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Abdominal Pain > Differential Diagnosis (LOs 12 + 14) > Flashcards

Differential Diagnosis (LOs 12 + 14) Flashcards

- LO 12 - Form a differential diagnosis of abdominal pain - LO 14 - Recognise key features of abdominal pain, and about how appendicitis is diagnosed and managed.

1
Q

1) Define gastritis.
2) State common symptoms.
3) State 3 common causes.
4) State one common complication

A

1) Inflammation of the lining of the stomach after its has been damaged/ or just inflammation if acute.
2) Indigestion, gwaning/burning epigastic pain, nausea and vomitting
3) Helicobacter Pylori bacteria, NSAIDS
4) Peptic ulcer

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2
Q

A) Name common causes of bowel obstruction.

B) Name common symptoms.

A

A) Adhesions after surgery, Crohn’s disease (inflamed intestine), diverticulitis, hernias, colon cancer
B) Colicky pain, Constipation, loss of appetite, vomiting, distention

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3
Q

Pain the right iliac fossa?

A
  • Appendicitis
  • Ureteric obstruction
  • IBD (Crohn’s Disease likely here at the terminal ileum/ ileocecal junction)
  • Strangulated Hernia/ Inguinal Hernia
  • Gynecological problems (ovarian torsion/ectopic pregnancy/
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4
Q

Pain in the periumbilical area?

A
  • Appendicitis
  • Small bowel obstruction
  • Large bowel obstruction
  • Abdominal Aortic Aneurysm
  • DKA (ask if patient is diabetic)
  • Acute mesenteric ischemia
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5
Q

Pain the epigastric area?

A
  • Gastritis / Gastric Ulcer (usually comes after gastritis) / Gastric Perforation
  • Perforated Oesophagus
  • Inferior Myocardial infarction
  • Indigestion/Dyspepsia (Reflux-like or ulcer-like)
  • Pancreatitis (More likely be in the LH too)
  • Cholecystitis (More likely in the RH too)
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6
Q

What would cause poorly localised generalised pain indicated in the abdomen? Give some clinical signs that would cause such pain.

A
  • It would indicate that the pain involves the visceral peritoneum, rather than the parietal.
  • Distention (of the internal organs),
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7
Q

What are some associated symptoms of visceral pain that can be present in some situations?

A
  • Vomitting
  • Sweating
  • Tachycardia
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8
Q

Why is parietal pain localised?

A

The peritoneum is innervated by the abdominal wall nerves which are linked to the dermatomes - one nerve for each dermatome.

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9
Q

Pain in the right hypochondrium?

A
  • Cholelithiasis (stones in the gallbladder hanging out may cause some pain)
  • Biliary Colic (pain radiates to the below right scapula)
  • Acute Cholecystitis
  • Cholangitis (inflammation of the bilary tree - stone or infected bile the ampulla of vater)
  • Hepatitis
  • RLL Pneumonia
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10
Q

Pain in the right lumbar region?

A
  • Pyelonephritis (kidney infection - usually secondary to UTI that starts in the hypogastric area)
  • Ureteric Obstruction (Renal Colic - radiates from loin to the testicle
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11
Q

Pain in the left hypochondrium?

A
  • Pancreatitis (Radiates to the back)
  • Gastritis
  • Splenic infarction or splenic artery aneurysm
  • LLL Pneumonia
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12
Q

Pain in the left iliac fossa?

A
  • Diverticulitis
  • IBD
  • Sigmoid Volvulus
  • Inguinal Hernia/Strangulated Hernia
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13
Q

Pain in the left lumbar region?

A
  • Pyelonephritis

- Ureteric Obstruction

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14
Q

Pain in the left iliac fossa?

A
  • Diverticulitis
  • IBD
  • Sigmoid Volvulus
  • Inguinal Hernia/Strangulated Hernia
  • Gynaecological problems
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15
Q

Pain in the suprapubic/hypogastric area?

A
  • UTI - VERY COMMON (leads to kidney infection sometimes, so may go to the left or light lumbar region)
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16
Q

State common symptoms and presentations of appendicitis.

A
  • Periumbilical pain that moves to the right iliac fossa
  • Nausea and vomiting
  • Fever
  • Tenderness
  • Guarding of the right iliac fossa
  • palpable mass in the right iliac fossa
    (Ask if they had it out before)
17
Q

Name one complication of appendicitis.

A

Peritonitis (appendix rupture leading to the infection of the peritoneum)

18
Q

Peritonitis is an infection of the peritoneum. Name some clinical signs.

A
  • The patient will avoid movement as there is rubbing and therefore it hurts
  • there will be sound on auscultation due to the rubbing and sticky nature of the infection due to the pus from neutrophils

(rubbing is from exudate and inflammation)

19
Q

Name 2 characteristics of acute inflammation.

A
  • Production of Exudate + neutrophils (when you do a FBC)

- Vasodilation (swelling)

20
Q

One cause of the sudden onset of pain is perforation which is a dangerous condition that requires immediate medical attention. State some causes of perforation in the GI tract.

A
  • Perforated peptic ulcer perofration
  • Diverticular disease
  • Bowel cancer
  • Obstructive Ischaemia
  • Inflammatory Bowel Disease
21
Q

List Charcots Triad.

A
  • RUQ Pain
  • Obstructive Jaundice
  • Fever +/- rigors

Abdominal Pain (1 decks)

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