Referred Pain

Question 1

Peptic ulcer of posterior wall of stomach or duodenum

Answer 1

Boring pain epigastric to mid-thoracic spine
Triggered or relieved by eating
Prolonged NSAIDs = cause

Question 2

Dissecting thoracic aneurysm

Answer 2

Chest and can radiate to the back if descending aorta is involved.

Sudden, unrelenting, unrelieved by position change.

Question 3

Myocardial ischemia

Answer 3

Anterior chest pain or heaviness
Occasional nausea
Sometimes radiating to the back

Question 4

Stable angina

Answer 4

Exertional

Relieved with rest

Question 5

Unstable angina

Answer 5

Random, unpredictable
Not related to activity
Risk factor for MI

Question 6

Cholecystitis

Answer 6

Right upper quadrant
Right infrascapular region
Often accompanied by: fever nausea and vomiting
1–2 hours after heavy meal
Murphy’s sign: palpate right sub costal region, deep breath. (+) = pain with inhalation

Question 7

Pancreatitis

Answer 7

Thoracolumbar junction

Question 8

Pyelonephritis (Kidney infection) and renal stones

Answer 8

Costovertebral angle
Flank area
Typically accompanied by: fever nausea vomiting and renal colic (flank pain, Lower abdominal pain into labia/testicles)
Risk factor: UTI-current or history

Question 9

Metastatic CA

Answer 9

PBKTL

Question 10

Gallbladder

Answer 10

Right upper abdominals
Right scapular region
Mid-lower thoracic spine

Question 11

Large intestine

Answer 11

Buttock
Middle L-spine
Lower abdomen
Symptoms in T11–L1 region

Question 12

Liver

Answer 12

T7 – T9 region
Similar to gallbladder
Right C-spine

Question 13

Stomach

Answer 13

Upper abdominal
Mid – lower thoracic spine
Generally T6-10

Question 14

Lower GI

Answer 14

Centralized LBP
Lower abdominal
Potentially lower thoracic
Fecal incontinence
Bloody diarrhea
Melena

Question 15

Upper thigh pain

Answer 15

Reproductive and urinary tract