Common abdominal histories - Abdominal Pain Flashcards
What would you want to ask about abdominal pain?
SOCRATES
What would you want to ask about on systemic questioning in someone with Abdo pain?
- General - fever, sweats
- GI
- Urological
- Gynaecological
What would you want to ask about in systemic enquiry of the GI system in someone with abdo pain?
- N+V
- Dyspepsia
- Dysphagia
- Weight loss/appetite
- Bowel habits
- Bloating
- Haematemesis
- Tenesmus
- Blood/mucus in the stool
What would you want to ask about on systemic questioning of the GU system in relation to abdominal pain?
Storage and infection
- Frequency
- Dysuria
- Urgency
- Nocturia
- Haematuria
- Incontinence
- Odour
What would you ask on systemic enquiry of the gynae system in relation to abdo pain?
4 Ps
- PV bleeding - menorrhagia, post-coital, post menopausal, intermenstrual
- PV discharge
- Pain - pelvic, dysmenorrhoea, dysparunia
- Pregnancy
What features of abdominal pain would suggest appendicitis as a cause?
- Young patient
- Periumbilical pain
- Moves to RIF
- Anorexia
What features of abdominal pain would suggest Biliary colic as a cause?
- Intermittent severe RUQ/epigastric pain
- Exacerbated by fatty foods - after 30-60 mins
What features of abdominal pain would indicate cholecystitis as the cause?
Continuous RUQ/epigastric pain
What features of abdominal pain would suggest CBD stone as a cause?
- Jaundice
- RUQ pain
What features of abdominal pain would suggest CHolangitis as a cause?
Charcot’s triad
- RUQ Pain
- Fever/Rigors
- Jaundice
Reynold’s Pentad - charcot’s, Plus:
- Shock
- Altered mental status
What features of abdominal pain would suggest pancreatitis as the cause?
- Epigastric/central pain - severe
- Radiating to back
- Relieved by sitting forward
- VOmiting
- Generally unwell looking
What features of abdominal pain suggest gastritis/peptic ulcer as a cause?
- EPigastric pain related to meals
- Risk factors - NSAIDs, alcohol, spicy food
What features associated with abdominal pain would suggest diverticulitis?
- Elderly
- LIF pain
- Pyrexia
What features of abdominal pain suggest bowel obstruction as a cause?
- Vomiting + abdo distention + obstipation/constipation
- Colicky pain
What featues of abdominal pain would suggest renal colic as the cause?
- Spasms of loin to groin pain (excruciating)
- Nausea and vomting
- Cannot lie still
