Chronic Abdominal Pain

Question 1

How could you distinguish clinically between visceral and abdominal wall pain?

Answer 1

Elicit Carnett’s sign - positive sign indicates pain arising from the abdominal wall and not the viscera

Question 2

How do you test for Carnett’s sign?

Answer 2

Ask the patient to lie down and to raise their straight legs against resistance. If this increases the intensity of the pain felt then this is a positive result indicating that the pain originates from the abdominal wall

Question 3

What is mebeverine?

Answer 3

Anti-spasmodic

Question 4

Give 3 potential complications of C.Diff diarrhoea

Answer 4

1. Pseudomebranous colitis
2. Toxic megacolon
3. Colonic perforation

Question 5

Give 4 indications for carrying out a stool culture after 3 days hospitalisation as part of investigations for infective diarrhoea.

Answer 5

1. Age > 65yrs
2. Comorbidities
3. Neutropenia
4. HIV infection

Question 6

What are the 4R’s used in the treatment of NBS?

Answer 6

1. Recognition
2. Relationship
3. Replacement
4. Reduction