intestinal obstruction Patient presents with colicky right lower quadrant and left lower quadrant pain; has
associated nausea vomiting, Anorexia, obstipation; physical exam shows hyperactive
high-pitched bowel sounds are hypo active bowel sounds, get an abdominal x-ray
Pancreatitis Patient presents with severe, visceral, diffuse pain. Has associated hypotension
tachycardia; pain is relieved by leaning forward. Physical exam shows abdominal
distention, diminished bowel sounds, diffuse rebound tenderness; will have elevated
amylase levels
ectopic pregnancy Patient will present with persistent right lower quadrant pain or left lower quadrant
pain. May have vaginal bleeding. Physical exam will show tender adnexal mass and
will have a positive hCG test.
Dissection or Rupture of Aortic Aneurysm Patient will present with ripping, tearing, intense pain in chest, abdomen, lower back.
Will have associated hypotension, feelings of doom, shock. Physical exam will show
shock, diminished femoral pulses; get x-ray and CT scan
Peptic Ulcer Disease (PUD) Patient presents with annoying pain in epigastric region radiating to the back, right
shoulder, or side. Associated nausea, hunger; worse with empty stomach, alcohol,
NSAIDs, ASA; relieved with food and antacids. Will have epigastric tenderness to
palpation. Studies done is endoscopy and barium swallow
gastroesophageal reflux disease (GERD) Patient will present with epigastric, retrosternal pain. This pain will be intermittent.
Patient may have sour taste, low-grade bleeding, hoarseness, pharyngitis; worse with
bending at the waist, NSAIDs, ASA, alcohol, caffeine, recumbency; relieved with
antacids. Test are barium swallow, upper G.I., esophageal endoscopy with biopsy
gastritis Patient will present with epigastric pain that is constant. May have associated nausea,
vomiting, diarrhea, fever, hemorrhage; worse with alcohol, NSAIDs, aspirin; is rarely
worse with food
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salpingitis Patient will present with right lower quadrant and or left lower quadrant pain. Pain will
be worse around menstruation and when ascending stairs. There will be cervical
motion and adnexal tenderness
irritable bowel syndrome (IBS) Patient will present with left lower quadrant pain right lower quadrant pain the pain
will be intermittent and recurrent. Will have associated diarrhea, mucus in store;
worse with stress and eating; often relieved by defecation. There will be: tender to
palpation; small bowel follow through to rule out other causes
Inflammatory bowel disease (Crohn's disease, ulcerative Patient will present with pain in the right lower quadrant and left lower quadrant; may
colitis) have diarrhea, weight loss, rectal bleeding, tenesmus, fever; worse with stress.
Physical exam will show tenderness in the right lower quadrant left lower quadrant;
order CBC with differential small bowel follow through (crohns) and a colonoscopy
(UC)
gastroenteritis This pain will be diffuse. May have associated nausea, vomiting, diarrhea, fever, chills;
worse with food; relieved with vomiting or defecation. Physical exam will show
hyperactive bowel sounds; stool ova and parasites, stool culture
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