peritonitis Flashcards
1
Q
primary
A
spontaneous bacterial peritonitis (SBP)
transmigration of bacteria thru bowel wall
enteric gram neg bacilli most common
klebsiella, pneumococcus, enterococcus
2
Q
secondary
A
peritonitis from sx amenable source
polymicrobial
penetrating trauma
perforation dt appy, colitis, peptic ulcer, diverticulitis, pancreatitis, cholecystitis
3
Q
SBP S&S
A
fever and abd pain with change in ams dt hepatic encephalopathy
4
Q
secondary S&S
A
acute abd pain, high fever, n/v, constipation, ascites, dyspnea, tachypnea, dehydration, abd exam: distention, rebound tender, general rigidity, decreased bs, hyperresonance
5
Q
diat test
A
paracentesis: evaluate ascitic fluid bld cultures (+) 25% wbc elevated in secondary bun: increase abd xray: free air/bowel dilation cxray: elevated diaphragm
6
Q
sbp tx
A
abx: 3rd generation cephalosporin for 10 days
7
Q
secondary tx
A
sx to eliminate source empiric abx monitor cultures iv fluid monitor vs, urinary output
