Abdominal Pain

Question 1

RUQ Pain

Answer 1

Biliary disease (cholelithiasis, cholecystitis); Fitz-Hugh-Curtis Syndrome; Pancreatitis; PUD

Question 2

RLQ Pain

Answer 2

Appendicitis; Inflammatory Bowel Disease; Ectopic pregnancy; Hernia

Question 3

LUQ Pain

Answer 3

Splenic infarct; Pulmonary disease (pneumonia, pulmonary embolism); Cardiac (MI, pericarditis); PUD

Question 4

LLQ Pain

Answer 4

Colitis, Diverticulitis, Ectopic pregnancy; Inflammatory bowl disease

Question 5

Epigastric Pain

Answer 5

GERD, PUD, Biliary disease (cholelithiasis, cholecystitis); Pancreatitis

Question 6

Periumbilical Pain

Answer 6

Aortic aneurysm; Inflammatory Bowel Disease

Question 7

Suprapubic

Answer 7

UTI, PID, Ectopic Pregnancy

Question 8

Flank Pain

Answer 8

Biliary Disease (right side), Splenic infarct; Nephrolithiasis, Pyelonephritis

Question 9

Diffuse Pain

Answer 9

Gastroenteritis, Inflammatory Bowel Disease, Irritable Bowel Syndrome

Question 10

Colicky pain in RUQ, triggered by fatty foods (MRCP, ERCP)

Answer 10

Cholelithiasis

Question 11

Severe RUQ pain, fever, nausea/vomiting (Murphy Sign +, RUQ ultrasound, increased alkaline phosphatase/bilirubin)

Answer 11

Cholecystitis

Question 12

Lower abdominal pain, fever, pain during pee/sex, abnormal cervical discharge/bleeding, adnexal tenderness (ultrasound, STI positive)

Answer 12

Fitz-Hugh-Curtis

Question 13

Sudden epigastric pain radiating to the back, nausea/vomiting, fever (ultrasound, CT, increased amylase/lipase)

Answer 13

Pancreatitis - may be caused by gallstone

Question 14

Vomiting, weight loss, bloating, hematemesis, melena (dark bloody stool) (EGD, urease breath test, H. pylori, NSAIDS)

Answer 14

PUD

Question 15

Initial periumbilical pain that migrates to the RLQ, anorexia, nausea, vomiting, fever (CT with IV contrast, ultrasound, Rovsing/obturator/psoas positive)

Answer 15

Appendicitis

Question 16

Abdominal pain, diarrhea (bloody = UC, non-bloody = Crohn’s), may have fever and weight-loss (Colonoscopy and biopsy, inflammatory markers)

Answer 16

Inflammatory Bowel Disease (IBD) - UC or Crohn’s

Question 17

Pelvic pain, vaginal bleeding, amenorrhea, history of PID (transvaginal ultrasound, beta-hCG)

Answer 17

Ectopic pregnancy

Question 18

Hypotension, shock (ultrasound)

Answer 18

Splenic infarct

Question 19

Cramping, bloating, painless rectal bleeding, nausea, vomiting, fever (colonoscopy, guarding)

Answer 19

Diverticulitis

Question 20

Fever, purulent, yellow-green productive cough, dyspnea, pleuritic chest pain, crackles/rales, wheezing (chest x-ray, sputum cultures)

Answer 20

Pneumonia

Question 21

Dyspnea, pleuritic chest pain, cough, hemoptysis, syncope, tachycardia (Chest CT, ECG)

Answer 21

Pulmonary embolism

Question 22

Squeezing chest pain w/ radiation to neck and shoulder, dyspnea, sweating, nausea (ECG, angiography)

Answer 22

MI

Question 23

Sharp pleuritic chest pain that is worse with inhalation, relieved by sitting up and leaning forward, shoulder pain, friction rub/Kussmaul’s sign (ESR, ECG)

Answer 23

Pericarditis

Question 24

Heartburn worse with meals and after lying down, regurgitation (upper endoscopy)

Answer 24

GERD

Question 25

Colicky flank pain, dysuria, CVA tenderness (renal ultrasound, urine analysis, blood tests - elevated creatinine)

Answer 25

Nephrolithiasis

Question 26

Fever, CVA tenderness, dysuria, urinary frequency (ultrasound of renal and bladder, urine analysis and culture)

Answer 26

Pyelonephritis