes of epigastric pain
Basal pneumoniae
What signs are suggestive of pancreatic cancer?
Painless jaundice + palpable gall bladder
What would very sudden onset pain suggest?
Perforated viscus (e.g. perforated duodenal ulcer)
Boerhaave’s perforation
Myocardial infarction
Pain which develops maximal intensity over 10-20mins?
Acute pancreatitis, biliary colic
Pain takes few hours to take peak intensity?
Cholecystitis, pneumonia
inflammatory causes
Sharp burning pain?
Peptic ulcer disease
GORD
Crampy pain
Gastroenteritis
Deep dull pain
Pancreatitis
Colicky
gallsones
Mesenteric ischaemia
Radiation to back?
Pancreatitis
Leaky AAA
Peptic ulcers if perforation
Shoulder tip radiation?
Pnemonia
Subphrenic abscess
Radiation to neck/jaw/arm
cardiac pathology
If pain is relieved with sitting forward
Acute pancreatitis
Food
Dodenal ulcer pain is relieved with food but WORSENS gasric ulcer pain
Fatty meals
Biliary colic
Worsened by large meals
GORD
Worse with exercise
Cardiac causes
Self limiting
Biliary colic
????
Very painful
MI
Acute pancreatitis
Perforated peptic ulcers
Meseneric ischaemia
Associated symptoms?
N+V+fever Pain on inspiration Sweating & weakness Jaundice Cough Heartburn Bitter/metallic taste in mouth Weight loss or gain
What would abdo pain plus chronic dry cough suggest?
GORD
