Approach to Abdominal Pain

Question 1

LLQ associated pain

Answer 1

Diverticular disease, ectopic pregnancy, ovarian cyst and torsion, endometriosis, IBS, PID

Question 2

RLQ associated pain

Answer 2

appendicitis, diverticular disease, IBS, IBD, ectopic pregnancy, ovarian cyst and torsion, PID

Question 3

RUQ associated pain

Answer 3

acute cholecystitis, biliary colic, acute hepatitis, duodenal ulcer, right lower lobe pneumonia, myocardial infarction

Question 4

LUQ associated pain

Answer 4

gastritis, pancreatitis, GERD, splenic pathology, left lower lobe pneumonia, myocardial infarction

Question 5

Periumbilical pain

Answer 5

appendicitis, gastritis, GERD, AAA, pancreatitis

Question 6

Ectopic pregnancy signs

Answer 6

irregular bleeding/spotting/amenorrhea, adnexal pelvic pain, Kehr’s sign

Question 7

Myocardial infarction signs

Answer 7

often mimics GERD or other benign conditions, such as typical stomach pain and presents atypically in women

Question 8

Irritable Bowel Syndrome symptoms

Answer 8

pain/cramps relieved with bowel movement, chronic constipation, chronic diarrhea, change in stool appearance

Question 9

Treatment for ectopic pregnancy

Answer 9

surgery or methotrexate

Question 10

Treatment for IBS

Answer 10

anti-spasmodics, anti-diarrheals, anti-constipation, SSRI, reassurance

Question 11

signs of appendicitis

Answer 11

Psoas and obturator signs, Rovsing’s, Markle signs, McBurney’s sign, cutaneous hyperesthesia, periumbilical pain, nausea, vomiting, anorexia, obstipation, fever

Question 12

symptoms of cystitis

Answer 12

suprapubic pain, dysuria, hematuria, fever

Question 13

treatment for cystitis

Answer 13

antibiotics and fluids

Question 14

symptoms of pyelonephritis

Answer 14

CVA tenderness, fever, hematuria

Question 15

treatment for pyelonephritis

Answer 15

antibiotics

Question 16

symptoms of renal calculi

Answer 16

flank pain, hematuria, CVA tenderness

Question 17

hepatitis symptoms

Answer 17

nausea, vomiting, anorexia, malaise, fever, jaundice

Question 18

hepatitis causes

Answer 18

virus, alcohol, drugs, autoimmune, toxins

Question 19

hepatitis physical exam findings

Answer 19

liver tenderness, hepatomegaly, and caput medusa

Question 20

hepatitis treatment

Answer 20

remove the offending agent, treat viral types, paracentesis

Question 21

Crohn’s symptoms

Answer 21

bouts of fever, RLQ pain, diarrhea

Question 22

Crohn’s treatments

Answer 22

diet, 5-ASA, steroids, anti-TNF drugs

Question 23

Ulcerative colitis symptoms

Answer 23

bloody diarrhea and fecal urgency

Question 24

Ulcerative colitis treatments

Answer 24

5-ASA, steroids, surgery

Question 25

What psychosocial issues can present with abdominal complaints

Answer 25

Depression, anxiety, somatization disorders, malingering, drug seeking

Question 26

how to differentiate between the two types of ulcers

Answer 26

gastric ulcers are usually worse with food intake

duodenal ulcers are usually relieved by eating

Question 27

symptoms of gastritis

Answer 27

nausea, vomiting, cramping, fever

Question 28

causes of gastritis

Answer 28

GI irritants, infection, stress

Question 29

treatment of gastritis

Answer 29

clear fluids for 24 - 48 hours then BRAT

Question 30

causes of pancreatitis

Answer 30

alcohol abuse and large fatty meals

Question 31

signs of pancreatitis

Answer 31

Cullen’s sign, Grey Turner’s sign, tender LUQ, nausea, vomiting, fever, chills

Question 32

treatment for pancreatitis

Answer 32

IV fluids and nothing by mouth

Question 33

Foods that exacerbate GERD

Answer 33

alcohol, chocolate, tobacco, caffeine, mint, tomato sauce/salsa

Question 34

treatment for GERD

Answer 34

H2 blockers, PPIs, diet changes, weight loss, Nissen fundoplication