Abdominal condition Flashcards
What are the symptoms of ectopic pregnancy?
S- unilateral lower abdominal pain
O- 6-8 weeks after last period
C- sharp
R- left shoulder
A- vaginal bleeding (watery, brown, random)
Nausea and vomiting due to pregnancy
T-
E-Adnexal tenderness
S-
Palpation- adnexal mass
HX: missed period 6-8 weeks and a positive pregnancy test.
- Associated more with oral contraceptives if on them
What are the symptoms of Ovarian torsion?
S: Unilateral lower abdo pain
O: sudden
C: worsens intermittently over hours
R: radiates to groin, back
A:
Nausea and vomiting
T: Usually during agitating movement
E: tenderness on one or diffused across both sides
S:severe
History: Early pregnancy or cysts
What are the symptoms of an Ovarian cyst?
Site: Adnexal tenderness, more commonly left sided
O: sudden if ruptured
C: sharp pain
R: shoulder, lower back, and thighs
A:
Breast tenderness due to hormone changes
Bowel changes (bloating, early satiety),
T- Usually during sex or exercise and midcycle
E: sex
S: severe
What are the symptoms of PID?
S: Bilateral lower abdominal pain
O: Last less than 7 days
C: Dull, achy, crampy and constant
R: -
A: Yellow discharge
N&V and fever based on severity
bleeding after sex
T: Within 5 days after the menstrual cycle as this creates an environment for bacteria to spread
E: Pain during sex, exercise, and palpation
S: -
HX: Caused by gonorrhea or chlamydia days to months
Under 25 and sexually active
What are the symptoms of Testicular torsion?
S: one sided testicle
O: sudden
C: intermittent to constant
R: radiates to lower abdomen if balls not dropped
A: swelling, nausea and vomiting
T: history severe scrotal pain which then resolved (intermittent)
E: negative prehrs sign
S: severe
Hx: Teenager (12-18)
What are the symptoms of oesophageal varices?
Liver disease
Painless
Blood in vomit or cough
What are the symptoms of Mallory weis tear?
epigastric, retrosternal, or back pain
Preceded by straining (vomiting, coughing) or alcohol
Self-limiting bloody vomit
Difficulty or Painful swallowing
What are the symptoms of gastric ulcer?
S: Epigastric (maybe pinpoint pain)
O: Shortly after meals
C: Burning
R: Back pain can indicate penetrating if complicated with pancreatitis
A: Indigestion
T: Can be present for a couple months
E:
Improved with vomiting and antacids
S: low-high
History: Associated with NSAIDS and h.pylori infection
What are the symptoms of duodenal ulcer?
S- epigastric
O - 2-3 hours after eating or at night
C - Burning pain
R - no back pain (unless perforated)
A-
T - Can be present for a couple months
E- empty stomach
S-
HX- Associated with NSAIDS and h.pylori
What are the symptoms of gastritis?
S- Epigastric
O-
C- Discomfort and indigestion
R- none
A- Nausea and vomiting
T- Improves after days to weeks
E- Can improve or worsen when eating
S-
HX- Associated with toxic consumption
Phlegmonous:
Abdominal pain
Purulent Emesis
Fever
Atrophic gastritis:
Chronic gastritis causes vitamin B12 deficiency (glossitis, mental decline)
What are the symptoms of gastroenteritis?
S: Upper abdomen
O: A day after exposure
C: crampy
R: none
A:
Nausea, and rarely vomiting
low grade fever
T:
Bowel:3 loose stools a day for 1-2 weeks
E: minimal tenderness
S: low
History: exposure to dodgey food
What are the symptoms of pancreatitis?
Site:Epigastric and ULQ pain
O: Gradual or sudden
C: dull, steady
R: center of the back
A:
Jaundice if caused by stones as may also block biliary duct
N&V
mild pyrexia
Fluid leak can cause Left side Pleural effusion and in severe cases Hypotensive and Grey turners, Foxs, and Cullens after several days
T:
E: tenderness and guarding
S: severe
History: Previous biliary colic
Alcohol abuse (4-8 years) or gallstones
What are the symptoms of Cholecystitis?
S- RUQ sharp pain
O- sudden (although shorter if gallstone passes)
C - sharp, Mass, and tenderness
R - Right shoulder, shoulder blade pain, back pain
A - low grade fever
E- Worse 15-20minutes after fatty foods and breathing deeply
Tests: Positive Murphy sign
PMX: 5 Fs
What are the symptoms of liver disease?
S: Right upper quadrant
O:
C: Dull
R:
A:
Muscle, joint pain, and burning and prickling sensation in limbs
Ankles edema, abdo distension, splenomegaly, and Hematemesis due to esophageal varices due to blood backup
mental status changes (hepatic encephalopathy)
T:
E:
S:
Examination: Smaller or enlarged liver, hard or soft
HX: Hepatic failure most commonly caused by paracetamol overdose
Alcohol abuse
Unsafe drugs or sex
Hand signs: red face and palms, white nails, clubbing
Head signs: yellow sclera, jaundice
Abdominal signs: caput medusae,abdominal bruit
What are the symptoms of cholangitis?
Abdominal distension
Jaundice
Abdominal pain
White poo
.
hernia
What are the symptoms of pyelonephritis?
S: Usually unilateral kidney pain
O: Develop over hours up to a day
C:
R: Lower abdominal pain if cystitis
A:
High fever
Nausea and vomiting
Lower UTI: urinary frequency and dysuria
T:
E: Costovertebral angle tenderness
S: varying
What are the symptoms of UTI?
