Autonomics and Pain Clinical Stuff

Question 1

What are causes of right hypochondriac pain?

Answer 1

gallstones, cholangitis, hepatitis, liver abscess

Question 2

What are causes of epigastric pain?

Answer 2

esophagitis, peptic ulcer, perforated ulcer, pancreatitis

Question 3

What are causes of left hypochondriac pain?

Answer 3

spleen abscess, acute splenomegaly, spleen rupture

Question 4

What are causes of right flank/lumbar pain?

Answer 4

ureteric colic, pyelonephritis

Question 5

What are causes of umbilical pain?

Answer 5

appendicitis (early), mesenteric adenitis, Meckel’s diverticulitis, lymphomas

Question 6

What are causes of left flank/lumbar pain?

Answer 6

ureteric colic, pyelonephritis

Question 7

What are causes of right inguinal pain?

Answer 7

appendicitis (late), Chron’s, cecum obstruction, ovarian cyst, ectopic pregnancy, hernias

Question 8

What are causes of hypogastric or pubic pain?

Answer 8

testicular torsion, urinary retention, cystitis, placental abruption

Question 9

What are causes of left inguinal pain?

Answer 9

diverticulitis, ulcerative colitis, constipation, ovarian cyst, hernias

Question 10

What structures case retroperitoneal pain? Where does the pain go to?

Answer 10

Pancreas, kidney, and aorta

Back

Question 11

What is colicky pain? What can cause it?

Answer 11

intermittent cramp like caused by obstruction of hollow muscular viscus

bowel obstructions from adhesions, stone in ureter, stone in neck of gall bladder

Question 12

How would a patient present with a gastric ulcer?

Answer 12

foregut visceral pain, worse on eating, pt tend to avoid meals

Question 13

How would a patient present with a perforated gastric ulcer?

Answer 13

foregut chronic visceral pain, sudden severe pain spreading all over abdomen, peritonitis

Question 14

How would a patient present with acute cholecystitis?

Answer 14

foregut visceral pain, somatic pain in RUQ, referred pain to right shoulder, nausea and vomiting, fever, tender RUQ, positive murphy

Question 15

How would a patient present with acute appendicitis?

Answer 15

midgut visceral pain, somatic pain in RLQ, nausea and vomiting, fever, tender RLQ, if appendix ruptured then signs of localized peritonitis in RLQ

Question 16

How would a patient present with adhesive small bowel obstruction?

Answer 16

history of previous abdominal surgery, midgut visceral colicky pain, vomiting, not flatus or bowel action, possible dehydration, distended soft abdomen non-tender, increased bowel sounds

Question 17

How would a patient present with passage of a kidney stone?

Answer 17

sudden onset of very severe colicky pain from loin to groin, patient writhing with pain and pacing, possible hematuria, afebrile, soft abdomen, tender renal angle

Question 18

How would a patient present with obstructing cancer of descending colon?

Answer 18

older age, weight loss, hindgut visceral colicky pain, no flatus or feces, distended abdomen, possible mass to feel in LLQ, increased bowel sounds

Question 19

How would a patient present with ruptured ectopic pregnancy?

Answer 19

woman of childbearing age, missed last period, sudden onset of severe pain in hypogastrium radiating to sacral area, afebrile, localized peritonitis in suprapubic, tenderness in rectouterine pouch on DRE or vag exam

Question 20

How would a patient present with leaking aortic aneurysm?

Answer 20

elderly male w/ history of atherosclerotic disease such as hypertension or cardiac disease
sudden onset of severe back pain
pale and shocked
hypotensive, tender epigastrium, palpable impulse from aneurysm in epigastrium