abdominal pain history

Question 1

what are causes of abdominal pain?

Answer 1

• apendicitis
• pancreatitis
• gastric/ duodenal ulcer
  diverticulitis
• IBS
  -renal colic
• gallstones
• ectopic pregnancy

Question 2

what are the common symptoms of apendicitis?

Answer 2

• initially umbilical pain then moves to the right illiac fossa
• a young patient in extreme pain

Question 3

what are common symptoms of pancreatitis?

Answer 3

• epigastric pain that radiates to the back
• relieved when sitting forward
• also get vomiting, nausea and reduced apetite

Question 4

how to tell between a duodenal ulcer history and gastric?

Answer 4

• gastric gets worse when you eat

- duodenal gets better when you eat

Question 5

what are symptoms of ulcers?

Answer 5

• reduced apetite
• nausea
• vomiting
• haematemasis
• melena

Question 6

what are the symptoms of diverticulitis?

Answer 6

• LIF pain
• bloating
• constipation
• fever
• +/- rectal bleeding

Question 7

what are symptoms of renal colic?

Answer 7

• acute intermitent severe loin-groin pain
• nausea
• vomiting
• haematuria

Question 8

what are symptoms of gallstones?

Answer 8

• RUQ/epigasgastric pain - intermitent and coliky, lasting approx 30mins
• worse with fatty foods
• may radiate to left shoulder
• +/- nausea and vomiting
• obstructive jaundice

Question 9

what are symptoms of ectopic pregnancy?

Answer 9

• r/l illiac fossa pain
• suprapubic pain
• amenorrhoea
• vaginal bleeding
• haemodynamic instabilitiy
• nausea/vomiting

Question 10

what are symptoms of irritable bowel syndrome?

Answer 10

• generalised abdominal pain relieved on defecation

Question 11

risk factors for appendicitis

Answer 11

family history
male
early teens

Question 12

how do you diagnose appendicitis?

Answer 12

clinical/ intraoperative

Question 13

what investigations would you do for apendicitis?

Answer 13

• FBC, CRP, U+E

- imaging such as uss, ct abdo/pelvis

Question 14

what are the investigations for pancreatis?

Answer 14

bedside:
- glasgow score 
Blood:
- abg, fbc, U+E,LFT, serum lipase, serum amylase, lipid profile 
imaging:
- uss and ct abdo/pelvis 

other:
faecal elastase

Question 15

risk factors for pancreatitis?

Answer 15

IGET SMASHED

• idopathic
• gallstones
• ethanol
• trauma
• steroids
• mumps/malignancy
• autoimmune
• scorpion bite
• hyperlipidemia/hypercalcaemia
• ercp
• drugs

Question 16

what are risk factors for ulcers?

Answer 16

• NSAIDS
• H.pylori
• Haematemisis
• melena

Question 17

risk factors for ulcers?

Answer 17

• NSAIDS
• stress
• h pylori
• steroids
• smoking
• alcohol

Question 18

what are risk factors for diverticulits?

Answer 18

• low fibre diet

- >60

Question 19

what are investigations you should do for someone with ulcers?

Answer 19

• pr exam
• fbc, u+e, crp/esr, h.pylori,
• axr (for bowel obstruction) and erect cxr (to look for free air under the diaphragm)
• ogd for biopsy (h.pylori)
• or urea breath test/ stool antigen

Question 20

what are the investigations you should do for renal colic?

Answer 20

bedside:
urinalysis

bloods:
fbc, u+e, bone profile (esp calcium stones

uss and non contrast CTKUB

Question 21

what are risk factors for an ectopic pregnancy?

Answer 21

• previous ectopic
  previous tubal surgery
• IUD
• pelvic inflammatory disease

Question 22

what are investigations for ectopic pregnancy?

Answer 22

• PV exam
• urine pregnancy test

bloods:
- FBC, CRP, serial BHCg

imaging:
transvaginal uss

Question 23

what are investigations for gallstones?

Answer 23

fbc, lft, serum lipase and amylase

US abdomen and MRCP