Clinical Dx - abdominal pain Flashcards
Blumberg test
- sudden release of deep abdominal pressure causes pain
- generalized peritonitis
Closed eyes sign
- pts (often F), eyes closed prior to abdominal region palpation = small chance of intra-abdominal pathology
Kehr’s sign
- left shoulder pain and abdominal pain
- spleenic rupture
Murphy’s sign
Abrupt cessation of inspiration with the thumb under the tip of rib 9 in RUQ
- cholecystitis
Murphy’s punch
tenderness on percussion of the CVA
- pyelonephritis
Obturator internus
right iliac fossa pain on internal rotation of right hip
- appendicitis
prehn’s sign
elevation of scrotum reduces scrotal pain
- epididymo-jorchitis
Psoas sign
right iliac fossa pain on hyperextension of right hip
- appendicitis
Puddle sign
- pts hand and knees, listen near umbilicus (stethoscope) and flick abdomen on the side (at different levels on the side). Sound becomes louder at a particular level fluid is present
- ascites
Rogoff’s sign
- pain on deep palpation over 12th rib
- adrenal inflammation
Rovsing’s sign
- right iliac fossa pain on pressure in the left iliac fossa
- appendicitis
alcholo, epigastric pain (relieved with bending forward)
acute pancreatitis
fever, umbilical pain radiating to the RLQ
appendicitis
recurrent abdominal cramps, diarrhea, flushing and wheezing
carcinoid syndrome
recurrent diarrhea with steatorrhea (foul smelling greasy stools)
celiac disease
RUQ pain, fat intolerance, right scapular pain, +murphy’s sign
cholecystitis
recurrent mucous diarrhea, right iliac fossa tenderness
crohn’s disease
left iliac pain, older person, blood in stool
diverticulitis
dysmenorrhea, infertility, no vaginal discharge
endometriosis
dyspepsia made worse with eating spicy foods
gastric ulcer
fever, abdominal rigidity, absent bowel sounds. + blumber
generalized peritonitis
nausea, jaundice, RUQ tenderness
hepatitis
distended abdomen, increased high-pitched bowel sonds
intestinal obstruction
pain relieved by defication, recurrent diarrhea
IRRITABLE BOWEL SYNDROME
Loin to groin colic with hematuria
kidney stones
old patient, abdominal pain and shock
mesenteric vascular occlusion
dysmenorrhea, purulent vaginal discharge, lower abdominal pain
pelvic inflammatory disease
fever, cough, rust-colored or currant jelly sputum
pneumonia
female with positive closed eyes sign
psychogenic abdominal pain
recurrent bloody diarrhea, LLQ tenderness
ulcerative colitis
