Clinical Dx - abdominal pain

Question 1

Blumberg test

Answer 1

• sudden release of deep abdominal pressure causes pain

- generalized peritonitis

Question 2

Closed eyes sign

Answer 2

• pts (often F), eyes closed prior to abdominal region palpation = small chance of intra-abdominal pathology

Question 3

Kehr’s sign

Answer 3

• left shoulder pain and abdominal pain

- spleenic rupture

Question 4

Murphy’s sign

Answer 4

Abrupt cessation of inspiration with the thumb under the tip of rib 9 in RUQ
- cholecystitis

Question 5

Murphy’s punch

Answer 5

tenderness on percussion of the CVA

- pyelonephritis

Question 6

Obturator internus

Answer 6

right iliac fossa pain on internal rotation of right hip

- appendicitis

Question 7

prehn’s sign

Answer 7

elevation of scrotum reduces scrotal pain

- epididymo-jorchitis

Question 8

Psoas sign

Answer 8

right iliac fossa pain on hyperextension of right hip

- appendicitis

Question 9

Puddle sign

Answer 9

• 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

Question 10

Rogoff’s sign

Answer 10

• pain on deep palpation over 12th rib

- adrenal inflammation

Question 11

Rovsing’s sign

Answer 11

• right iliac fossa pain on pressure in the left iliac fossa

- appendicitis

Question 12

alcholo, epigastric pain (relieved with bending forward)

Answer 12

acute pancreatitis

Question 13

fever, umbilical pain radiating to the RLQ

Answer 13

appendicitis

Question 14

recurrent abdominal cramps, diarrhea, flushing and wheezing

Answer 14

carcinoid syndrome

Question 15

recurrent diarrhea with steatorrhea (foul smelling greasy stools)

Answer 15

celiac disease

Question 16

RUQ pain, fat intolerance, right scapular pain, +murphy’s sign

Answer 16

cholecystitis

Question 17

recurrent mucous diarrhea, right iliac fossa tenderness

Answer 17

crohn’s disease

Question 18

left iliac pain, older person, blood in stool

Answer 18

diverticulitis

Question 19

dysmenorrhea, infertility, no vaginal discharge

Answer 19

endometriosis

Question 20

dyspepsia made worse with eating spicy foods

Answer 20

gastric ulcer

Question 21

fever, abdominal rigidity, absent bowel sounds. + blumber

Answer 21

generalized peritonitis

Question 22

nausea, jaundice, RUQ tenderness

Answer 22

hepatitis

Question 23

distended abdomen, increased high-pitched bowel sonds

Answer 23

intestinal obstruction

Question 24

pain relieved by defication, recurrent diarrhea

Answer 24

IRRITABLE BOWEL SYNDROME

Question 25

Loin to groin colic with hematuria

Answer 25

kidney stones

Question 26

old patient, abdominal pain and shock

Answer 26

mesenteric vascular occlusion

Question 27

dysmenorrhea, purulent vaginal discharge, lower abdominal pain

Answer 27

pelvic inflammatory disease

Question 28

fever, cough, rust-colored or currant jelly sputum

Answer 28

pneumonia

Question 29

female with positive closed eyes sign

Answer 29

psychogenic abdominal pain

Question 30

recurrent bloody diarrhea, LLQ tenderness

Answer 30

ulcerative colitis