icr: abd pain

Question 1

ulcerative colitis

Answer 1

diarrhea, rectal bleeding, crampy abd pain

begins at rectum and works up; crypt distortion

Question 2

ulcerative colitis

Answer 2

diarrhea, rectal bleeding, crampy abd pain

begins at rectum and works up; crypt distortion

Question 3

crohns disease

Answer 3

diarrhea, and crampy pain relieved with defacation
RLQ tenderness, palpable mass, fever
ulceration, rectal sparing, and skip lesions

Question 4

PUD

Answer 4

burning epigastric pain, pain with food/weightloss (gastric) or after food/relieved by antacids (duodenal);
break in mucosa

Question 5

pancreatitis

Answer 5

caused by gallstones (increased bilirubin, AST or ALT), alcohol, drugs,
boring pain that RADIATES TO BACK
elevated amylase and lipase

Question 6

cholecystitis

Answer 6

cholesterol stones or pigmented
severe RUQ pain precipitated by a large fatty meal
murphys sign
increased WBC, stones

Question 7

appendicitis

Answer 7

anorexia, pain that moves to RLQ, fever
obturator sign and psoas sign
WBC>20k = perforation
enlarged thickened appendix

Question 8

viral gastroenteritis

Answer 8

crampy adb pain, stool without blood, WBC normal, nausea/diarrhea

Question 9

acute intestinal obstruction

Answer 9

due to surgery, hernia, cancer, volvulus, intussusseption
pain, vomiting, constipation
abd distentsion, rigidity, shock
air fluid levels on CT

Question 10

acute intestinal ischemia

Answer 10

due to arterial occlusion or veno occlusion
severe unrelenting acute pain, risk for thrombus or emboli
thumbprinting on plain film (bowel edema)

Question 11

pelvic inflammation disease

Answer 11

infx spreads from vagina to endometrium; pain for less than three weeks
cervix with yellow discharge — positive chlamydia

Question 12

IBS

Answer 12

altered bowel habits and abd pain without structural abnormalities
chronic pain
normal labs — atleast 3 days/mo for 3 months for ddx with atleast 2 of:
improvement with defacation
change in stool freq
change in stool appearrance

Question 13

parietal pain

Answer 13

direct stimulation of peritoneum
intense and precisely located
appendicitis

Question 14

visceral pain

Answer 14

inflammation of hollow organ
cant be localized, dull, noxious
lithiasis and PUD

Question 15

crohns disease

Answer 15

diarrhea, and crampy pain relieved with defacation
RLQ tenderness, palpable mass, fever
ulceration, rectal sparing, and skip lesions

Question 16

PUD

Answer 16

burning epigastric pain, pain with food/weightloss (gastric) or after food/relieved by antacids (duodenal);
break in mucosa

Question 17

pancreatitis

Answer 17

caused by gallstones (increased bilirubin, AST or ALT), alcohol, drugs,
boring pain that RADIATES TO BACK
elevated amylase and lipase

Question 18

cholecystitis

Answer 18

cholesterol stones or pigmented
severe RUQ pain precipitated by a large fatty meal
murphys sign
increased WBC, stones

Question 19

appendicitis

Answer 19

anorexia, pain that moves to RLQ, fever
obturator sign and psoas sign
WBC>20k = perforation
enlarged thickened appendix

Question 20

viral gastroenteritis

Answer 20

crampy adb pain, stool without blood, WBC normal, nausea/diarrhea

Question 21

acute intestinal obstruction

Answer 21

due to surgery, hernia, cancer, volvulus, intussusseption
pain, vomiting, constipation
abd distentsion, rigidity, shock
air fluid levels on CT

Question 22

acute intestinal ischemia

Answer 22

due to arterial occlusion or veno occlusion
severe unrelenting acute pain, risk for thrombus or emboli
thumbprinting on plain film (bowel edema)

Question 23

pelvic inflammatory disease

Answer 23

infx spreads from vagina to endometrium; pain for less than three weeks
cervix with yellow discharge — positive chlamydia

Question 24

IBS

Answer 24

altered bowel habits and abd pain without structural abnormalities
chronic pain
normal labs — atleast 3 days/mo for 3 months for ddx with atleast 2 of:
improvement with defacation
change in stool freq
change in stool appearrance

Question 25

parietal pain

Answer 25

direct stimulation of peritoneum
intense and precisely located
appendicitis

Question 26

visceral pain

Answer 26

inflammation of hollow organ
cant be localized, dull, noxious
lithiasis and PUD