approach Flashcards
pain in small bowel obstruction
umbilical or supraumbilical
pain in large bowel obstruction
infraumbilical
pain radiation in colonic obstruction
lumbar
sudden distension of billiary tree produces what type of pain
steady
colicky pain is a misnomer
pain in acute distension of gall bladder
pain in right hypochondrium radiating to tip of right scapula
pain in distension of common bile duct
epigastric region with radiation to lumbar region
pain of pancreatic duct distension
aggravated by supine position
relived by upright posture
urinary tract obstruction and pain
urinary bladder- dull suprapubic pain
ureterovesicle junction- severe supra pubic and flank pain radiating to scrotum,penis and medial thigh
ureteropelvic jn- costovertebral pain
rest of ureter- flank pain that extends to same side of abdomen
pain due to diaphragmatic pleuritis
RUQ radiating to supraclavicular area
Intrathoracic diseases causing abdominal pain
esophageal disease MI pericarditis pneumonia pulmonary infarction
differences btw pain reffered to abdomen and abdominal pain
pain referred to abdomen:
abdominal muscle spasm relieved during inspiration
pain not aggravated or relived by palpation
splinting of involved hemithorax
decreased repiratory excursion on involved side
cause of abdominal pain in lead poisoning and porphyria
hyperperistalsis
causes of elevated amylase
pancreatitis
strangulated intestinal obstruction
acute cholecystitis
intestinal perforation
which is more specific? lipase or amylase
lipase
Solid food dysphagia occurs when the esophageal lumen is less than
13mm
Most common structural causes of esophageal dysphagia
schatzki rings
peptic strictures
eosinophilic esophagitis
disorder in scleroderma
absent peristalsis and relaxation of LES
Investigation for diagnosing gastroparesis
gastric scintigraphy
Drugs causing GERD
nitrates
CCB
theophylline
progesterone
Hy’s law
DILI
ALT> 3ULN
elevated TB 2ULN
normal ALP