Dysuria and frequency issues
Nocturia
cramp-like Supra pubic pain
Prostatitis
Perineal and rectal pain with tender prostate
Fever
What are the symptoms of volvulus?
under 1 year old
sudden severe pain
abdominal distension, tenderness, and rebound tenderness
bilious vomiting as blockage backs up to stomach
What are the symptoms of appendicitis?
S: Central pain
O: Within 12 hours
C: intermittent before becoming constant
R: Central pain, which moves over to a right lower quadrant pain
A: anorexia (no desire to eat) as a later sign
Nausea and vomiting later sign
low-grade fever
Diarrhea or constipation
T: Usually doesn’t last more than 48 hours
E: Worse on movement (McBurneys, psoas and obturators sign)
S: Severe
What conditions are common in pediatrics?
intussusception
malrotation
Meckels diverticulum
Hirchsprungs disease
Necrotising enterocolitis
Mesenteric lymphadenitis (appendicitis differential)
What are the symptoms of intussusception?
Under 1 year old
Colicky RUQ pain for several minutes then none with sausage mass
Vomiting, which can become bilious after everything expelled
blood in the stool (red currant jelly)
What are the symptoms of volvulus and their causes?
Very sudden Severe cramps which progress to severe pain with Bilious vomiting
Usually no physical findings
ischemia can then lead to guarding
And distension
hypertension due to pain which can progress to dehydration and hypotension
Malrotation: usually within first month
What are the symptoms of Meckels diverticulum?
Under 2 years - 8 years old
May contain gastric tissue which releases acids causing ulcers and blood in stools
Obstipation (complete inability to pass)
Tenderness near belly button
If inflamed - Meckels diverticulitis:
Occurs in adults, pain which radiates from periumbilical to RLQ
What are the symptoms of Hirchsprungs disease?
- Unable to move anal sphincter
Delayed pass of meconium at birth (up to 48hrs)
Chronic abdo distension and vomiting due to backup and then extremely loose and foul stools due to time spent in the colon.
Can cause enterocolitis causing fever, and not eating
What are the symptoms of Necrotising enterocolitis?
Occurs in preterm babies (<32)
Bacteria colonize colon causing swelling, which might show intestinal loop through the skin, palpable bowel, abdo distension, reduced bowel sounds, sepsis
first week of life
How can Mesenteric lymphadenitis be differentiated from appendicitis?
Mesenteric lymphadenitis: swelling of the lymph nodes in the abdomen due to infection
symptoms start after viral or bacterial infection
diarrhea
fever (as opposed to low-grade)
under 10s is more common than appendicitis
Over 20s much rarer
What are the symptoms of AAA?
S: Epigastric and lower back
O: sudden
C: tearing
R: Flank or isolated groin due to pressure on femoral nerve
A: palpable pulsatile mass
hypotension, pallor, mottling due to rupture
N&V, and early satiety due to stomach compression
LOC in elderly
T: Progressing symptoms
E:
S: Severe
HX: atherosclerotic disease, over 65, smoking
What are the symptoms of Kidney stones?
S: Unilateral flank pain
O: Sudden pain in the morning or night which increases over around 2 hours
If started during the day is usually slow and insidious
C: sharp, cramping as body tries to push stone
R: radiates down to the groin or areas of the abdomen
A:
Stone lodged in the ureter (renal colic) causes urinary frequency or urgency
Nause and vomiting
T: Dehydration
E:
S: Severe
What are the symptoms of UC and Crohn’s?
- weight loss
- bloody diarrhea (more likely UC)
- fever (at the very start)
- pain when pooing
Crohn’s:
Right-sided abdo pain
Yellow poop (excess fat due to poor absorption of SI)
UC:
left-sided abdo pain
tenesmus (sensation of needing the toilet) causing cramps
What are the symptoms of SBO and LBO?
Intermittent severe cramping
Vomiting, then bilious, then fecal (more likely SBO)
Abdominal distension (cecum tenderness risk of perforation)
hard poo = big block (compacted) soft = small
SBO:
Caused by adhesions (due to surgery or inflammation) and hernias
constipation
LBO:
Caused by colon cancer
sudden inability to toilet
empty rectum = obstruction further up
What are the symptoms of mesenteric ischemia?
S: non-localised
O: sudden or 10-20 minutes after eating
C- out of proportion constant or colicky pain
R-
A-
Mucosal lining sheds causing diarrhea and melaena
Emesis
T -
E- minimal tenderness
S - severe
History: previous association with atherosclerotic disease
What are the symptoms of CKD and DKD?
S: Usually unilateral Kidney pain
O: varies
C:
R: Can also cause abdo pain
A:
Metabolic acidosis causes protein loss and muscle loss
Changes in water management cause hypertension and peripheral and pulmonary edema
Fatigue, pruritus, and restless legs due to anemia
T: Progress from CKD stages 1-3
E:
S: varies
DKD has a 10+ year history of poorly controlled diabetes
What are the symptoms of hemorrhoids vs anal fissures?
hemorrhoids: straining puts pressure on veins causing lumps
anal fissure: A tearing sensation causing pain
What are the symptoms of BPH?
Urinary frequency and urgency, nocturia
Difficulty urinating, weak, interrupted
The feeling of incomplete bladder emptying
Strain to empty bladder
HX: men over 50
What symptom is associated most with bladder cancer?
Painless hematuria
What symptoms are most associated with diverticulitis?
S: Lower left quadrant pain
O: sudden
C: cramping
R: Generalised abdo pain if peritonitis from perforation
A: Low-grade Fever
Painless rectal bleeding
N&V
Bloating, constipation, or obstipation
T:
E: worse when the colon is full and tender
S:
HX: Over 50
