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OCSE Stop > PC: Abdo pain > Flashcards

PC: Abdo pain Flashcards

1
Q

What is the usual method for exploring pain

A

SOCRATES

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2
Q

What relevant symptom review questions must you ask

A

General:
Fever, night sweats

GI: weight loss, change in appetite

Work down body: dysphasia, nausea/ vommiting, GORD, bowel habit changes, tenesmus, blood/ mucus in stool

Urological:
Storage- frequency, volume, urgency, nocturia, incontinent
Infection- dysuria, Haematuria, odour

GYN: PV bleeding (menorrhagia, intermenstrual, post-coital, post-menopausal)
PV discharge
Pain (pelvic, dysmenorrhea, dyspareunia)
Pregnancy

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3
Q

What clues would suggest appendicitis

A

Usually young patients
Periumbilical pain
Moves to RIF
Anorexia

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4
Q

Gall stones

A

Billiary colic
Intermittent severe RUQ/ epigastric pain
exacerbated 30-60 mins after fatty foods

Cholecystitis
Continuous RUQ/ epigastric pain

CBD stones
Jaundice
RUQ pain

Cholangitis- charcots triad
jaundice
fever/ rigors
RUQ pain

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5
Q

Acute Pancreatitis

A

Severe epigastric/ central pain
Radiating to back
Relived by sitting forward
Vomitting

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6
Q

Gastritis/ peptic ulcer

A

epigastric pain exacerbated by food

RFs: NSAIDs, alcohol, spicy foods

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7
Q

Bowel obstructions

A

Vommiting + abdo distension + no bowel motions

colicky pain

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8
Q

Ectopic pregnancy

A

increasing iliac fossa/ pelvic pain
4-12 weeks gestation/ lack of contraception, recent period of amenorrhoea
May have spotting

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9
Q

Other Abdo pain differentials to consider

A 
Ruptured AAA
Gastroenteritis 
Volvulus 
Pyelonephritis 
IBD
Mesenteric ischemia / isqceamic colitis 
Pelvic inflammatory disease 
Endometriosis 
Constipation 
MI 
Pneumonia
DKA
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10
Q

Top differential?

Usually young patients
Periumbilical pain
Moves to RIF
Anorexia

A

Appendicitis

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11
Q

Top differential?

Intermittent severe RUQ/ epigastric pain
exacerbated 30-60 mins after fatty foods

A

Billary colic

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12
Q

Top differential?

Jaundice
RUQ pain

A

Cholecystisitis

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13
Q

Top differential?

jaundice
fever/ rigors
RUQ pain

A

CBD stone

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14
Q

Top differential?

Severe epigastric/ central pain
Radiating to back
Relived by sitting forward
Vomitting

A

Cholangitis

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15
Q

Top differential?

epigastric pain exacerbated by food

RFs: NSAIDs, alcohol, spicy foods

A

Peptic ulcer/ gastritis

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16
Q

Top differential?

Vommiting + abdo distension + no bowel motions
colicky pain

A

Bowel obstruction

17
Q

Top differential?

increasing iliac fossa/ pelvic pain
4-12 weeks gestation/ lack of contraception, recent period of amenorrhoea
May have spotting

A

Ectopic pregnancy

OCSE Stop (12 decks)

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