Abdominal Pain Flashcards
1
Q
Peptic Ulcer Disease
A
- Duodenal ulcers: more common than gastric ulcers, epigastric pain relieved by eating
- Gastric ulcers: epigastric pain worsened by eating
- Features of upper gastrointestinal haemorrhage may be seen (haematemesis, melena etc)
2
Q
Appendicitis
A
- Pain initial in the central abdomen before localising to the right iliac fossa
- Anorexia is common
- Tachycardia, low-grade pyrexia, tenderness in RIF
- Rovsing’s sign: more pain in RIF than LIF when palpating LIF
3
Q
Acute Pancreatitis
A
- Usually due to alcohol or gallstones
- Severe epigastric pain
- Vomiting is common
- Examination may reveal tenderness, ileus and low-grade fever
- Periumbilical discolouration (Cullen’s sign) and flank discolouration (Grey-Turner’s sign) is described but rare
4
Q
Biliary Colic
A
- Pain in the RUQ radiating to the back and interscapular region, may be following a fatty meal. Slight misnomer as the pain may persist for hours
- Obstructive jaundice may cause pale stools and dark urine
- It is sometimes taught that patients are female, forties, fat and fair although this is obviously a generalisation
5
Q
Acute Cholecystitis
A
- History of gallstones symptoms
- Continuous RUQ pain
- Fever, raised inflammatory markers and white cells
- Murphy’s sign positive (arrest of inspiration on palpation of the RUQ)
6
Q
Diverticulitis
A
- Colicky pain typically in the LLQ
- Fever, raised inflammatory markers and white cells
7
Q
Abdominal Aortic Aneurysm
A
- Severe central abdominal pain radiating to the back
- Presentation may be catastrophic (e.g. Sudden collapse) or sub-acute (persistent severe central abdominal pain with developing shock)
- Patients may have a history of cardiovascular disease
8
Q
Intestinal Obstruction
A
- History of malignancy/previous operations
- Vomiting
- Not opened bowels recently
- ‘Tinkling’ bowel sounds
9
Q
Medical Causes
A
- Myocardial infarction
- Diabetic ketoacidosis
- Pneumonia
- Acute intermittent porphyria
- Lead poisoning
