Conditions

Question 1

Biliary stones / biliary colic

Answer 1

acute pain, sudden and intense pain, lasts minutes to hours, located behind the breastbone or upper right abdominal area, referred pain between shoulder blades, chills and fever, jaundice, nausea and vomiting, tenderness on palpation, jaundice, xanthelasma
normal vitals unless progressed to cholecystitis or cholangitis

Question 2

Cholecystitis

Answer 2

signs of peritoneal irritation, pain may radiate to right shoulder, pain begins in epigastric region and localises to the RUQ, pain initially colicky then constant, nausea, vomiting
vitals: potentially fever, tachycardia, hypotension (if progresses to septic shock)

Question 3

Acute pancreatitis

Answer 3

upper abdominal pain, abdominal px that radiates into the back, worse after eating, tenderness on palpation, vomiting, nausea

vitals: hypotension, tachycardia, fever

Question 4

Chronic pancreatitis

Answer 4

upper abdominal pain, unintentional weight loss, steatorrhea (oily, smelly stools)

Question 5

Liver cirrhosis

Answer 5

portal hypertension, ascites, fatigue, easily bleeding / bruising, loss of appetite, nausea, oedema in legs and feet, weight loss, itchy skin, jaundice, spider naevi, redness of palms, loss of periods, loss of sex drive, gynecomastia (men), testicular atrophy
vitals: raised and bounding pulse, hypotension

Question 6

Hepatic encephalopathy

Answer 6

confusion, drowsiness, slurred speech

Question 7

IBS - Irritable bowel syndrome

Answer 7

altered bowel habits (diarrhoea, constipation, after food urgency)
diffuse, LLQ Ian without radiation, occasionally sharp pain, pain improving with defecation, abdominal bloating / distention, dyspepsia, heartburn, nausea, vomit, sexual dysfunction, urinary urgency, worse in pre-menstrual period, comorbid fibromyalgia, stress related

Question 8

IBD - Irritable Bowel Disease

Answer 8

systemic symptoms: weight loss, fever, sweats, malaise, arthralgia
extraintestinal symptoms: arthritis, uveitis, liver disease
bloody stools, tenesmus (more w UC, less w CD)
perianal disease, esp. w CD: fistulas, abscesses
acute RLQ pain, fever, may mimic appendicitis or intestinal obstruction

Question 9

Gastric ulcers

Answer 9

burning abdominal px, indigestion, heartburn, nausea, malaise

Question 10

Crohn’s disease

Answer 10

abdominal pain, diarrhoea, rectal bleeding, weight loss, nausea, loss of appetite, malnutrition, vitamin deficiencies, fatigue, bone loss, psychological issues
growth failure in paediatric pts, may precede GI symptoms by years
may be complicated by intestinal fistulization or obstruction
unpredictable flares, and remissions
vitals: fever

Question 11

Tietze’s syndrome

Answer 11

insidious onset of anterior chest-wall pain, exacerbated my certain movements and deep inspiration
sharp, nagging, aching, pressure like, usually quite localised, may radiate extensively, may be severe