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AbdominalPain

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Acute Abdominal Pain in Children

This tutorial covers the key facts in a child presenting with acute abdominal pain.  
Mr Raymond Buick
almost 10 years ago
10
4
164

Acute abdominal pain

<p>This episode covers an approach to children with acute abdominal pain. The podcast covers an approach to history, an approach to physical examination, discusses investigations and lists indications for a surgical consult.&nbsp;This episode was written by Peter MacPherson and Dr. Melanie Lewis. Peter is a medical student at the University of Alberta. Dr. Lewis is a general pediatrician and an Associate Professor of Pediatrics at the University of Alberta and Stollery Children's Hospital. She is also the Clerkship Director.&nbsp;</p>  
Pedscases.Com
over 8 years ago
11
2
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Chronic Abdominal Pain

<p>This podcast addresses chronic abdominal pain in children. It gives medical students an approach to the history and physical examination in chronic abdominal pain and discusses the role of investigations. 'Red Flag' findings on history and physical exam are stressed. We specifically discuss Irritable Bowel Syndrome, Inflammatory Bowel Disease, Peptic Ulcer Disease, Constipation, Lactose Intolerance and Functional Abdominal Pain.&nbsp;<span style="font-size: 11px; color: #333333;">This episode was written by Peter MacPherson and Dr. Melanie Lewis. Peter is a medical student at the University of Alberta. Dr. Lewis is a general pediatrician and an Associate Professor of Pediatrics at the University of Alberta and Stollery Children's Hospital. She is also the Clerkship Director.&nbsp;</span></p>  
Pedscases.Com
over 8 years ago
Preview
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36

Renal colic

A detailed presentation about renal colic  
DR. AMY
over 6 years ago
Preview 300x212
17
735

The Basic Acute Abdomen

The basic and common differentials for the patient presenting with acute abdominal pain  
ugo icheke
over 6 years ago
Preview
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42

Abdominal Pain in Pregnancy

For Obstetrics and Gynaecology  
Rupali Shah
almost 6 years ago
Preview 300x419
124
3680

Causes of Acute Abdomen

Picture showing different causes of abdominal pain in the areas which they tend to affect. (note: some of the causes in the Left and right iliac fossa can affect both sides although they are only drawn in one!) http://leadonpaper.blogspot.co.uk/2014/01/the-acute-abdomen.html#more  
Caren Chu
over 4 years ago
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Henoch Schonlein Purpura (HSP)

This is a vasculitis that most commonly occurs in children. It tends to only affect the small vessels, and typically presents with: Palpable purpura – red/purple discolorations in the skin, often on the extensor surfaces of the feet, legs, arms, or sometimes on the buttocks. The rash may initially resemble urtricaria, but later becomes palpable. GI disturbance – may include colicky abdominal pain, abdominal tenderness, melena – occurs in 50% of patients  
almostadoctor.com - free medical student revision notes
over 4 years ago
Www.bmj
1
18

A man with a palpable abdominal mass and night sweats

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  
bmj.com
over 4 years ago
Www.bmj
1
10

A man with a palpable abdominal mass and night sweats

A 78 year old man presented with an eight week history of left sided abdominal pain and back pain, associated with anorexia, 3 kg weight loss, and night sweats. He was previously well, had no medical history of note, was taking no regular drugs, and was an ex-smoker.  
bmj.com
over 4 years ago
Preview
1
107

Abdominal (GI) Examination OSCE Station Guide

The abdominal examination aims to pick up on any gastrointestinal pathology that may be causing a patient's symptoms e.g. abdominal pain or altered bowel habit.  
OSCE Skills
over 4 years ago
Preview
2
63

C for Chocolate: The Acute Abdomen

 
leadonpaper.blogspot.co.uk
over 4 years ago
Preview
1
47

Acute Abdominal pain. Acute Abdomen information. Patient | Patient

For acute abdomen pain See also the separate article abdominal Pain . Acute abdominal pain has painful severe symptoms. Read about Acute Abdomen and abdominal pain  
Patient.co.uk
almost 4 years ago
Preview
1
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An unexpected finding after a fall from a horse

A 37 year old jockey was admitted with left sided abdominal pain and fullness one week after a fall from a horse. Before this he had been fit and well. On examination, he was tender in the left upper outer quadrant of his abdomen and his blood pressure was 90/55 mm Hg. A computed tomography scan showed an area of active bleeding in the parenchyma of the spleen and a large subcapsular haematoma.  
bmj.com
almost 4 years ago
Preview
1
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Obstructive jaundice and pancreatic disease

A 72 year old man was admitted under the surgical team with a short history of upper abdominal pain associated with vomiting, pruritis, pale stools, and dark urine. Four days earlier he had presented to his general practitioner with a four week history of polydipsia and polyuria. His fasting blood glucose concentration was raised. He was clinically diagnosed with new onset type 2 diabetes and given dietary advice. He drank alcohol occasionally and was a smoker with a history of chronic obstructive pulmonary disease and cystectomy for transitional cell carcinoma of the bladder 10 years previously.  
bmj.com
almost 4 years ago
9
1
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Surgery Mock MCQ

An obese 63 year old lady presents with jaundice. There is no history of abdominal pain. Examination of her abdomen reveals a palpable gall bladder. There is evidence of extensive pruritis. She tells you she drinks 42 units of alcohol a week. Her blood results are as follows: Albumin 32 (35-50) Alk Phos 456 (<110) ALT 88 (<40) Bilirubin 120 (<20) INR 1.6 GGT 400 (0-70) What’s the most likely diagnosis? a. Gallstones b. Paracetamol Overdose c. Pancreatic cancer d. Alcoholic Hepatitis e. Primary billiary cirrhosis  
Af Del
almost 5 years ago
Foo20151013 2023 4ktnps?1444774050
4
155

