Abdo pain

Question 1

What are the features of a duodenal ulcer?

Answer 1

Epigastric pain relieved by eating
Upper GI bleeding
Common

Question 2

What is the management of a duodenal ulcer?

Answer 2

H. pylori eradication therapy if appropriate
PPI
Bleeding= endoscopic intervention

Question 3

What are the features of a gastric ulcer?

Answer 3

Epigastric pain worsened by eating

Upper GI bleeding

Question 4

What is the management of a gastric ulcer?

Answer 4

H. pylori eradication therapy if appropriate
PPI
Bleeding= endoscopic intervention

Question 5

What are the features of appendicitis?

Answer 5

Generalised abode pain then localising to McBurney’s point
Rovsing sign +
Anorexia, tachycardia, fever

Question 6

What is the management of appendicitis?

Answer 6

Appendicectomy

Question 7

What are the features of acute pancreatitis?

Answer 7

Severe epigastric pain, radiating to back
Vomiting, anorexia, pyrexia
History of alcohol

Question 8

What is the management of acute pancreatitis?

Answer 8

Supportive

Treat cause

Question 9

What are the features of biliary colic?

Answer 9

Pain in RUQ, radiating to back and R shoulder, worse following large/fatty meal
Obstructive jaundice

Question 10

What are the features of acute cholecystitis?

Answer 10

Continuous RUQ pain
Murphy’s sign +
History of biliary colic
Pyrexia

Question 11

What is the management of acute cholecystitis?

Answer 11

Laparoscopic cholecystectomy

IV antibiotics

Question 12

What are the features of cholangitis?

Answer 12

Charcot’s triad- fever, RUQ pin, jaundice

Question 13

What is the management of cholangitis?

Answer 13

IV antibiotics

Biliary decopression

Question 14

What are the features of diverticulitis?

Answer 14

Colicky pain in LLQ

Pyrexia

Question 15

What is the management of diverticulitis?

Answer 15

Antibiotics

Question 16

What are the features of AAA?

Answer 16

Severe central abdo pain radiating to back

Painful pulsatile mass

Question 17

What is the management of AAA?

Answer 17

Endoscopic/open repair

Question 18

What are the features of aortic dissection?

Answer 18

Sudden onset severe ripping abdo pain radiating to back

Blood pressure instability

Question 19

What is the management of aortic dissection?

Answer 19

A= Open/endoscopic repair
B= BB, analgesia

Question 20

What are the features of intestinal obstruction?

Answer 20

Generalised abdominal pain
Vomiting
Distension
Constipation
Tinkling bowel sounds

Question 21

What are the features of an ectopic pregnancy?

Answer 21

Constant lower abdominal pain, associated with shoulder tip pain
Vaginal bleeding
History amennorrhoea/ + pregnancy test

Question 22

What is the management of an ectopic pregnancy?

Answer 22

Salpingectomy

Methotrexate

Question 23

What are the features of renal colic?

Answer 23

Loin pain radiating to groin- severe, colicky
restless patient
Haematuria

Question 24

What are the features of acute pyelonephritis?

Answer 24

Loin pain radiating to groin

Fever and rigors

Question 25

What is the management of acute pyelonephritis?

Answer 25

Antibiotics 10-14 days

Question 26

What are the features of acute urinary retention?

Answer 26

Suprapubic pain
Haven’t passed urine recently
Lower abdominal distension, palpable bladder
Often history of BPH

Question 27

What is the management of acute urinary retention?

Answer 27

Catheterise

Question 28

What are the features of abdominal migraine?

Answer 28

Episodic central abdominal pain
Other migraine features e.g. N&V
More common in children
With or without migraine/history of migraine

Question 29

What are some uncommon causes of abdominal pain? 4

Answer 29

MI
Lower lobe pneumonia
DKA
Lead poisoning

Question 30

What is done in a woman of child bearing age presenting with abdominal pain?

Answer 30

MUST do pregnancy test