Abdominal pain history/examination

Question 1

When assessing a patient with a suspected surgical problem what must you ensure?

Answer 1

That the nurses know she/he is to be kept NBM

Question 2

What must always be enquired about in women of a child-bearing age (i.e. less than 60?)

Answer 2

Whether they could be pregnant, contraception, LMP

Question 3

Diffuse central chest pain –> RIF

Answer 3

Appendicitis

Question 4

Epigastric pain

a) during meals
b) between meals

Answer 4

a) gastric ulcer

b) duodenal ulcer

Question 5

Episodic epigastric/RUQ pain exacerbated/provoked by a fatty meal

Answer 5

Biliary colic

Question 6

LIF pain and tenderness, commoner in the elderly

Answer 6

Diverticulitis

Question 7

Lymph node in the supraclavicular fossa which is a sign of gastric cancer

Answer 7

Virchow’s node

Question 8

Areas to percuss in abdo exam?

Answer 8

Liver, spleen, bladder, shifting dullness

Question 9

Areas to ausculate in abdo exam?

Answer 9

Bowel sounds, abdominal aorta for bruit, 2.5cm and lateral to the umbilicus for bruit of renal artery stenosis

Question 10

Difference between prostate enlargment in BPH and carcinoma?

Answer 10

In BPH, smoothly enlarged with a palpable midline groove; in cancer, irregularly enlarged and midline groove may no longer be palpable

Question 11

Herniation through a) inguinal canal b) Hesselbach’s triangle c) below inguinal ligmant

Answer 11

a) indirect b) direct c) femoral