Poo transplants

When is it medically advisable to eat some one else's poo? When you need a poo transplant. Poo transplants could be the solution to one of the biggest problems facing the NHS today- the bacterial infection Clostridium difficile. C.diff, as it's known to its friends, infects about 18,000 people in England and Wales every year and is involved in the deaths of about 2000 people. C.diff typically arises due to imbalances in the normal gut bacteria. The gut is like a city, a city with about 100 trillion bacterial residents happily munching away on a banquet of bowel contents. The average person has about 1000 different types of bacteria in their gut, and about 3% of healthy adults have C.diff in that mix. The C.diff doesn't cause them any problems because its numbers are kept in check by the other gut bacteria. However treatment with broad spectrum antibiotics such as clindamycin, cephalosporins, ciprofloxacin and co-amoxiclav, can disrupt this happy community- killing off vast swathes of bacteria but crucially not the C.diff. Given free rein the C.diff multiplies rapidly and produces toxins which damage the gut. In some people this causes mild diarrhoea and abdominal pain, in others it can lead to torrential diarrhoea, perforation of the colon and death. Traditional treatment includes stopping any broad spectrum antibiotics and possibly prescribing antibiotics which target the C.diff such as metronidazole or vancomycin. However with antibiotic use comes the risk of resistance. Moreover our current approach isn't entirely effective and about 22% of patients treated suffer a recurrence. This can result in a cycle of illness and hospital admission which is costly to the patient and the hospital. So it's time to start thinking outside of the box. Cue the poo transplant. The thinking goes like this- if the cause of the problem is disruption to the normal community of gut bacteria, why not just pop those bacteria back in to crowd out the C.diff? Simples. Practically, the first step is to identify a donor, usually a close relative of the patient, and screen them for a range of infectious diseases and parasites. It's also advisable to make sure they haven't recently consumed anything the intended recipient is allergic to, before asking them to make their "donation". You then pop it in a household blender and blitz it down, adding saline or milk to achieve a slurry consistency. Next you need to strain your concoction to remove large materials- one medic in the UK uses coffee filters. Top tip. Then you're ready to administer it- about 25ml from above (e.g. via nasogastric tube), or 250ml from below. Now, its important to note that poo transplants are still an experimental treatment. To date only small case studies have been carried out, but with 200 total reported cases, an average cure rate of 96% and no serious adverse events reported to date, it's worth carrying out a large trial to assess it thoroughly. Poo transplants- arguably the ideal treatment for a cash strapped NHS. It's cheap, plentiful and it seems to work. Now to convince people to consume someone else's poo... Bottoms up! FYI: This was first posted on my own blog. Image Courtesy of Marcus007 at de.wikipedia [Public domain], from Wikimedia Commons  
Dr Catherine Carver
over 5 years ago
Foo20151013 2023 e7fpn8?1444774293
3
214

The Importance Of Clinical Skills

In the USA the issue of indiscriminate use of expensive, sophisticated, and time consuming test in lieu of, rather than in addition to, the clinical exam is being much discussed. The cause of this problem is of course multifactorial. One of the factors is the decline of the teaching of clinical skills to our medical students and trainees. Such problems seem to have taken hold in developing countries as well. Two personal anecdotes will illustrate this. In the early nineties I worked for two years as a faculty member in the department of ob & gyn at the Aga Khan University Medical School in Karachi, Pakistan. One day, I received a call from the resident in the emergency room about a woman who had come in because of some abdominal pain and vaginal bleeding. While the resident told me these two symptoms her next sentence was: “… and the pelvic ultrasound showed…” I stopped her right in her tracks before she could tell me the result of the ultrasound scan. I told her: “First tell me more about this patient. Does she look ill? Is she bleeding heavily? Is she in a lot of pain and where is the pain? What are her blood pressure and pulse rate? How long has she been having these symptoms? When was her last menstrual period? What are your findings when you examined her ? What is the result of the pregnancy test?”. The resident could not answer most of these basic clinical questions and findings. She had proceeded straight to a test which might or might not have been necessary or even indicated and she was not using her clinical skills or judgment. In another example, the resident, also in Karachi, called me to the emergency room about a patient with a ruptured ectopic pregnancy. He told me that the patient was pale, and obviously bleeding inside her abdomen and on the verge of going into shock. The resident had accurately made the diagnosis, based on the patient’s history, examination, and a few basic laboratory tests. But when I ran down to see the patient, he was wheeling the patient into the radiology department for an ultrasound. "Why an ultrasound?" I asked. “You already have made the correct diagnosis and she needs an urgent operation not another diagnostic procedure that will take up precious time before we can stop the internal bleeding.” Instead of having the needless ultrasound, the patient was wheeled into the operating room. What I am trying to emphasize is that advances in technology are great but they need to be used judiciously and young medical students and trainees need to be taught to use their clinical skills first and then apply new technologies, if needed, to help them to come to the right diagnosis and treatment. And of course we, practicing physicians need to set the example. Or am I old fashioned and not with it? Medico legal and other issues may come to play here and I am fully aware of these. However the basic issue of clinical exam is still important. Those wanting to read more similar stories can download a free e book from Smashwords. The title is: "CROSSCULTURAL DOCTORING. ON AND OFF THE BEATEN PATH." You can access the e book here.  
DR William LeMaire
over 4 years ago