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During a busy Emergency Department (ED) late shift, your next patient is a 21-year-old female who has booked in with a complaint of acute abdominal pain.
In terms of the diagnosis of patients presenting with acute abdominal pain, which of the following statements is correct?
You are seeing an 18-year-old male who has presented to the ED with a 48-hour history of central abdominal pain. He is finding it difficult to describe his symptoms. The pain appears to be poorly localised, and constant.
With regards to the mechanism of this patient’s abdominal pain, which of the following statements is true?
A 65-year-old male presents to the ED with sudden onset of upper abdominal pain that started 3 hours ago. He has subsequently developed nausea and vomiting.
Which one of the following diagnoses is most strongly suggested by a history of sudden onset upper abdominal pain?
An 85-year-old female presents to the ED with left iliac fossa (LIF) pain that has been present for 2 days, but steadily worsening and associated with altered bowel habit. Past medical history includes diabetes and chronic renal impairment. She lives alone, mobilises with a wheeled frame and has twice daily carers. On exam she has some mild lower abdominal tenderness but no guarding. Observations are Temp 37.2oc, HR 88, BP 153/91, RR 22, SO2 96%. Routine bloods are largely normal, including WCC 9.4 x109/L, CRP 5 mg/L and renal function at baseline. A venous blood gas is also relatively normal, including glucose 9.2 mmol/L and lactate 1.4 mmol/L.
Which of the following management strategies is most appropriate?
A 75-year-old female presents to the ED with right upper quadrant (RUQ) pain and diarrhoea. She looks unwell. Observations are Temp 38.2oc, HR 90, BP 122/70, RR 25, SO2 92% in room air. Examination reveals a soft abdomen with some RUQ tenderness. There are reduced breath sounds at the right lung base.
Which of the following initial investigations is most likely to be diagnostic?
You are assessing a 25-year-old male with central abdominal pain. He appears well. Clinical exam reveals mild, diffuse abdominal tenderness without guarding. Vital signs are normal. You await his laboratory blood results prior to making a final decision on his disposition.
With regards to inflammatory markers in patients with acute abdominal pain, which of the following statements is true?
A 19-year-old male presents with right iliac fossa (RIF) pain and vomiting. Examination reveals marked RIF tenderness and guarding. He has taken paracetamol at home within the past two hours.
Which of the following do you prescribe for the patient’s pain?
A 75-year-old female presents to the ED with sudden onset of diffuse abdominal pain. She is previously fit and well. Observations are T 37.5oc, HR 98, BP 151/78, RR 24, SO2 99% in room air. On examination, there is rigidity throughout her abdomen. You prescribe IV fluids, analgesia and antibiotics.
Which of the following management strategies is most appropriate?
Your next patient on a busy weekend late shift is a 45-year-old female who is presenting to the ED with central abdominal pain. A quick look at her electronic records reveals she has had similar presentations seven times in the past few months, including one ED attendance only 72 hours previous, all with normal investigations. She has been drinking alcohol today and is demanding morphine for her pain. She does not have a specific care plan in place.
Which of the following should you do?
You are assessing a 45-year-old male who has given a history of LIF pain and altered bowel habit for two days, tending towards constipation. Past medical history includes gastro-oesophageal reflux and gout. His observations are all within normal physiological parameters.
Which of the following findings is most likely to influence your management of this patient?
Useful review
good module
good module
excellent learning module
Very useful module.
Informative
Very good refresher module
Useful content and very helpful resources for abdominal pain and its management.
Really helpful in the approach to abdominal pains in ED. Recommendable.
Excellent module
Very helpful
Good update and key points.
Nice one.
Good article
good
Great module
enjoyed this. started with basics and went on to cover the spectrum of common presentations
Revisited this learning as it had been some time since I had undertaken it – very useful revision and learning
Good module
Excellent
Excellent module
Very informative and practical
This learning changed my approach for abdominal pain patients.