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Oxford cases in medicine and surgery > Epigastric pain > Flashcards

Epigastric pain Flashcards

1
Q

What is the most likely cause of epigastric pain that radiates to the back?

A

Pancreatitis

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2
Q

What is the most likely cause of epigastric pain that radiates to the shoulder tip?

A

Anything with diaphragmatic involvement

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3
Q

What is the most likely cause of epigastric pain that radiates to the jaw/ neck/arm?

A

Cardiac

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4
Q

What is the most likely cause of epigastric pain that radiates retrosternally?

A

Oesophagitis

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5
Q

What is the most likely cause of epigastric pain that is exacerbated by deep breathing?

A

Basal pneumonia

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6
Q

Which cause of epigastric pain is most likely to produce severe vomiting?

A

Pancreatitis

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7
Q

Which type of MI can cause vomiting and why?

A

Inferior - irritation of diaphragm

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8
Q

What is Boerhaave’s perforation?

A

Spontaneous perforation of the oesophagus

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9
Q

Recall 1 difference and 1 similarity between Boerhaave’s perforation and a Mallory Weiss tear

A

Similarity: both brought on by vomiting
Difference: Boerhaave’s is transmural, Mallory-Weiss tears are not transmural

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10
Q

Describe the appearance of stool in CBD obstruction

A

Pale (as bile not reaching bowel)

Floaty and foul-smelling (due to poor fat digestion)

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11
Q

Recall 4 drugs that predispose to peptic ulcer disease

A

NSAIDs
Salicylates
Bisphosphonates
Steroids

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12
Q

In which abdominal pathology is movement especially painful?

A

Peritonitis

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13
Q

How can acute pancreatitis lead to jaundice?

A

Oedema of head of pancreas compresses CBD

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14
Q

In which condition do patients develop “board-like rigidity”?

A

Peritonitis

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15
Q

What blood tests should be ordered in acute pancreatitis and why?

A 
FBC (WCC raised?) 
U&E (baseline for resuscitation)
LFT (origin of pathology?) 
Amylase (diagnostic for pancreatitis) 
Calcium (prognostic for pancreatitis)
Albumin (prognostic for pancreatitis) 
Glucose (hyperglycaemia = more severe) 
ABG (ARDS is a complication of pancreatitis) 
Troponin (just in case of MI)
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16
Q

Recall the mnemonic for and the components of the modified Glasgow scale

A 
PANCREAS
PaO2
Age
Neutrophilia
Calcium
Renal function (high urea)
Enzymes (high LDH) 
Albumin 
Sugar

Oxford cases in medicine and surgery (1 decks)

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