- History
- collapse at toilet
- lightheadedness
- ischaemic heart disease
- progressive-vomiting pain, distension
- menstrual abnomalities
- malignancy
- Signs
- Pallor and sweating
- Hypotension
- Atrial fibrillation or tachycardia
- Fever
- Prostration
- Rebound tenderness and guarding
- Decreased urine output
- Key history
- Dysphagia/odynophagia
- Nausea/vomiting
- Loss of appetite
- Reflux
- Abdominal pain
- Abdominal distension
- Altered bowel habit
- systemic symptoms: malaise/fatigue/jaundice/fever
Murtagh Triad
- Pale child + severe colic + vomiting = acute intussusception
- intense pain + pale and 'shocked' +/- back pain = ruptured AAA
- Anxiety and prostration + intense central pain + profuse vomiting +/- bloody diarrhoea = mesenteric arterial occlusion
- Localised RIF pain + a/n/v + guarding = acute appendicitis
- Colicky central pain + vomiting + distension = SBO
- Colicky pain + distension +/- vomiting = LBO
- Sudden severe pain + anxious, still, 'grey', sweaty + deceptive improvement = perforated peptic ulcer
- Intense pain (loin) --> groin + microscopic haematuria = ureteric colic
- acute pain + left sided radiation + fever = acute diverticulitis
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