Abdominal Pain

Question 1

Main causes of right upper quadrant pain and how to differentiate them?

Answer 1

Biliary Collic - provoked by fatty food
Acute cholecystitis - fever and raised inflammatory markers
Ascending cholangitis - charcots triad (pain, fever and jaundice)

Question 2

Differentiating between gastric ulcer and duodenal ulcer?

Answer 2

Gastric - pain worse when eating

Duodenal - More common and pain relieved by eating.

Both NSAIDs and alcohol are causes, features including haematemesis and melena.

Question 3

Differentials for appendicitis?

Answer 3

Cholecystitis, 
Diverticulitis 
Ovarian cyst (torsion, rupture, haemorrhage)
Ectopic
PID
Mesentetric adenitis
UTI
Crohns

Question 4

What are the vascular causes of abdominal pain?

Answer 4

Ruptured abdominal aortic aneurysm - central pain radiating to the back, catastrophic or sub-acute.

Mesentric ischemia - central pain, Hx of AF, diarrhoea or rectal bleeding present, metabolic acidosis.