EMQ: 20
Abdominal pain
a) Acute
appendicitis
b)
Diverticular disease
c) Abdominal
aortic aneurysm
d) Perforated
peptic ulcer
e) Crohn's
disease
f)
Ulcerative colitis
g) Acute
pancreatitis
h) Diverticulitis
i) Acute
viral hepatitis
j) Acute
cholecystitis
Match one of the options above to the most likely
scenario given below:
1) A 55-year-old male who has been taking antacids
for long standing dyspepsia, presents with severe upper abdominal pain that
has subsequently spread and become generalised. For the week prior to
admission he had used ibuprofen to ease pain in his right knee
On examination he is afebrile, pulse rate 120
beats per minute, BP 110/60. His abdomen does not move with respiration, it is
rigid. Percussion note over the right lower ribs is resonant and bowel sounds
are absent
2) A 76-year-old female presents with colicky
pain in the left iliac fossa. She also complains of rectal bleeding and
diarrhoea. She is febrile. A thickened mass is palpable in the left iliac
fossa. It is tender. The white cell count shows a neutrophilia.
3) A 27-year-old male presents with anorexia,
nausea, vomiting and fever of a few days duration. He has recently returned
from a holiday in the Far East. On examination he is febrile, has icteric
sclera and has tender hepatomegaly.
4) A 35-year old male presents with sudden onset of epigastric pain
radiating to the back. The pain is severe and characterized as deep and
boring. Eating food worsens the pain and bending forward relieves the pain. On
examination the patient is febrile he has a tachycardia, and hypotension.
Abdominal examination reveals flank ecchymosis and umbilical ecchymosis. On
palpation there is epigastric tenderness with localized guarding and rebound,
Bowel sounds are sluggish.
5) A 75-year-old male presents with central abdominal pain radiating
through to his back. On examination he is tachycardic and hypotensive and has
a pulsatile mass in the central abdomen with a systolic bruit audible over it
