EMQs in Clinical Medicine.pdf - Peshawar Medical College

6 The abdomen and surgery
QUESTIONS
54 Abdominal pain
A
B
C
D
E
F
G
large bowel obstruction
acute pancreatitis
perforated viscus
appendicitis
small bowel obstruction
acute cholecystitis
ulcerative colitis
H
I
J
K
L
M
aortic dissection
diverticulosis
duodenal ulcer
renal colic
colorectal carcinoma
mesenteric adenitis
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 45-year-old man with a history of gallstones presents in A&E with severe
epigastric pain radiating to the back and vomiting.
2 A 28-year-old man presents with sharp left loin and left upper quadrant pain
radiating to the groin. He is not jaundiced.
3 A 44-year-old woman presents with continuous right upper quadrant pain,
vomiting and fever. Murphy’s sign is positive.
4 A 26-year-old man with a previous history of abdominal surgery presents with
colicky central abdominal pain, rapidly followed by production of copious bilestained
vomitus.
5 A 50-year-old man presents with epigastric pain worse at night and relieved by
eating or drinking milk.
Answers: see page 166.