abdominal pain

Question 1

Abdominal pain radiating to the spine or flank may result from conditions such as

Answer 1

pancreatitis, gastric or duodenal ulceration, cholecystitis, pyelonephritis, or a leaking abdominal aortic aneurysm.

Question 2

A leaking abdominal aortic aneurysm usually presents with

Answer 2

abdominal pain that radiates to the back and signs of shock.

Question 3

criteria for considering ectopic pregnancy in a patient

Answer 3

A female aged 10-50 years whose last menstrual period was more than four weeks ago may have an ectopic pregnancy.

Question 4

bowel perforation usually presents with

Answer 4

non-specific abdominal pain for 1-2 days followed by signs of peritonitis (abdominal tenderness with pain made worse by movement).

Question 5

all patients with epigastric pain should also get an…

Answer 5

ECG + consider myocardial ischemia or cardiac event

Question 6

outline the steps of an abdominal assessment

Answer 6

Ensure patient is supine; General inspection of abdo: scars, masses, distention, pulsating, stomas

Palpate the 9 regions

Auscultate for bowel sounds if concerns of obstruction

Question 7

name some red flags for abdominal pain

Answer 7

Severe pain.
Abnormal vital signs.
Pain radiating to the back.
Loin or flank pain.
Temperature > 40°C.
Rigors.
Female aged 10-50 years and last menstrual period (LMP) more than four weeks ago.
Pregnant.
Abdominal tenderness on palpation.
Pain made worse by movement.
Indigestion or epigastric pain.
Persistent or recurrent vomiting.
Aged < 5 years.
Aged ≥ 65 years.
Immunocompromised (for example on steroids or immunotherapy).

Question 8

outline some of the time critical causes of abdominal pain

Answer 8

Ectopic pregnancy

Ruptured abdominal aortic aneurysm:

Peritonitis and sepsis

testicular/ovarian torsion

Uncontrolled gastro haemorrhage
- acute bowel obstruction
- acute pancreatitis
- ACS or cardiac pain

Question 9

anatomy in the RUQ of the abdominal cavity

Answer 9

liver, R kidney, gallbladder

Question 10

organs in epigastric region

Answer 10

stomach, spleen, start of small intestine, pancreas

Question 11

organs in LUQ

Answer 11

tip of liver, stomach, pancreas, L kidney, spleen

Question 12

RLQ organs

Answer 12

appendix,

Question 13

what is peritonitis

Answer 13

inflammation of the abdominal tissue/cavity , usually due to perforation of an organ

Question 14

what occurs in an ectopic pregnancy

Answer 14

when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes, has no room to grow and thus can cause rupture
( symptomatic usually 6-8 weeks gestation)

Question 15

presentation of ectopic pregnancy

Answer 15

R or L lower quadrant pain (depending on where the egg is), recent sexual activity last 6-8 weeks, tearing pain, tachycardia and signs of shock.

Question 16

presentation of acute pancatitis

Answer 16

Epigastric pain radiates directly through the abdomen to the back

Nausea and vomiting are often present, along with accompanying anorexia.

Diarrhea can also occur.

Positioning can be important, because the discomfort frequently improves with the patient sitting up and bending forward.

jauindence

fever

Question 17

risk factors for pancreatitis

Answer 17

alcohol, gallstones, steroid use, autoimmune issues

Question 18

peritonitis presentation

Answer 18

Belly pain or tenderness.
Bloating or a feeling of fullness in the abdomen.
Fever

Question 19

where would we expect pain in billary colic

Answer 19

in the RUQ where the gallbladder is