abdominal pain history Flashcards
what are causes of abdominal pain?
- apendicitis
- pancreatitis
- gastric/ duodenal ulcer
diverticulitis - IBS
-renal colic - gallstones
- ectopic pregnancy
what are the common symptoms of apendicitis?
- initially umbilical pain then moves to the right illiac fossa
- a young patient in extreme pain
what are common symptoms of pancreatitis?
- epigastric pain that radiates to the back
- relieved when sitting forward
- also get vomiting, nausea and reduced apetite
how to tell between a duodenal ulcer history and gastric?
- gastric gets worse when you eat
- duodenal gets better when you eat
what are symptoms of ulcers?
- reduced apetite
- nausea
- vomiting
- haematemasis
- melena
what are the symptoms of diverticulitis?
- LIF pain
- bloating
- constipation
- fever
- +/- rectal bleeding
what are symptoms of renal colic?
- acute intermitent severe loin-groin pain
- nausea
- vomiting
- haematuria
what are symptoms of gallstones?
- RUQ/epigasgastric pain - intermitent and coliky, lasting approx 30mins
- worse with fatty foods
- may radiate to left shoulder
- +/- nausea and vomiting
- obstructive jaundice
what are symptoms of ectopic pregnancy?
- r/l illiac fossa pain
- suprapubic pain
- amenorrhoea
- vaginal bleeding
- haemodynamic instabilitiy
- nausea/vomiting
what are symptoms of irritable bowel syndrome?
- generalised abdominal pain relieved on defecation
risk factors for appendicitis
family history
male
early teens
how do you diagnose appendicitis?
clinical/ intraoperative
what investigations would you do for apendicitis?
- FBC, CRP, U+E
- imaging such as uss, ct abdo/pelvis
what are the investigations for pancreatis?
bedside: - glasgow score Blood: - abg, fbc, U+E,LFT, serum lipase, serum amylase, lipid profile imaging: - uss and ct abdo/pelvis
other:
faecal elastase
risk factors for pancreatitis?
IGET SMASHED
- idopathic
- gallstones
- ethanol
- trauma
- steroids
- mumps/malignancy
- autoimmune
- scorpion bite
- hyperlipidemia/hypercalcaemia
- ercp
- drugs
what are risk factors for ulcers?
- NSAIDS
- H.pylori
- Haematemisis
- melena
risk factors for ulcers?
- NSAIDS
- stress
- h pylori
- steroids
- smoking
- alcohol
what are risk factors for diverticulits?
- low fibre diet
- >60
what are investigations you should do for someone with ulcers?
- pr exam
- fbc, u+e, crp/esr, h.pylori,
- axr (for bowel obstruction) and erect cxr (to look for free air under the diaphragm)
- ogd for biopsy (h.pylori)
- or urea breath test/ stool antigen
what are the investigations you should do for renal colic?
bedside:
urinalysis
bloods:
fbc, u+e, bone profile (esp calcium stones
uss and non contrast CTKUB
what are risk factors for an ectopic pregnancy?
- previous ectopic
previous tubal surgery - IUD
- pelvic inflammatory disease
what are investigations for ectopic pregnancy?
- PV exam
- urine pregnancy test
bloods:
- FBC, CRP, serial BHCg
imaging:
transvaginal uss
what are investigations for gallstones?
fbc, lft, serum lipase and amylase
US abdomen and MRCP
