Group Teaching - Abdominal Pain

Question 1

When taking a history from a patient presenting with abdominal pain, what 8 salient points about the pain will help you make the correct diagnosis?

Answer 1

• Site
• Onset
• Character
• Radiation
• Associated symptoms
• Time
• Exacerbating / Relieving factors
• Scale / Severity

Question 2

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the right hypogondriac region?

Answer 2

Gallbladder

Question 3

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the epigastric region?

Answer 3

• Stomach
• Duodenum
• Pancreas

Question 4

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the left hypogondriac region?

Answer 4

Pancreas

Question 5

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the right lumbar region?

Answer 5

Kidney

Question 6

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the umbilical region?

Answer 6

• Small bowel
• Caecum
• Retroperitoneal structures

Question 7

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the left lumbar?

Answer 7

Kidney

Question 8

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the right iliac region?

Answer 8

• Appendix
• Caecum

Question 9

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the hypogostric region?

Answer 9

• Colon
• Bladder
• Uterus & Adnexae

Question 10

The diagram below shows the surface anatomy of the abdominopelvic regions. Which intra-abdominal organs produce pain in the left iliac region?

Answer 10

Sigmoid colon

Question 11

Where does pain from the gallbladder radiate?

Answer 11

Through to the back & the right

Question 12

Where does pain from the stomach, duodenum & pancreas radiate?

Answer 12

Straight through to the back

Question 13

Where does pain from the pancreas radiate?

Answer 13

Through to the back & the left

Question 14

Where does pain from kidney radiate?

Answer 14

In loin & radiates to groin

Question 15

Where does pain from small bowel, caecum and retroperitoneal structures radiate?

Answer 15

Doesn’t normally radiate

Question 16

Where does pain from the lower three zones radiate?

Answer 16

Lower abdominal pain rarely radiates

Question 17

What is the character of pain from the bladder?

Answer 17

Colicky

Question 18

What is the character of pain from the liver?

Answer 18

Constant

Question 19

What is the character of pain from the gallbladder / pancreas?

Answer 19

Colicky

Question 20

What is the character of pain from the spleen?

Answer 20

Constant

Question 21

What is the character of pain from the kidney?

Answer 21

Constant

Question 22

What is the character of pain from the bowels?

Answer 22

Colicky

Question 23

Diagnose:
* S Central then shifts to right iliac region
* O Gradual onset
* C Constant
* R No radiation
* A Nausea, anorexia, fever
* T No previous pain
* E Worse on movement
* S Dull ache

Answer 23

Appendicitis

Question 24

Diagnose:
* S Central
* O Gradual onset
* C Colicky
* R None
* A Vomiting, bowels not open
* T Previous colicky pain
* E Passing flatus relieves pain
* S Moderate

Answer 24

Bowel Obstruction

Question 25

Diagnose:
* S Loin
* O Sudden onset
* C Colicky
* R To groin
* A Vomiting
* T Previous colicky pain
* E Cannot find a comfortable position
* S Severe – 10/10

Answer 25

Ureteric Colic

Question 26

Diagnose:
* S Right upper quadrant
* O Sudden onset
* C Colicky
* R Right shoulder
* A Nausea, indigestion
* T After eating
* E Fatty foods
* S Can be 10/10

Answer 26

Biliary Colic