Acute Abdominal Pain

Question 1

Cardio Causes

Answer 1

Inferior MI

AAA rupture

Question 2

Upper GI Causes

Answer 2

Perf. peptic ulcer
SBO
Severe gastroenteritis

Question 3

Lower GI Causes

Answer 3

IBD flare (TMC, perforation, obstruction, haemorrhage)
Ischaemic Bowel
Appedicitis 
Diverticulitis
LBO
Strangulated hernia (femoral)

Question 4

Hepatobiliary Causes

Answer 4

Biliary colic
Cholecystitis
Cholangitis
Hepatitis
Acute Pancreatitis

Question 5

Renal/Urinary Causes

Answer 5

Renal Stones
UTI
Pylonephritis
Testicular Torsion

Question 6

Metabolic Causes

Answer 6

DKA
Addisonian Crisis
Hypercalcaemia
Porphyria

Question 7

Gynae Causes

Answer 7

Ectopic Pregnancy
Ruptured Ovarian Cyst
Ovarian torsion

Question 8

Other

Answer 8

Peritonitis

Sickle Cell Crisis

Question 9

Bedside

Answer 9

Urine dip: blood, infection
Pregnancy test

ABG: DKA, pancreatitis

Question 10

Bloods

Answer 10

FBC (low Hb, bleed, WCC)
UE (renal tract)
CRP (IBD, infection, inflammation
LFTs (deranged in hepatitis, high ALP in cholecystitis)
amylase (pancreatitis)

Also: clotting, G&S/crossmatch if bleeding, glucose
as part of acute abdo work up

Question 11

Imaging

Answer 11

Erect CXR (perforation)
AXR - bowel obstruction
USS- gall bladder, gynae pathology, pyelonephritis, AAA rupture
MRCP - gall stones

Question 12

Special Tests

Answer 12

Endoscopy (GI bleed, malignancy)

ERCP (mx gallstones)

Question 13

RED FLAGS

Answer 13

Peritonitis
Shock (high HR, low Hb - volume loss and bleeding)
Torsion
Back pain in elderly person with CVD risk (?AAA)

Question 14

Social Hx

Answer 14

Alcohol
Smoking
Food/travel/vaccinations

Question 15

Systems R/v

Answer 15

• Urinary (polyuria, oliguria) colour?
• Last Menstrual Period, PV bleed
• Jaundice, itching
• Constipation (obstruction)
• Diarrhoea (IBD flare, GE)

Question 16

Drug Hx

Answer 16

NSAIDs, steroids
Insulin compliance (DKA)