Abdominal Pain at University Of Plymouth | Flashcards & Summaries

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Lernmaterialien für Abdominal Pain an der University of Plymouth

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TESTE DEIN WISSEN
Symptoms of renal colic 
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  • Classical presentation of “loin to groin” pain 
  • “colicky pain” that comes in waves and very severe
  • Nausea and vomiting normally associated with the pain
  • Signs of infection - fever, tachycardia, malaise, rigors
  • Haematuria
  • Dysuria
  • Urgency
  • Flank tenderness
it is important to monior obs and look for signs of infection / sepsis. An infected-obstructed urinary system is a urological emergency.
Lösung ausblenden
TESTE DEIN WISSEN
Risk factors for developing UTI
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TESTE DEIN WISSEN
  • Female - men have a longer urethra and prostatic secretions have some anti microbial properties
  • Catheterisation 
  • Pregnancy - progesterone relaxes smooth muscle causing stasis  of urine (slowing or stoppage of normal flow due to decreased ureteral tone) -> easier colonisation of bacteria
  • Menopause - drier vagin and urethra
  • Sexual activity
Lösung ausblenden
TESTE DEIN WISSEN
Explain UTI’s
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A UTI is infection in any part of the urinary system. Can be upper UTI (kidneys - pyelonephritis) or lower UTI (bladder - cystitis). 

This results from colonisation and ascending spread of microorganisms (generally E.coli - 90%) from the urethra to bladder to kidneys, or from haematogenous spread via the blood.  
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TESTE DEIN WISSEN
What organ systems can present with abdominal pain?
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TESTE DEIN WISSEN
  • Gastrointestinal
  • Renal and urinary system 
  • Gynaecological
  • Vascular
  • Referred cardiac
  • Respiratory
Lösung ausblenden
TESTE DEIN WISSEN
Symptoms of Pyelonephritis 
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TESTE DEIN WISSEN
  • Fever
  • Flank / back pain   <—- these = classic triad 
  • Vomiting
  • dysuria
  • polyuria
  • signs of sepsis
  • malaise
  • rigors
  • atypicsl presentation in elderly 
Lösung ausblenden
TESTE DEIN WISSEN
Red flag Symptoms of UTI
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TESTE DEIN WISSEN
  • Haematuria
  • Pregnancy
  • Altered mental staus
  • septic symptoms
  • rigors
  • nausea and vomiting
  • immunosupression
  • obstructive urinary symptoms (hesitancy, straining, poor stream)
Lösung ausblenden
TESTE DEIN WISSEN
UTI in pregnancy 
Lösung anzeigen
TESTE DEIN WISSEN
  • Progesterone (“pregnancy hormone” - helps fertilised egg be implanted in uterus) causes smooth muscle relaxation. This causes stasis of urine, causing easier colonisation of bacteria and increased risk of UTI
  • Untreated pyelonephritis during pregnancy can lead to premature labour, underweight baby, developmental delays, cerebral palsy and foetus death
Lösung ausblenden
TESTE DEIN WISSEN
Signs and Symptoms of lower UTI
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TESTE DEIN WISSEN
  • Dysuria - pain on urination
  • Polyuria - increased frequency of urination
  •  Haematuria - blood in urine
  • Supra-pubic discomfort
  • Cloudy urine
  • Offensive smelling urine
  • Darker urine due to volume depletion and blood
  • Atypical presentation in elderly - off legs, delirium, falls, confusion, immobility
  • Spinal cord injury patients - autonomic dysreflexia, fever, chills
Lösung ausblenden
TESTE DEIN WISSEN
UTI differential diagnosis
Lösung anzeigen
TESTE DEIN WISSEN
  • STI
  • DKA / hyperglycaemia - polyuria 
  • Dehydration - dark urine colour due to volume depletion
  • Appendicitis - lower abdominal pain 
  • Vaginitis - dysuria, polyuria
  • Preeclampsia - preoteinuria
  • Ectopic
  • Polycystic kidney disease
  • Renal stones
  • Benign prostate enlargement - polyuria
Lösung ausblenden
TESTE DEIN WISSEN
Risk factors / predisposing factors for kidney stones
Lösung anzeigen
TESTE DEIN WISSEN
  • Dehydration - decreased water and urine excretion concentrates the calcium forming substances
  • Infection 
  • High salt intake
  • Increased BMI
  • High meat intake
  • Immobilisation - immobility from SCI allows calcium to be released into circulation which is eventually filtered by kidneys
  • Male sex
  • Family hx
  • Metabolic disorders
  • Crohns disease
  • Anatomical abnormalities 
Lösung ausblenden
TESTE DEIN WISSEN
Pathophysiology of Kidney Stones 
Lösung anzeigen
TESTE DEIN WISSEN
Calcium oxalate is the most common type of stone and is thought to develop from the precipitation of calcium crystals.

