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Abdominal Pain – Acute (ALL)
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1. Which clinical feature most suggests appendicitis in a patient with acute abdominal pain?
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Pain migration to right iliac fossa
Rebound tenderness in left iliac fossa
Diffuse upper abdominal pain
Pain worsens after eating
2. Which symptom is most suggestive of appendicitis?
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Pain that migrates from periumbilical to left iliac fossa
Pain that migrates from periumbilical to right iliac fossa
Shoulder tip pain
Left-sided flank pain
3. In a woman of reproductive age, which condition must always be considered in acute abdominal pain?
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IBS
Ectopic pregnancy
Pancreatitis
Gastritis
4. What investigation should be done urgently in all females of childbearing age with lower abdominal pain?
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Prolactin
Lipase
Urine β-hCG
FBC
5. Which feature suggests peritonitis?
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Light stools
Malaena
Bloating only
Abdominal rigidity and involuntary guarding
6. What is the first-line imaging for suspected biliary colic in primary care or A&E?
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Abdominal Ultrasound
MRI
CT abdomen
AXR
7. What is the hallmark symptom of renal colic?
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Constant flank pain
Intermittent severe loin-to-groin pain
Sharp right iliac pain
Mild suprapubic discomfort
8. Which test helps identify pancreatitis in acute upper abdominal pain?
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Creatinine
Serum amylase
Urinalysis
LFTs only
9. Which red flag in abdominal pain requires immediate surgical assessment?
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Intermittent bloating
Constipation with pain and increased flatus
Nausea only
Sudden, severe pain with rigid abdomen
10. What feature suggests bowel obstruction?
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Abdominal distension with vomiting and no bowel movement
Upper abdominal pain with loss of appetite
Rectal bleeding
Weight loss
11. Which abdominal emergency presents with severe back and abdominal pain in older males?
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Cholecystitis
Pancreatitis
Diverticulitis
Ruptured AAA
12. What is the best initial test to confirm a suspected AAA in A&E?
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ECG
Abdominal ultrasound
CT Chest
CT Abdo
13. Which presentation is typical for mesenteric ischaemia?
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Colicky pain after meals
Pain improved by defecation
Severe pain out of proportion to examination
Sudden right iliac fossa tenderness
14. Which is a common cause of acute abdominal pain in children?
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Angina
Diverticulitis
Mesenteric adenitis
Gastric ulcer
15. What feature supports diagnosis of diverticulitis?
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Left lower quadrant pain, fever, and raised CRP
Diarrhoea with reduced WCC
Colicky upper abdominal pain, fever with raised Na
Jaundice with elevated GGT
16. Which medication is most appropriate for initial pain relief in undifferentiated abdominal pain?
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Paracetamol ± codeine; NSAIDs with caution
Morphine only
Mebeverine
Amitriptyline (nocte)
17. What finding would increase suspicion for perforated ulcer?
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Constipation
Intermittent colic with shoulder tip pain and pus under diaphragm
Sudden epigastric pain with shoulder tip pain and free air under diaphragm
Tenesmus
18. In older patients, what is a common but serious cause of acute abdominal pain and vomiting?
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IBS
Gastritis
Renal cysts
Large bowel obstruction
19. What should always be examined in men presenting with lower abdominal pain?
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Chest
Testes and inguinal region
Lower limbs
Spine
20. Which of the following is least likely to be associated with acute abdominal pain?
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Ureteric stone
PMR
Pyelonephritis
Acute appendicitis