Abdominal Pain

Question 1

What is shifting pain?

Answer 1

Pain that moves from one area to another and is no longer sore in the original place

Question 2

What is spreading pain?

Answer 2

Pain that radiates to a large area

Question 3

How to tell the difference between gastric and duodenal ulcers?

Answer 3

Gastric ulcers are worse on eating where as duodenal ulcers are better on eating

Question 4

What gives a throbbing pain?

Answer 4

Inflammation

Question 5

What gives a colic pain?

Answer 5

Obstruction

Question 6

What are the 5 main categories that you should consider when a patient presents with abdominal pain?

Answer 6

Inflammatory pain
Underlying malignancy
Drug related
Infectious cause
Iatrogenic

Question 7

What is the most likely cause of the main if the patient doesn’t want to be moved or touched?

Answer 7

inflammation

Question 8

What is the most likely cause of the pain if the patient is moving around?

Answer 8

Colic

Question 9

What can you ask the patient to do to try and illicit if they have peritonitis?

Answer 9

“Puff up your tummy”
“Suck your tummy in”
“Give me a gentle cough”
“Give me a big cough”
They will also not like percussion

Question 10

Murphy’s sign?

Answer 10

a sign of gallbladder disease consisting of pain on taking a deep breath when the examiner’s fingers are on the approximate location of the gallbladder.

Question 11

Rebound tenderness?

Answer 11

Press hard and the pain is not that bad but when you suddenly release it cause an increase in pain - no longer do this to assess for peritonitis (coughing and percussion is better)

Question 12

As well as sound what else can you percuss for?

Answer 12

Tenderness (peritonism)

Patients may also guard - this is different to tenderness - you would not do this if you have peritonitis

Question 13

What signs/symptoms should you look for it abdo. pain patients which suggest that they are very sick?

Answer 13

Extreme pain and tenderness
Hypotension
High pulse rate

Question 14

What is McBurney’s point?

Answer 14

McBurney’s point is the name given to the point over the right side of the abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus (navel). This point roughly corresponds to the most common location of the base of the appendix where it is attached to the cecum.

Question 15

What type of pain does a perforated appendix cause?

Answer 15

Generalised pain and guarding with peritonism

Question 16

Iliopsoas test?

Answer 16

Patient lies down on let lateral position, apendix falls forward and extend the right leg and if this increases pain it is a sign of peritonitis