acute abdomen

Question 1

organs that become inflamed commonly

Answer 1

• appendix
• gallbladder
• colon
• fallopian tube
• pancreast

Question 2

what is diverticulitis?

Answer 2

inflammation of the colon

Question 3

what is salpingitis?

Answer 3

inflammation of the fallopian tube

Question 4

organs that become obstructed commonly

Answer 4

intestine
gallbladder/bile
ureter
urethra/bladder

Question 5

organs that become ischaemic commonly

Answer 5

intestine (strangulated hernia)

ovary

Question 6

organs that become perforated commonly

Answer 6

duodenum
stomach
colon
gallbladder

Question 7

history: nausea, vomiting, central abdo pain which later shifts to the right iliac fossa
examination: fever, tenderness, guarding or palpable mass in the right iliac fossa

Answer 7

acute appendicitis

Question 8

history: vomiting at onset associated with severe acute onset abdo pain, previous history of dyspepsia, ulcer disease, NSAIDS or corticosteroid therapy
examination: shallow breathing with minimal abdo wall movement, abdo tenderness and guarding

Answer 8

perforated peptic ulcer with acute peritonitis

Question 9

history: anorexia, nausea, vomiting, constant severe epigastric pain, previous alcohol abuse
examination: fever, periumbilical or loin bruising, epigastric tenderness, variable guarding, reduced or absent bowel sounds

Answer 9

acute pancreatitis

Question 10

history: sudden onset of severe, tearing back/loin/abdo pain, hypotension and past history of vascular disease and hypertension
examination: shock and hypotension, pulsatile, tender, abdominal mass, asymmetrical femoral pulses

Answer 10

ruptured aortic aneurysm

Question 11

history: anorexia, nausea, vomiting, bloody diarrhoea, constant abdo pain, previous history of vascular disease and hypertension
examination: atrial fibrillation, heart failure, asymmetrical peripheral pulses, absent bowel sounds, variable tenderness and guarding

Answer 11

acute mesenteric ischaemia

Question 12

history: colicky central abdo pain, nausea, vomiting and contsipation
exam: surgical scars, hernias, mass, distension, visible peristalis

Answer 12

intestinal obstruction

Question 13

history: premenopausal, delayed or missed menstrual period, hypotension, unilateral iliac fossa pain, pleuritic shoulder tip pain, prune juice like vaginal discharge
examination: suprapubic tenderness, periumbilical bruising, pain and tenderness on vaginal examination

Answer 13

ruptured ectopic pregnancy

Question 14

history: sexually active young female, previous STI, recent gynaecological procedure, irregular menstruation, right upper quadrant pain,
examination: fever, vaginal discharge, pelvic peritonitis causing tenderness on rectal examination, swelling/fullness in the fornix on vaginal examination

Answer 14

pelvic inflammatory disease

Question 15

what is Murphy’s sign associated with?

Answer 15

acute cholecystitis

Question 16

what is Rovsing’s sign?

Answer 16

palpation in the left iliac fossa produced pain in the right iliac fossa

Question 17

what is Roving’s sign associated with?

Answer 17

acute appendicitis