pain and appendicitis :

Question 1

what are the 9 regions of the abdomen?

Answer 1

Question 2

what are the characteristics of GI pain?

Answer 2

• poorly located
• onset over hours
• onset over hours
• a dull kind of ache

Question 3

how to describe the features of abdominal pain?

Answer 3

SOCRATES

the site, onset, character, radiation, associated symptoms, timing, relieving factors , severity

Question 4

what are the areas that present with abdominal pain?

Answer 4

foregut - oesophagus, stomach, pancreas, liver, gallbladder and duodenum

midgut - duodenum to the mid-transverse colon

hind gut - transverse colon to the anal canal

Question 5

what is peritonitis?

eg. appendicitis

Answer 5

it is a sharp pain that is very severe

• it is localized initially but it becomes more generalized
• the pain is also much worse on movement

Question 6

what tendencies do patients with peritonitis tend to display?

Answer 6

they guard : involuntary contractions of abdominal muscles to protect the area

they rebound tenderness: – the application of pressure gives no pain but release and rebound gives pain.

Question 7

what is colicky pain?

Answer 7

this is pain that comes and goes due to the contractions of a hollow tube in an attempt to relieve the obstructions present

an example of where the pain is apparent is in kidney stones

Question 8

what might pancreatitis present with?

Answer 8

• presents with a very variable set of symptoms such as jaundice, low blood pressure
• the pain is normally localized to the epigastrium and radiates towards the neck
• nausea and vomiting are also common

jaundice may be present due to lack of removal of the bilirubin pigment

Question 9

how does diagnosis of abdominal pain happen?

Answer 9

• history
• examination
• tests

Question 10

what tests are carried out for pancreatitis?

Answer 10

• simple examinations - BP, pulse, urine dipstick
• blood tests - Full blood count,
• complex blood tests - Amylase, Lipase, Triglycerides
• simple imaging - xrays, Ultrasounds
• cross-sectional imaging - CT scan
• invasive tests - ERCP

Question 11

what are the causes of pancreatitis?

GET SMASHED

Answer 11

Gall stones

Ethanol

Trauma

Steroids

Mumps

Autoimmune

Scorpium venom

Hyperlipidaemia

ERCP

Drugs

Question 12

what are systemic complications of pancreatitis?

Answer 12

Hypovolaemia. LOW VOLUME ▪

Hypoxia. LOW OXYGEN ▪

Hypocalcaemia. LOW CALCIUM ▪

Hyperglycaemia. HIGH SUGAR ▪

DIC.

▪ Multiple organ failure.

Question 13

what are local complications of pancreatitis?

Answer 13

• pancreatic necrosis
• fluid collections
• splenic vein thrombosis
• chronic pancreatitis