Lower Abdominal Pain

Question 1

In a possible aortic dissection, why is it important to measure distal pulses?

Answer 1

As dissection proceeds , ripped intima occludes vessel > lose flow to that limb

Question 2

When is surgical intervention for a abdominal aortic aneurysm recommended?

Answer 2

Larger than 5 cm

Question 3

What is the differential diagnosis for an inguinal hernia?

Answer 3

Hydrocoele
Inguinal lymph node enlargement
Psoas abscess
Undescended testis
Tumour - rare

Question 4

What is an incarcerated hernia?

Answer 4

Irreducible

Question 5

What is a strangulated hernia?

Answer 5

Blood supply compromised

Question 6

Does a normal lactate level exclude ischaemia?

Answer 6

No

Question 7

What does mesenteric stranding on CT abdomen mean?

Answer 7

Inflammatory change

Question 8

What are the complications of diverticulitis?

Answer 8

Contained perforation
Abscess
Free perforation
Bleeding
Large bowel obstruction

Question 9

For diverticulitis, what antibiotics are given?

Answer 9

Gram -ves > ceftriaxone/gentamicin
Anaerobes > metronidazole/tazocin (if metronidazole shortage)
Gram +ve cocci > ampicillin/amoxicillin

Question 10

What is the response to blood loss in fit, young people?

Answer 10

Good vasoconstriction
HR increased with stable BP
Volume depletes so much > collapses