Flashcards in Session 11 - Signs and Symptoms of Abdominal Disorders Deck (32):
Give four common presentations for abdominal disorders
Upper abdominal pain
Give four causes of dyspepsia
o Chronic peptic ulcer disease
o Functional/non ulcer
What is functional dyspepsia?
60% of dyspepsia
No functional problem found to account for symptoms - 3 months of dyspepsia with no structural causes found
What are the three main actions when someone presents with dyspepsia?
o Empirical acid suppression
o Non invasive H-pylori testing/eradication
o Early endoscopy
How common is abdominal pain as a presentation?
2% of all admissions
What is the first thing you need to do when thinking about abdominal pain?
How do you localise abdominal pian?
Is it intra-peritoneal/extra-peritoneal?
What embryological division does it belong to?
WHat are the three embryological divisions of the abdomen and where does pain localise?
Foregut – Up to 2nd part of Duodenum - Epigastric area
Midgut – Up until the distal third of the transverse colon - Peri-umbilical
Hindgut – Supra-pubic
Give three causes of foregut pain
o Ulcers-epigastric pain
Commonly in the first part of the duodenum / lesser curve of the stomach
o Pancreatits – Epigastric pain, back pain (retroperitoneal structure)
o Gallstones – Epigastric pain, can also get Right Upper Quadrant (RUQ) pain. Often refered to as colicky pain (slight misnomer as the pain fairly constant).
Give two examples of causes of midgut pain
‘Real’ colicky pain
o Small bowel – Every 2-3 minutes
o Large bowel – Every 10-15 mins
Give four signs and symptoms of small bowel obstruction
o Vomiting (fairly early feature)
o Abdominal distension
o Xray may show
central abdominal distended loops
Circular folds (extending the full width of the bowel lumen)
Give one cause of hindgut pain
What is a sigmoid volvulus?
Causes 8% of all intestinal obstruction
Twists on itself or its mesentery, causing bowel obstruction and an interrupted blood supply
What is anorexia?
Loss of appetite
Give five causes of anorexia
o Subjectively unpleasant food or surroundings
o Symptom of a physical disorder
o Symptom of a psychological disorder
Give five physical causes of anorexia
Cancer (in particular GI tract)
What do you need to distinguis between when asking about weight loss?
Intentional or unintentional?
More than a 5% unintentional weight loss should be investigated
What is nausea?
Subjective sensation of needing toi vomit
Give four causes of nausea
o Food poisoning (Staphlococcal, salmonella, E-coli)
o Gastroenteritis (viral- Norwalk)
HOw is constipation classified?
Defecate less than 3 times a week - Change in bowel habit more important
Give four causes of constipation
Why is a good history necessary for diarrhoea?
Many causes which change depending on the time and place of onset
What are five categories of diarrhoea?
o Secretory (Infection)
o Osmotic (Lactose intolerance)
o Abnormal Intestinal Motility (Thyrotoxicosis, IBS)
o Exudative (Colitis, Cancer)
o Malabsorption (Pancreatic enzyme/Bile Salt Deficiency)
What is dyspagia?
o Difficulty swallowing (solids and liquids)
o Differentiate from painful swallowing (Odynophagia)
What are two broad categories of dysphagia?
Difficulty initating swallow
Food sticking in oesophagus
Give five causes of bleeding from oesophagus (haematemesis)
o Acute/chronic peptic ulcer
o Mallory-Weiss tear
Tear in oesophagus from repetitive retching
o Oesophageal/Gastric Varices
o Erosive Oesophagitis
o Gastric/Oesophageal cancer
Give six causes of rectal bleeding
Vascular malformation of the gut blood vessels
o Diverticular disease
o Colonic carcinoma
o Haemorrhoids/Anal fissure
o Inflammatory Bowel Disease
o Massive upper GI bleed
Give course for hepatic portal vein so superior vena cava
Hepatic portal vein -> Left gastric vein-> Oesophageal veins -> Azygous vein -> Upper extremities vein > SVC
Give five causes of abdominal distension
The five F's
Give three cause sof fluid ascites