Acute Abdominal Pain in the Elderly

1. What age does the WHO use to define elderly? What percentage of the Jamaican

population is in this elderly age group? 2.Explain referred pain?

3. Explain visceral pain?

4.Explain parietal pain?

5. What percentage of the elderly patient with acute abdominal pain usually get admitted to

hospital and what percentage eventually have surgery?

6. What is the mortality rate for the elderly patient with a correct diagnosis versus those

with an incorrect diagnosis of abdominal pain?

7. What confounding factors may prevent receiving an accurate history of the patients

pain?

8.

What issues may prevent getting useful vital signs in the elderly with abdominal pain? How reliable are laboratory tests e.g WBC?

9. What is the reason that may prevent a reliable abdominal examination in the elderly

patient with acute abdominal pain?

10. What types of complications of surgical disease are seen more commonly in the elderly

with abdominal pain?

11. What is the commonest surgical cause of abdominal pain in elderly patients? How is this

investigated?

12. Appendicitis has a higher mortality rate in the elderly patient what are the factors that cause this to be so?

What is the classic triad of features for patients presenting with ruptured aortic aneurysm? How is this investigated?
13.

What misdiagnosis maybe made for this condition? What is the mortality in hemodynamically stable patient vs. the patient in shock from a ruptured AAA?

14. What is the commonest non-surgical cause of abdominal pain in the elderly? What

factors predispose to this /? What blood tests aid in the diagnosis of this disease? What is the imaging modality of choice for this condition?

15. a) What percentage of patients older than 70 years have diverticular disease? 50%

b) What is the Pathophysiology of diverticular disease? c) What are the complications of diverticular disease?

16. What are the common causes for large bowel obstruction in the elderly? 17. What are the common causes for small bowel obstruction? 18. Why is peptic ulcer disease increasing in the elderly? What are the complications of PUD?
19. a) What is the examination finding in the patient with a diagnosis of Mesenteric

Ischemia and how frequently does it occur?

b) What is the mortality rate and why?

C) What are the four distinct entities that encompass Mesenteric ischemia and outline the associated risk factors?

18. List eight pathologies for non abdominal causes of abdominal pain