The Acute Abdomen 1

Question 1

Common diagnoses?

Answer 1

Acute cholecystitis
Perforated peptic ulcer
Appendicitis
Diverticulitis

Question 2

Add pic of quadrants and organs

Answer 2

G

Question 3

Investigation?

Answer 3

Blood = FBC, U&E, LFT, amylase

Urine = dipstick for nitrite, blood protein, WCC

X-ray= erect chest, abdomen

Question 4

Causes of acute abdominal pain?

Answer 4

Gastritis
Biliary colic
Gastroenteritis
Inflammatory bowel disease
Non specific abdominal pain

Question 5

Acute cholecystitis?

Answer 5

Pyrexia, tachycardia, RUQ peritonitis

Question 6

Murphy’s sign?

Answer 6

Positive for cholecystitis

Negative for choledocholithiasis, pyelonephritis, ascending cholangitis

Question 7

Differential diagnosis for RUQ pain

Answer 7

Duodenal ulcer
Biliary colic
Hepatitis
Right basal pneumonia
NSAP

Question 8

Perforated peptic ulcer?

Answer 8

Shock
Fever
Tachycardia
Rigidity + guarding

Question 9

Diff diagnosis for peptic ulcer?

Answer 9

Pancreatitis
Gastritis
Cholecystitis
Leaking aortic aneurysm

Question 10

Perforated peptic ulcer management

Answer 10

Resuscitation
-oxygen, iv, ng tube, antibiotics, analgesia

Emergency surgery
-laparotomy & repair

H pylori eradication

Question 11

Appendicitis signs

Answer 11

Nausea, vomiting, RIF pain, anorexia

Pyrexic, tachycardia, foetor, RIF peritonitis (mcburney’s point) rovsings sign, PR tenderness

Question 12

Diff diagnosis for appendicitis

Answer 12

Uti
Mesenteric adenitis
Ovarian Cust
Pid/tuboovarian abscess
Crohns
Nsap(non specific abdo pain)

Question 13

Investigations

Answer 13

Urine - negative dipstick

Blood - raised WCc in 90%

Ultrasound

Lap

Question 14

Appendicitis management

Answer 14

Iv
Analgesia
Appendicectomy