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GI > Abdominal Pain > Flashcards

Abdominal Pain Flashcards

1
Q

What is shifting pain?

A

Sore in one spot, then jumps into another: no longer sore in original place

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2
Q

What is spreading pain?

A

Starts in one place and gradually spreads into another

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3
Q

What is somatic pain?

A

Sore to touch

Localised

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4
Q

What is visceral pain?

A

Sore whether you press or not

Regional

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5
Q

Which organs are most likely to be affected in epigastric pain?

A

Stomach
Duodenum
Pancreas
Oesophagus

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6
Q

Where is stomach pain usually felt?

A

In the front

Epigastric

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7
Q

Where is pain form the pancreas and duodenum commonly felt?

A

Epigastric pain

In the front, but radiating to then back

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8
Q

What is the epigastrium the site of referred pain for?

A

MI
Pneumonia
Indigestion

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9
Q

Which organs are most likely to be affected by RUQ pain?

A

Liver

Gall bladder

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10
Q

Which organs are most likely to be affected by LUQ?

A

Spleen

Tail of pancreas

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11
Q

What is the RUQ the site of referred pain for?

A

Right basal pneumonia

Right renal angle

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12
Q

Which organs are most likely to be affected by central pain?

A

Small bowel
Large bowel up to transverse colon
Starting point of acute appendicitis

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13
Q

Which organs are most likely to be affected by RIF pain?

A

Appendicitis
Ruptured ovarian cyst
Pelvic inflammatory disease

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14
Q

Which organs are most likely to be affected by LIF pain?

A

Diverticular disease
Acute diverticulitis
Ruptured ovarian cyst
Pelvic inflammatory disease

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15
Q

Which organs are most likely to be affected by suprapubic pain?

A

Bladder

Pelvic organs in females

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16
Q

What is the LUQ the site of referred pain for?

A

Left basal pneumonia

Left renal angle

17
Q

How do you differentiate between gastric and duodenal ulcer pain?

A 
Gastric = worse on eating 
Duodenal = improves on eating
18
Q

Where does liver pain commonly refer and why?

A

Left shoulder

Causes diaphragmatic irritation

19
Q

What is the differential for pain which is specifically related to movement?

A

MSK causes

20
Q

What is the cause of throbbing pain?

A

Inflammation

21
Q

What is the cause of colicky pain?

A

Obstruction

22
Q

What are the main categories for causes of pain?

A 
Inflammation 
Underlying malignancy 
Related to drugs 
Related to infection 
Iatrogenic (self or medical profession)
23
Q

How might a colicky pain present in a patient?

A

Patient moving around

24
Q

How might an inflammatory pain present in a patient?

A

Patient lying still (worse on movement)

25
Q

How might general peritonitis present in a patient?

A

Abdomen not moving with respiration

26
Q

What are you looking for when asking the patient to “take a deep breath in”?

A

Murphy’s sign

Gallbladder pain

27
Q

How do you check for peritonitis in a patient?

A 
“Puff up your tummy”
“Suck your tummy in”
“Give me a gentle cough”
“Give me a big cough”
Pain on percussion
28
Q

What is dull percussion a sign of?

A

Normal

Fluid

29
Q

What is tympanic percussion a sign of?

A

Gas

30
Q

When might listening to bowel sounds be important?

A

After bowel surgery

31
Q

What are bruits and what causes them?

A

Noise caused by turbulence

Heard well in abdominal aortic aneurysms

32
Q

What is the classic presentation of appendicitis?

A

1 - Pain, usually epigastric or umbilical and generalised
2 - Anorexia, nausea, or vomiting
3 - Tenderness somewhere in the abdomen or pelvis. Commonly localised at RIF.
4 - Fever
5 - Leucocytosis

33
Q

What is the classic presentation of a perforated appendix?

A

Generalised pain and guarding with peritonism

34
Q

What is the classic presentation of biliary colic?

A 
Gradual onset 
Colicky pain, comes and goes 
Worse on eating: dairy, spicy, fatty 
Nausea and anorexia 
Pain radiates to right back 
Some pain and irritation in right shoulder 
Tender in deep palpation 
Murphy's negative 
No temperature and normal bloods
35
Q

What is the classic presentation of acute cholecystitis?

A 
Same as biliary colic +
Murphy's positive 
High temperature 
Leukocytosis 
Localised peritonitis in RUQ
36
Q

What is the common presentation of diverticulitis?

A 
Sluggish bowels
Pain relieved by moving bowels/passing wind 
Localised severe pain in LIF on exam 
Temperature
High pulse rate
37
Q

What are the three presentations of abdominal pain that you must differentiate very quickly?

A

Ischaemic gut
Ruptured AAA
Acute pancreatitis

GI (24 decks)

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