Kidney stones are generally symptomless until they pass into the ureter where they can become lodged and obstruct the flow of urine. The obstruction to flow within the ureters leads to the release of prostaglandins which cause vasodilation of surrounding vessels and stimulate ureteric smooth muscle spasm. Vasodilation of blood vessels promotes a natural diuresis which further places pressure on the kidneys and can lead to distension of the renal capsule - this is what causes the intense pain associated with renal colic.
Lösung ausblenden
TESTE DEIN WISSEN
Renal Colic Differential Diagnosis
Lösung anzeigen
TESTE DEIN WISSEN
  • UTI
  • Pyelonephritis
  • Ectopic
  • STI
  • Choleycistitis
  • Hepatitis
  • Biliary colic
  • Pelvic inflamm disease
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Q:
Symptoms of renal colic 
A:
  • Classical presentation of “loin to groin” pain 
  • “colicky pain” that comes in waves and very severe
  • Nausea and vomiting normally associated with the pain
  • Signs of infection - fever, tachycardia, malaise, rigors
  • Haematuria
  • Dysuria
  • Urgency
  • Flank tenderness
it is important to monior obs and look for signs of infection / sepsis. An infected-obstructed urinary system is a urological emergency.
Q:
Risk factors for developing UTI
A:
  • Female - men have a longer urethra and prostatic secretions have some anti microbial properties
  • Catheterisation 
  • Pregnancy - progesterone relaxes smooth muscle causing stasis  of urine (slowing or stoppage of normal flow due to decreased ureteral tone) -> easier colonisation of bacteria
  • Menopause - drier vagin and urethra
  • Sexual activity
Q:
Explain UTI’s
A:
A UTI is infection in any part of the urinary system. Can be upper UTI (kidneys - pyelonephritis) or lower UTI (bladder - cystitis). 

This results from colonisation and ascending spread of microorganisms (generally E.coli - 90%) from the urethra to bladder to kidneys, or from haematogenous spread via the blood.  
Q:
What organ systems can present with abdominal pain?
A:
  • Gastrointestinal
  • Renal and urinary system 
  • Gynaecological
  • Vascular
  • Referred cardiac
  • Respiratory
Q:
Symptoms of Pyelonephritis 
A:
  • Fever
  • Flank / back pain   <—- these = classic triad 
  • Vomiting
  • dysuria
  • polyuria
  • signs of sepsis
  • malaise
  • rigors
  • atypicsl presentation in elderly 
Mehr Karteikarten anzeigen
Q:
Red flag Symptoms of UTI
A:
  • Haematuria
  • Pregnancy
  • Altered mental staus
  • septic symptoms
  • rigors
  • nausea and vomiting
  • immunosupression
  • obstructive urinary symptoms (hesitancy, straining, poor stream)
Q:
UTI in pregnancy 
A:
  • Progesterone (“pregnancy hormone” - helps fertilised egg be implanted in uterus) causes smooth muscle relaxation. This causes stasis of urine, causing easier colonisation of bacteria and increased risk of UTI
  • Untreated pyelonephritis during pregnancy can lead to premature labour, underweight baby, developmental delays, cerebral palsy and foetus death
Q:
Signs and Symptoms of lower UTI
A:
  • Dysuria - pain on urination
  • Polyuria - increased frequency of urination
  •  Haematuria - blood in urine
  • Supra-pubic discomfort
  • Cloudy urine
  • Offensive smelling urine
  • Darker urine due to volume depletion and blood
  • Atypical presentation in elderly - off legs, delirium, falls, confusion, immobility
  • Spinal cord injury patients - autonomic dysreflexia, fever, chills
Q:
UTI differential diagnosis
A:
  • STI
  • DKA / hyperglycaemia - polyuria 
  • Dehydration - dark urine colour due to volume depletion
  • Appendicitis - lower abdominal pain 
  • Vaginitis - dysuria, polyuria
  • Preeclampsia - preoteinuria
  • Ectopic
  • Polycystic kidney disease
  • Renal stones
  • Benign prostate enlargement - polyuria
Q:
Risk factors / predisposing factors for kidney stones
A:
  • Dehydration - decreased water and urine excretion concentrates the calcium forming substances
  • Infection 
  • High salt intake
  • Increased BMI
  • High meat intake
  • Immobilisation - immobility from SCI allows calcium to be released into circulation which is eventually filtered by kidneys
  • Male sex
  • Family hx
  • Metabolic disorders
  • Crohns disease
  • Anatomical abnormalities 
Q:
Pathophysiology of Kidney Stones 
A:
Calcium oxalate is the most common type of stone and is thought to develop from the precipitation of calcium crystals.

Kidney stones are generally symptomless until they pass into the ureter where they can become lodged and obstruct the flow of urine. The obstruction to flow within the ureters leads to the release of prostaglandins which cause vasodilation of surrounding vessels and stimulate ureteric smooth muscle spasm. Vasodilation of blood vessels promotes a natural diuresis which further places pressure on the kidneys and can lead to distension of the renal capsule - this is what causes the intense pain associated with renal colic.
Q:
Renal Colic Differential Diagnosis
A:
  • UTI
  • Pyelonephritis
  • Ectopic
  • STI
  • Choleycistitis
  • Hepatitis
  • Biliary colic
  • Pelvic inflamm disease
Abdominal Pain

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