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Unit 5 CMN 568 Acute Abdominal Pain PPT Questions and Answers Fully Solved
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Unit 5 CMN 568 Acute Abdominal Pain PPT
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Unit 5 CMN 568 Acute Abdominal PainPPT
Gyn history is taken for acute abdominal pain in what female ages? B) What are the
components of the gyn history? - answer All women of childbearing age. LMP, method
of contraception, STD risks
Medications taken go in what part of the Subjective note? – answer PMH
What 3 things must be considered in acute abdominal pain as far as the SH? - answer
Smoking
Alcohol
Recent travel
What is the order of the abdominal exam? - answer Look
Listen
Palpate
Percuss
On what patients will you do a rectal exam? - answerMost patients with acute
abdominal pain
On what patients would you do a testicular exam? - answerAll male patients that
present with acute abdominal pain
What conditions will present with diffuse abdominal pain? (6) - answerInflammatory
bowel disease (IBD), Irritable bowel syndrome (IBS), gastroenteritis, AAA, bowel
obstruction, ischemic bowel
What conditions will present with Epigastric pain? (4) - answerMI, peptic ulcer disease
(PUD), biliary disease (gallbladder), pancreatitis
What conditions will present with RUQ pain? (3) - answerhepatitis, gallbladder (biliary)
disease, renal disease (pyleo or renal stone)
What conditions will present with LUQ pain? (2) - answerspleen, renal disease
What conditions will present with periumbilical pain? (2) - answerearly appendicitis,
small bowel disease
What conditions will present with LLQ pain?(4) - answerdiverticulitis (can be diffuse),
PID, ovarian cyst, ectopic pregnancy
, What conditions will present with RLQ pain?(4) - answerappendicitis, PID, ovarian cyst,
ectopic pregnancy
What are the physical signs that indicate appendicitis? - answer-Rosvings-Palpation of
the left lower quadrant causes pain in the right lower quadrant.
-Iliopsoas-Extension of the right hip causes pain in the right lower quadrant
-Obturator-Pain felt in the right lower quadrant on internal rotation of the right hip.
McBurney-Rebound tenderness and sharp pain when McBurneys point is palpated
What are the physical signs that indicate inflamed GB (Cholecystitis)? - answerMurphy's
sign: RUQ pain on deep inspiration. Abrupt cessation of inspiration on palpation of GB.
What are the signs of peritoneal irritation? (5) - answerGuarding and rebound
tenderness. Absent BS. Abdominal pain on walking. Markle (heel jar).
Describe voluntary guarding - answerusually symmetric, muscles more tense on
inspiration, usually does hurt to rise from supine to sitting position (using abdominal
muscles), lessens with distraction
Describe involuntary guarding - answeraysmmetrical, rigidity present on inspiration and
expiration, rising to sitting position greatly increases pain, doesn't change with
distraction
List the lab tests you may order for acute abdominal pain and indicate what it is you are
looking for. (6) - answerCBC with diff to look for infection and blood loss
CMP: check hydration with BUN, Creatinine, electrolytes, check LFTs for hepatitis or
biliary disease (GB)
Amylase/ lipase: elevated in pancreatitis
UA: nitrates, leukocytes, RBCs may indicate UTI
Stool for occult blood: cancer, IBD, diverticulitis, PUD
Pregnancy test on ALL childbearing age females (remember this even in young teens)
List the Imaging studies you may do for acute abdominal pain and what you are looking
for(3) - answerKUB (flat film): may detect renal stones, look for stool in colon, free air in
perforation, dilated loops of bowel in obstruction
Abdominal Ultrasound: look for gallstones, ovarian cysts or ectopic pregnancy,
hydronephrosis due to renal stone, high specificity for appendicitis but not as sensitive
as CT.
*CT: most sensitive test for diagnosing acute abdominal pain. Useful for appendicitis,
abscesses, AAA, diverticulitis, bowel obstruction, tumors*
What are the s/s of appendicitis? - answerAnorexia, periumbilical pain that later
migrates to RLQ, nausea &vomiting usually *after* onset of pain, prefers to remain still
pain at McBurney's point (RLQ), rebound tenderness, + Obturator, Rovsing and
Iliopsoas signs, involuntary abdominal guarding (rigidity)
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