Objectives:
By the end of Family Medicine Clerkship, students will be able to:
1. Given a patient presenting with abdominal pain, perform a patient-centered interview and focused physical exam, list and interpret clinical findings. Then,
a. identify signs and symptoms of a surgical abdomen
b. identify red flags of potential serious causes including referred pain from chest
c. identify psychosocial factors associated with chronic and recurrent abdominal pain.
d. propose a relevant differential diagnosis that includes common causes of abdominal pain and less common but important causes of abdominal pain.
2. For patients with acute abdominal pain, propose an initial management plan that includes appropriate and timely referral/investigation for potentially serious causes.
3. For patients with chronic/recurrent abdominal pain, propose a management plan that highlights initial investigations and basic management.
Clinical Cards
Microcases
https://cards.ucalgary.ca/deck/356
References
Recommended Resources Addressing the Objectives
Evaluating acute abdominal pain in adults (8 pages)
Objectives covered: 1a,b,d, 2
http://www.aafp.org/afp/2008/0401/p971.pdf
Cartwright SL, Knudson MP. Evaluation of acute abdominal pain in adults. Am Fam Physician 2008 Apr 1;77(7):971-978.
PMID:18441863
A review of chronic abdominal pain in children (11 pages)
Objectives covered: 1a, 1c, 1d, 3
http://pedsinreview.aappublications.org/content/33/11/509.full.pdf+html
McFerron BA, Waseem S. Chronic recurrent abdominal pain. Pediatr Rev 2012 Nov;33(11):509-16; quiz 516-7.
PMID:23118316
Diagnosis and management of IBS in adults (8 pages) *Might change with time
Objectives covered: 1c, 3
http://www.aafp.org/afp/2012/0901/p419.html
Wilkins T, Pepitone C, Alex B, Schade RR. Diagnosis and management of IBS in adults. Am Fam Physician 2012 Sep 1;86(5):419-426.
PMID:22963061
Prevalence of various causes of abdominal pain, plus red flags (1 page)
Objectives covered: 1b, 1d
http://thehub.utoronto.ca/family/wp-content/uploads/2013/07/1-pager-CFPC-abdo-pain.pdf
Ponka D, Kirlew M. Top 10 differential diagnoses in family medicine: generalized abdominal pain. Can Fam Physician 2007 Sep;53(9):1509.
PMID:22644880
Foundational Knowledge
The Calgary Guide – basis of GI abdo pain
http://calgaryguide.ucalgary.ca/slide.aspx?slide=Acute%20GI%20related%20Abdominal%20Pain.jpg
Additional Resources
When is Irritable Bowel Syndrome Not Irritable Bowel Syndrome? Diagnosis and Treatment of Chronic Functional Abdominal Pain (7 pages) *Might change with time
Objectives covered: 1c, 3
http://www.ncbi.nlm.nih.gov/pubmed/22644880
Grover M. When is irritable bowel syndrome not irritable bowel syndrome? Diagnosis and treatment of chronic functional abdominal pain. Curr Gastroenterol Rep 2012 Aug;14(4):290-296.
PMID:18441863
Instructional videos on the approach to history and examination of the abdomen
Objectives covered: 1