Abdominal pain

Question 1

Framework for abdo pain

Answer 1

Acute vs Chronic
Medical vs Surgical
Adbominal vs Non-abdominal
?Pschological (diagnosis by exclusion)

Question 2

Intussusception

Answer 2

Most common abdo pain in 3 months - 2 yrs

Telescoping of bowel into more distal bowel

Question 3

Sx of intussusception

Answer 3

Partially formed stool
Red current jelly stool
Vomiting (clear then becomes more bilious)
Colic abdo pain
Mass
Infarction
Peritonitis

Question 4

Ix for intussusception

Answer 4

Abdo US

AXR

Question 5

Abdo US findings for intussusception

Answer 5

Doughnut / target sign

Question 6

AXR findings for intussusception

Answer 6

Dilated proximal bowel

Multiple fluid levels

Question 7

Mx of intussusception

Answer 7

Drip and suck resus
Air enema < 120 mmHg
Laparotomy reduction/resection

Question 8

Extra abdominal causes of abdo pain

Answer 8

Hernia
Testes
Hip
Vertebrae
URT
LRT

Question 9

Chronic abdo pain

Answer 9

Less likely to be surgical

Question 10

Colic pain vs Inflammatory pain

Answer 10

Inflammatory constant - eg. peritonitis

Question 11

Differentials for RIF pain

Answer 11

Appendicitis
Mesenteric adenitis
Psoas abscess
Apparently pneumonia too but meh

Question 12

Mesenteric adenitis

Answer 12

Inflammed abdominal lymph node

Question 13

Abdo pain + tachypnoea

Answer 13

Think respiratory problem

Question 14

Initial Mx of constipation

Answer 14

Fluid intake
Dietary management
Toileting routine
Laxatives - eg. movicol

Question 15

Anatomical anomaly which makes testicular torsion more likely

Answer 15

‘Bell and clapper’ anomaly

Question 16

Differentials for sudden severe testicular pain

Answer 16

Testicular torsion
Hydatid of morgagne
Epididymo-orchitis
Idiopathic scrotal oedema

Question 17

Mx of testicular torsion

Answer 17

Emergency surgical scrotal exploration

Bilateral orchidopexy

Question 18

Hydatid of morgagne

Answer 18

Torsion of small outpouching of testes

May see small dark spot

Question 19

Global developmental delay

Answer 19

2 SD Delay in 2/4 main domains

Only in children <5yo

Question 20

age of weaning off breast milk

Answer 20

6mo

Question 21

advice on weaning off early

Answer 21

dont give solid before 4 mo (risk of allergy)

between 4-6 only fruit/veg puree

Question 22

stages of weaning

Answer 22

smooth texture
mashed food (7-9 mo) + proteins
chopped family food (9-12 mo) + 600 ml/day milk

Question 23

What type of milk to give when

Answer 23

full fat 1-2 yr

semi-skimmed >2yp

Question 24

Coeliac o/e

Answer 24

buttock wasting
anaemia
rash