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CMN 568, Unit 4, Differential dx of Abd pain Questions and Answers Fully Solved
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CMN 568, Unit 4, Differential dx of Abd pain
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CMN 568, Unit 4, Differential dx of Abdpain
- answer when to test with stool culture for gastroenteritis (diarrhea)
what is NSAP - answernon-specific abdominal pain, common in pediatric patients
in abdominal anatomy (look at a picture) the large intenstine begins on the
______________side of the body and then transverses and joins with rectum on
____________side of body - answerright (where the appendix hangs out); left
when dividing abdominal regions in quadrants what is a good "marker" - answerthe
umbilicus is the "cross" where all regions meet transverse and vertical (I always thought
lower regions were higher for serious)
describe oldcarts - answeris a good way to get an abdominal hx
o-onset
L-location
D-Duration (chronic =greater than 2 weeks)
C-character (sharp or dull)
A-aggravating factors
R-relieving factors
T-timing (constant or intermittent)
S-Associated symptoms (nausea vomiting)
Smoking worsens symptoms of what? but may help with.... - answerGERD, PUD,
Chrohns may help with ulcerative colitis
during abdominal exam a visible peristalsis may indicate - answerblockage
pulsations in the abdominal exam could indicate a - answerAAA
where do you hear an aortic bruit? a renal bruit? - answeraortic bruit can be heard near
the epigastric area, renal bruits are to the R and L of aortic bruit and slightly below in
upper L and R quads.
do you do a rectal exam on most patients with abdominal pain? what is a guiac stool? -
answermost patients presenting with abd pain u want to check the rectum for stool in
the valut, guiac stool is stool for occult blood
specific male and female exams for abd pain - answermen: testicular tortion, hernia-
lower abd pain raditiating to groin
, Women: PID, ovarian cysts, endometriosis
Diffuse abd pain can be - answerinflammatory bowel disease, IBS, gastroenteritis, AAA,
bowel obstruction, ischemic bowel.
Epigastric Pain - answerMI, PUD, biliary disease, pancreatitis
right upper quadrant pain - answerhepatitis, gallbladder (biliary), renal disease (pyleo or
renal stone)
left upper quad pain - answerspleen, or renal disease
periumbilicus pain - answerappendicitis or small bowel disease
left lower quadrant pain - answerdiverticulitis (can be difficulse) PID, ovarian cyst,
ectopic pregnancy
right lower quadrant pain - answerappedendicitis, ectopic pregnancy, PID, ovarian cyst
Murphy's sign - answerpain on inspiration when NP presses palpates RUQ. Sign of
Gallbladder inflammation
Rovsing sign - answerpalpation on LLQ causes pain on RLQ (this is a sign of
APPENDICITIS)
Cope Obturator Test - answerpain in RLQ on INTERNAL rotation of the right hip. (sign
of appendicitis)
Iliopsoas sign - answerEXTENSION of R hip causes pain in RLQ (seen with
appendicitis)
three tests to perform if suspect appencitis - answerRovsing, Cope Obturator, Iliopsoas
sign
peritoneal irritation two signs - answerguarding and rebound tenderness
what is rebound tenderness - answerslowly press on stomach and then release
pressure, abd pain should increase after test if positive for peritoneal irritation
two types of guarding differences - answervoluntary: symetric, rigid on inspiration,
lessens w/distraction, ok to go from supine to sitting
Involuntary: assymetrical, rigid on insp and expiration, LAYING IS BETTER POSITION,
doesn't cnage with distraction
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