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Bates' Guide To Physical Exam > Abdomen- Ab pain > Flashcards

Abdomen- Ab pain Flashcards

1
Q

Ab pain- cancer of stomach (process)

A

Predominantly adenocarcinoma (90-95%)

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2
Q

Ab pain- cancer of stomach (location)

A

Increasingly in ‘cardia’ and GE junction; also in distal stomach

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3
Q

Ab pain- cancer in stomach (timing)

A

Shorter than peptic ulcer, pain is persistent and slowly progressive

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4
Q

Ab pain- cancer in stomach (factors aggregate/relieve)

A

Aggravates- food

Relieves- NOT relieved by food or antacids

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5
Q

Ab pain- cancer in stomach (associated symptoms)

A

Anorexia, nausea, early satiety, weight loss, sometimes bleeding. Ages 50-70 commonly

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6
Q

Ab pain- acute pancreatitis (process)

A

Acute inflammation of the pancreas

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7
Q

Ab pain- acute pancreatitis (location)

A

Epigastric, may radiate to the back or other parts of the abdomen; may be poorly localized

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8
Q

Ab pain- acute pancreatitis (quality)

A

Usually steady

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9
Q

Ab pain- acute pancreatitis (timing)

A

Acute onset, persistent pain

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10
Q

Ab pain- acute pancreatitis (aggregate/relieve)

A

Aggravate- lying supine

Relieve- leaning forward with trunk flexed

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11
Q

Ab pain- acute pancreatitis (symptoms/setting)

A

Nausea, vomiting, ab distention, fever. Often history of previous attacks and alcohol abuse or gallstones

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12
Q

Ab pain- chronic pancreatitis (process)

A

Fibrosis of the pancreas secondary to recurrent inflammation

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13
Q

Ab pain- chronic pancreatitis (location)

A

Epigastric, radiating through the back

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14
Q

Ab pain- chronic pancreatitis (quality)

A

Steady, deep

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15
Q

Ab pain- chronic pancreatitis (timing)

A

Chronic or recurrent course

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16
Q

Ab pain- chronic pancreatitis (aggregate/relieve)

A

Aggregate-alcohol, heavy or fatty metals

Relieve- possibly leaning forward with trunk flexed; often intractable

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17
Q

Ab pain- chronic pancreatitis (symptoms/setting)

A

Decreased pancreatic function; diarrhea with fatty stools (steatorrhea) and diabetes mellitus

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18
Q

Ab pain- cancer of the pancreas (process)

A

Predominantly adenocarcinoma (95%)

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19
Q

Ab pain- cancer of the pancreas (location)

A

Epigastric and in either upper quadrant; often radiates to the back

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20
Q

Ab pain- cancer of the pancreas (quality)

A

Steady, deep

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21
Q

Ab pain- cancer of the pancreas (timing)

A

Persistent pain; relentlessly progressive illness

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22
Q

Ab pain- cancer of the pancreas (aggregate/relieve)

A

Relieve- same as chronic pancreatitis

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23
Q

Ab pain- cancer of the pancreas (symptoms/setting)

A

Anorexia, nausea, vomiting, weight loss, jaundice; depression

24
Q

Ab pain- biliary colic (process)

A

Sudden obstruction of the cystic duct or common bike duct by gallstone

25
Q

Ab pain- biliary colic (location)

A

Epigastric or RUQ; may radiate to R scapula and shoulder

26
Q

Ab pain- biliary colic (quality)

A

Steady, aching; NOT colicky

27
Q

Ab pain- biliary colic (timing)

A

Rapid onset over a few minutes, lasts one to several hours and subsides gradually. Often recurrent

28
Q

Ab pain- biliary colic (settings/symptoms)

A

Anorexia, nausea, vomiting, restlessness

29
Q

Ab pain- acute cholecystitis (process)

A

Inflammation of the gallbladder, usually from obstruction of the cystic duct by a gallstone

30
Q

Ab pain- acute cholecystitis (location)

A

RUQ or R abdominal; may radiate to R scapular area

31
Q

Ab pain- acute cholecystitis (quality)

A

Steady, aching

32
Q

Ab pain- acute cholecystitis (timing)

A

Gradual onset, course longer than in biliary colic

33
Q

Ab pain- acute cholecystitis (aggregate/ relieve)

A

Aggravate- jarring, deep breathing

34
Q

Ab pain- acute cholecystitis (symptoms/setting)

A

Anorexia, nausea, vomiting, fever

35
Q

Ab pain- acute diverticulitis (process)

A

Acute inflammation of the colonic diverticulum, a saclike mucosal outpouring through the colonic muscle

36
Q

Ab pain- acute diverticulitis (location)

A

LLQ

37
Q

Ab pain- acute diverticulitis (quality)

A

May be cramping at first, but becomes steady

38
Q

Ab pain- acute diverticulitis (timing)

A

Often a gradual onset

39
Q

Ab pain- acute diverticulitis (symptoms/setting)

A

Fever, constipation. There may be initial brief diarrhea

40
Q

Ab pain- acute appendicitis (process)

A

Acute inflammation of the appendix with distention or obstruction

41
Q

Ab pain- acute appendicitis (location)

A
  • poorly localized peri umbilical pain followed usually by

- RLQ pain

42
Q

Ab pain- acute appendicitis (quality)

A
  • Mild but increasing, possibly cramping

- steady and more severe

43
Q

Ab pain- acute appendicitis (timing)

A
  • Lasts roughly 4-6 hours

- Depends on intervention

44
Q

Ab pain- acute appendicitis (aggregate/relieve)

A

Aggravate- movement or cough

Relieve- if it subsides temporarily, suspect perforation of the appendix

45
Q

Ab pain- acute appendicitis (symptoms/setting)

A

Anorexia, nausea, vomiting, which typically follow the onset of pain; low fever

46
Q

Ab pain- acute mechanical intestinal obstruction (process)

A

Obstruction of the bowel lumen, most commonly caused by:

  • adhesions or hernias (small bowel)
  • cancer and diverticulitis (colon)
47
Q

Ab pain- acute mechanical intestinal obstruction (location)

A
  • Small bowel: periumbilical or upper abdominal

- Colon: lower abdominal or generalized

48
Q

Ab pain- acute mechanical intestinal obstruction (quality)

A

Cramping in both

49
Q

Ab pain- acute mechanical intestinal obstruction (timing)

A
  • Small bowel: paroxysmal; may decrease as bowel mobility is impaired
  • Colon: paroxysmal, though typically milder
50
Q

Ab pain- acute mechanical intestinal obstruction (symptoms/setting)

A
  • Small bowel: vomiting of bile and mucus (high obstruction) or fecal material (low obstruction); obstinate on develops
  • Colon: obstipation early. Vomiting late if at all. Prior symptoms of underlying cause
51
Q

Ab pain- mesenteric ischemia (process)

A

Blood supply to the bowel and mesentery blocked from thrombosis or embolus (acute arterial occlusion), or reduced from hypoperfusion

52
Q

Ab pain- mesenteric ischemia (location)

A

May be periumbilical at first, then diffuse

53
Q

Ab pain- mesenteric ischemia (quality)

A

Cramping at first, then steady

54
Q

Ab pain- mesenteric ischemia (timing)

A

Usually abrupt onset, then persistent

55
Q

Ab pain- mesenteric ischemia (symptoms/setting)

A

Vomiting, diarrhea (sometimes bloody), constipation, shock

Bates' Guide To Physical Exam (6 decks)

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