Gastrointestinal

Question 1

Biliary colic

Answer 1

RUQ pain - waxes and wanes
(ingestion of fatty meal prior to pain)
Colicky -> restless with rapid escalation pain
bending/moving to find position of comfort
pain lasts less than 6 hrs

Question 2

Cholecystitis/cholangitis

Answer 2

RUQ pain
(ingestion of fatty meal prior to pain)
radiation around right side to the back/right shoulder tip
pain lasts >24 hrs
constant pain - aggravated by movement (inflammation)
jaundice -> dark urine, pale stools, scleral icterus, pruritus
cholangitis - charcot’s triad and reynolds pentad
pain, fever/chills, jaundice + confusion and shock/hypotension
murphy’s sign - positive in cholecystitis -> tenderness and insp arrest upon palpation of costal margin along midclavicular line

Question 3

Hepatitis

Answer 3

constant pain, aggravated by movement (inflammation)
med history, travel, social hx (alcohol and rec drug use)

Question 4

pneumonia

Answer 4

diaphragmatic irritation from lower lobe pneumonia - may cause RUQ or LUQ pain
SOB, productive cough

Pleuritic and sharp/knife life