ROSH Gastrointestinal Practice Exam

Which medical history aspect is significant in a patient experiencing acute abdominal pain?

1. Presence of chronic diabetes

2. Family history of bowel disease

3. Use of nonsteroidal anti-inflammatory drugs

4. Previous surgical histories

The correct answer is: Use of nonsteroidal anti-inflammatory drugs

In the context of acute abdominal pain, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) stands out as a significant aspect of the medical history. NSAIDs can lead to gastrointestinal complications, such as peptic ulcers, gastritis, or even gastrointestinal bleeding, all of which may manifest as acute abdominal pain. Understanding the patient's history with NSAID use is crucial because it could direct the clinician towards specific diagnoses or treatment plans related to potential drug-induced conditions. While chronic diabetes can affect gastrointestinal motility and lead to complications such as diabetic gastroparesis, it is less directly associated with acute abdominal pain compared to the immediate effects of NSAIDs. Similarly, a family history of bowel disease is important for long-term management and screening but may not be as relevant in the acute setting unless there are symptoms suggesting inherited conditions. Previous surgical histories can also provide context, particularly regarding adhesions or complications from prior surgeries, but they do not specifically point to acute issues related to abdominal pain like NSAIDs can. Hence, NSAID use is particularly significant in evaluating the etiology of acute abdominal pain.