pain Flashcards
causes of painful lips, tongue or buccal mucosa
- deficiencies (iron, folate, vitamin B12, vitamin C)
- dermatological disorders
- chemotherapy
- ulcers
causes of mouth ulcers
IBD
gluten enteropathy
what is heartburn
hot, burning retrosternal discomfort which radiates upwards
likeliest cause of heartburn
GORD
what is reflux
sour taste in the mouth from regurgitating gastric acid
how can you differentiate heartburn from cardiac chest pain?
- burning quality
- upward radiation
- association with acid reflux
- occurence on long flat or bending forward
what is waterbrash
sudden appearance of fluid in the mouth due to reflex salivation as a result of GORD or rarely peptic ulcer disease
what is dyspepsia?
pain or discomfort centred in the upper abdomen
what is the classical symptom of peptic ulceration?
- worse on an empty stomach
- eased by eating
what is fat intolerance classical in?
common in all causes of dyspepsia including gallbladder disease
what is odynophagia?
pain on swallowing often precipitated by drinking hot liquids
what does odynophagia indicate?
active oesophageal ulceration from peptic oesophagitis or oesophageal candidiasis
what are the foregut structures and where is the pain from these structures localised?
- stomach, pancreas, liver and biliary system
- localised above the umbilicus
what are the midgut structures and where is the pain from these structures localised?
- small bowel and appendix
- central abdominal pain
what are the hindgut structures and where is the pain from these structures from?
- colon
- lower abdomen
where is the pain from unpaired structures localised?
midline and radiates to the back
where is the pain from paired structures?
radiates to the affected side
what does sudden onset of severe abdominal pain suggest?
hollow viscus perforation
ruptured AAA
mesenteric infarction
what does pain precipitated by constipation suggest?
colorectal cancer or diveritucular disease as the cause of perforation
what does pain precipitated by dyspepsia suggest?
peptic ulceration
what does abdo pain in someone with co-exitsting peripheral vascular disease, hypertension, or AF suggest?
AAA
mesenteric ischaemia
what does the development of circulatory pain following the onset of pain suggest?
intra-abdo sepsis or bleeding e.g. ruptured AAA
what symptoms does torsion of the testis or ovaries produce?
severe acute abdo pain and nausea
what kind of pain does inflammation produce?
constant pain exacerbated by movement or coughing
