acute abdomen

Question 1

whst

Answer 1

recent, rapid onset of urgent abdominal or pelvic pathology

usually presenting with abdominal pain

Question 2

differential diagnoses: generalised abdo pain

Answer 2

peritonitis
ruptures AAA
intestinal obstruction
ischaemic colitis

Question 3

differential diagnoses: RUQ pain

Answer 3

biliary colic
acute cholecystitis
acute cholangitis

Question 4

differential diagnoses: epigastric pain

Answer 4

acute gastritis
peptic ulcer
pancreatitis
ruptured AAA

Question 5

differential diagnoses: central abdo pain

Answer 5

ruptured AAA
intestinal obstruction
ischaemic colitis
early stages appendicits

Question 6

differential diagnoses: right iliac fossa pain

Answer 6

acute appendicitis
ectopic pregnancy 
ruptured ovarian cyst
ovarian torsion 
meckel's diverticulitis

Question 7

differential diagnoses: L iliac fossa pain

Answer 7

diverticulitis
ectopic pregnancy
ruptured ovarian cyst
ovarian torsion

Question 8

differential diagnoses: suprapubic pain

Answer 8

lower UTI
acute urinary disease
PID
prostatitis

Question 9

differential diagnoses: loin to groin pain

Answer 9

renal colic (kidney stones)
ruptured AAA
pyleonephritis

Question 10

differential diagnoses: testicular pain

Answer 10

testicular torsion

epididymo-orchitis

Question 11

peritonitis

Answer 11

inflammation of the peritoneum

Question 12

signs of peritonitis

Answer 12

guarding 
rigidity 
rebound tenderness
\+ cough test
percussion tenderness

Question 13

localised peritonitis

Answer 13

caused by underlying organ inflammation

e.g. appendicitis, cholecystitis

Question 14

generalised peritonitis

Answer 14

may be caused by perforation of abdo organ (e.g. perforated duodenal ulcer, ruptured appendix) releasing contents into peritoneal cavity –> generalised inflammation

Question 15

spontaneous bacterial peritonitis

Answer 15

assoc w sponataneous infection of ascites in pt w liver diease

treat with broad-spectrum antibx

Question 16

ABCDE assessment: A

Answer 16

ensure airway patent and secure

Question 17

ABCDE assessment: B

Answer 17

breathing 
resp rate
oxygen sats 
listen to lungs
provide O2 if needed

Question 18

ABCDE assessment: C

Answer 18

BP, HR, heart sounds, CRT

IV access (wide bore cannunla)
take bloods
IV fluid bolus if needed

Question 19

ABCDE assessment: D

Answer 19

AVPU

Glucose level

Question 20

ABCDE assessment: E

Answer 20

full assessment

abdo exam

Question 21

what to do immediate if bowel obstruction

Answer 21

NG tube