Page 1 of 1: D/D of abd pain

HANNA · Credits: 1064256 My Scrapbook

Theme : Abdominal pain

A. Acute cystitis
B. Addison's disease
C. Appendicitis
D. Cancer of the colon
E. Chronic inflammatory bowel disease
F. Diverticular disease
G. Ectopic pregnancy
H. Endometriosis
I. Inguinal hernia
J. Lead poisoning
K. Pelvic inflammatory disease
L. Primary spasmodic dysmenorrhoea
M. Pseudo-obstruction
N. Ruptured follicular cyst
O. Toxic megacolon
P. Urinary retention
Q. Vesical calculus
R. Volvulus

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Each of the subjects below is a woman presenting with lower abdominal pain. Select the most likely diagnosis from the list of options.

1) A 30 year old woman presents with a six hour history of severe pain in the lower abdomen. She has had a normal bowel motion this morning and her weight is steady. Her last period was six weeks ago and she has an IUCD for contraception.

2) A 15 year old girl presents with agonizing pain in the right lower abdomen for four hours. She has vomited once but not had a bowel motion since the previous day. Her weight is steady. Her periods started 12 months ago and are still irregular, but the last was three weeks ago. She is not sexually active.

3) A 23 year old woman presents with a three day history of low abdominal pain, frequency of micturition and a yellow, offensive vaginal discharge. Her bowel actions are regular and her weight is steady. Her last period was three weeks previously and she is on no contraception

4) A 24 year old woman presents with a four month history of right-sided lower abdominal pain, watery diarrhoea and a loss of weight of 6Kg. Her periods are regular on the contraceptive pill.

5) A 65 year old with a ten year history constipation, and of left-sided lower abdominal pain which is worse on defecation. Her weight is steady and she has normal micturition, She has had no periods for 15 years.

ayesha · Credits: 78895 My Scrapbook My Reading List 262569 Books

ectpoic
appendicitus
pid
ca colon
diverticular d/s

uzmagha · Credits: 993 My Scrapbook

1-G
2-A
3-K
4-E
5-F

uzmagha · Credits: 993 My Scrapbook

1-G
2-A
3-K
4-E
5-F

tania · Credits: 6560 My Scrapbook

1.g...as there are no s/s of urinary complaints

2.L...as pt. is still having irregular periods

4. E...ca colon cannot occur at such young age

5.m...diverticular dis presents with bleeding P/R

HANNA · Credits: 1064256 My Scrapbook

Comments:

1 This patient has a short, acute history of abdominal pain. She has missed her last period, and has normal bowel motions, with no weight loss. The IUCD is associated with a small risk of ectopic pregnancy, and this is the most likely diagnosis from the above list.

2 Again this patient has an acute history of right lower abdominal pain. Appendicitis is relatively common at this age, and is the most likely diagnosis in this scenario

3 Pelvic Inflammatory Disease (PID), is associated with a malodorous, green or yellow discharge. It may be associated with STDs but may occur in a sexually inactive female.

4 The most likely answer in this case is chronic inflammatory bowel disease given the weight loss, abdominal pain and diarrhoea. Addison’s disease would present insidiously, but in a very similar fashion.

5 In a patient of this age Diverticular disease is extremely common. The fact that weight loss is not present suggests that malignancy is not present.

tania · Credits: 6560 My Scrapbook

2. i still think that it is L...because girl has just started menstruating & during early years perioda are usually irregular & painful.since they have particularly mentioned this thing in the theme so it must be pointing some clue toward ans.

5.i have also doubt abt diverticular dis....as it gets relieved on defecation....OHOM Pg-470....i think its pseudo obstruction?

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