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Hugh's MD2 Foundation > Abdominal Pain > Flashcards

Abdominal Pain Flashcards

1
Q

What is Murphy’s sign?

A

Place two fingers on the RUQ; pain on inspiration and cessation of inspiration

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2
Q

Where is pain from obstruction of paired structures referred to?

A

The flank

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2
Q

What is acute cholecystitis?

A

Inflammation of the gall bladder

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3
Q

What the types of abdominal hernia’s?

A

Umbilical

Fermoral

Inguinal

Incisional

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3
Q

What is choledocholithiasis?

A

Stone in the common bile duct

(Not causing inflammation)

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3
Q

How does acute appendicitis usually appear on examination?

A

Tenderness in R iliac fossa (McBurney’s point)

Guarding

+/- Rovsing’s sign (palpation of L lower quadrant causes pain to be felt in RLQ)

Percussion tenderness

Normal auscultation

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4
Q

What type of pain is typically relieved by leaning forward?

A

Epigastric that radiates to the back

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5
Q

High pitched bowel sounds are indicative of what usually?

A

Obstruction

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7
Q

What is ascending cholangitis?

A

Inflammation of the common bile duct

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8
Q

What is biliary colic?

A

Pain due to obstruction of the cystic duct by gall stones

(Not inflammatory pain)

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9
Q

Where is pain from obstruction of the gut felt?

A

Midline

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10
Q

What is McBurney’s point?

A

The point, 1/3 third of the way between the ASIS and the umbilicus where pain from appendicitis is felt

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12
Q

How does peritonitis present?

A

Generalised tenderness

Generalised pain

Abdominal guarding and rebound tenderness

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13
Q

What are some non-abdominal causes of abdominal pain?

A

Heart

Lung/diaphragm

Back/muscular pain

Herpes/zoster

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15
Q

What is colicky pain?

What typically causes it?

A

Pain that waxes and wanes

Obstruction of a hollow viscus

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16
Q

How does inflammatory pain usually present?

A

Usually localised

Sharp

Often severe

Constant

16
Q

What is the pain of gastroenteritis typically like?

A

Epigastric/central

Colicky

Variable

Gradual onset

18
Q

How does pain progress in appendicitis?

A

Initially visceral and referred

Once inflammation becomes transmural and touches the peritoneum in the right iliac fossa the pain moves

  • Patient can finger the spot
19
Q

What is rebound tenderness?

A

Pain on removal of pressure applied during examination

20
Q

What special physical signs are looked for in appendicitis?

A

Rovsing’s sign - Pain > in RIF than LIF when the LIF is pressed

Psoas sign - Pain on extending R hip while the patient lies on left (if retrocaecal appendix)

Cope/Obturator sign - pain on flexion and internal rotation of R hip if appendix in close relation to obturator internus

21
Q

How does pain from perforation present?

A

Localised

Sharp

Usually severe

Sudden, can be on a background of pre-existing pain

22
Q

What are the three types of hollow viscus obstructions?

A

Intraluminal eg stone

In the wall eg colon cancer

Extrinsic eg adhesion

23
Q

What are the causes of pancreatitis?

A

I GET SMASHED

Idiopathic

Gall stones

EtOH

Trauma

Steroids

Malignancy

Autoimmune

Scorpion

Hyperlipidaemia

ERCP

Drugs - particularly flucloxicilin

24
Q

What is ERCP?

What risk is associated with it?

A

Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems.

Pancreatitis

25
Q

Why does diaphragmatic pathology often refer pain to the shoulder tip?

A

Because they share innervation from C3/4

26
Q

What is Mittelschmerz pain?

A

Pain with ovulation

27
Q

What is Grey Turner’s sign? What causes it? In which conditions might it be found?

A

Brusing in the flanks

Bleeding in the retroperitonium

Acute pancreatitis

28
Q

What is Cullen’s sign? In which condition might it be seen?

A

Superficial oedema and bruising around the umbilicus

Acute pancreatitis

29
Q

What is Meckel’s diverticulum?

A

A congenital diverticulum present at birth and remenent of the omphalomesenteric duct

Hugh's MD2 Foundation (47 decks)

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