Abdominal Pain Flashcards Preview

Hugh's MD2 Foundation > Abdominal Pain > Flashcards

Flashcards in Abdominal Pain Deck (29):
1

What is Murphy's sign?

Place two fingers on the RUQ; pain on inspiration and cessation of inspiration

2

Where is pain from obstruction of paired structures referred to?

The flank

 

2

What is acute cholecystitis?

Inflammation of the gall bladder

3

What the types of abdominal hernia's?

Umbilical

Fermoral

Inguinal

Incisional

3

What is choledocholithiasis?

Stone in the common bile duct

(Not causing inflammation)

3

How does acute appendicitis usually appear on examination?

Tenderness in R iliac fossa (McBurney's point)

Guarding

+/- Rovsing's sign (palpation of L lower quadrant causes pain to be felt in RLQ)

Percussion tenderness

Normal auscultation 

4

What type of pain is typically relieved by leaning forward?

Epigastric that radiates to the back

5

High pitched bowel sounds are indicative of what usually?

Obstruction

7

What is ascending cholangitis?

Inflammation of the common bile duct

8

What is biliary colic?

Pain due to obstruction of the cystic duct by gall stones

(Not inflammatory pain)

9

Where is pain from obstruction of the gut felt?

Midline

10

What is McBurney's point?

The point, 1/3 third of the way between the ASIS and the umbilicus where pain from appendicitis is felt

12

How does peritonitis present?

Generalised tenderness

Generalised pain

Abdominal guarding and rebound tenderness

13

What are some non-abdominal causes of abdominal pain?

Heart

Lung/diaphragm

Back/muscular pain

Herpes/zoster

15

What is colicky pain?

What typically causes it?

Pain that waxes and wanes

Obstruction of a hollow viscus

16

How does inflammatory pain usually present?

Usually localised

Sharp

Often severe

Constant

16

What is the pain of gastroenteritis typically like?

Epigastric/central

Colicky

Variable

Gradual onset

18

How does pain progress in appendicitis?

Initially visceral and referred

 

Once inflammation becomes transmural and touches the peritoneum in the right iliac fossa the pain moves

- Patient can finger the spot

19

What is rebound tenderness?

Pain on removal of pressure applied during examination

20

What special physical signs are looked for in appendicitis?

Rovsing's sign - Pain > in RIF than LIF when the LIF is pressed

Psoas sign - Pain on extending R hip while the patient lies on left (if retrocaecal appendix)

Cope/Obturator sign - pain on flexion and internal rotation of R hip if appendix in close relation to obturator internus

21

How does pain from perforation present?

Localised

Sharp

Usually severe 

Sudden, can be on a background of pre-existing pain 

22

What are the three types of hollow viscus obstructions?

Intraluminal eg stone

In the wall eg colon cancer

Extrinsic eg adhesion

23

What are the causes of pancreatitis?

 I GET SMASHED

Idiopathic

 

Gall stones

EtOH

Trauma

 

Steroids

Malignancy

Autoimmune

Scorpion

Hyperlipidaemia

ERCP

Drugs - particularly flucloxicilin

24

What is ERCP?

What risk is associated with it?

Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy and fluoroscopy to diagnose and treat certain problems of the biliary or pancreatic ductal systems.

 

Pancreatitis

25

Why does diaphragmatic pathology often refer pain to the shoulder tip?

Because they share innervation from C3/4

26

What is Mittelschmerz pain?

Pain with ovulation

27

What is Grey Turner's sign? What causes it? In which conditions might it be found?

Brusing in the flanks

 

Bleeding in the retroperitonium

 

Acute pancreatitis

28

What is Cullen's sign? In which condition might it be seen?

Superficial oedema and bruising around the umbilicus

 

Acute pancreatitis

29

What is Meckel's diverticulum?

A congenital diverticulum present at birth and remenent of the omphalomesenteric duct