Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgical Recall > Chapter 34: Acute Abdomen > Flashcards

Chapter 34: Acute Abdomen Flashcards

1
Q

what is an acute abdomen?

A

Undiagnosed sudden pain that lasts less than seven days and forces patient to seek medical attention

NOTE: NOT surgical abdomen because most acute abdomen do not need surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are peritoneal signs?

A

Signs of peritoneal irritation:

  1. extreme tenderness
  2. percussion tenderness
  3. rebound tenderness
  4. voluntary guarding
  5. Involuntary guarding/rigidity (late)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

rebound tenderness

A

pain upon releasing the palpating hand pushing on the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

motion pain

A

abdominal pain upon moving, pelvic rocking, moving of stretcher or heel strike

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

voluntary guarding

A

abdominal muscle contraction with palpation of abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

involuntary guarding

A

rigid abdomen as the muscles gaurd involuntarily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

colic

A

intermittent severe pain ususally because of the intermittent contraction of a hollow viscus against an obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what condisions can mask abdominal pain

A
  1. Steroids
  2. Diabetes
  3. Paraplegia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MC cause of acute abdominal surgery in US

A

Acute appendecitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should go first, auscultation or palpation

A

auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

best way for patient to localize the pain

A

point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

classic position of pateint with peritonitis

A

motionless with knee flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

classic position of patient with kidney stone

A

restless, writhing in pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

lab tests to evaluate a patient with acute abdomen

A
  1. CBC with differential
  2. Chem-10
  3. AMylase
  4. Type and screen
  5. Urinalysiss
  6. LFTs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a left shift on CBC differential

A

sign of inflammatory response ie. immature neutrophils (bands)

NOTE: Many call >80% of WBCs as neutrophils a “left shift”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

women of childbearing age with an acute abdomen should recieve

A

BHCG to rule out ectopic/pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which xrays are used to evaluate patient with an acute abdomen

A
  1. uproght cxr
  2. upright abdomnial film
  3. supine abdominal
  4. if patient cannot stand: left lateral decubitus abdominal film
18
Q

how is free air ruled out if the patient cannot stand

A

left lateral decubitus because free air collects over the liver ie NOT confused with gastric bubble

19
Q

must consider this with every case of acute abdomen

A

appendicits

20
Q

ddx of RUQ

A
  1. cholecystitis
  2. hepatitis
  3. pud
  4. perforated ulcer
  5. pancreatitis
  6. liveer tumor
  7. gastritis
  8. hepatic abscess
  9. choledocolithiasis
  10. cholangitis
  11. pyelonephritis
  12. nephrolithiasis
  13. appendecitis (esp during pregnancy)
  14. thoracic causes
    1. pleurisy
    2. pneumoia
    3. PE
    4. pericarditis
    5. MI (esp. inferior wall)
21
Q

ddx of LUQ

A
  1. PUD
  2. perorated ulcer
  3. gastritis
  4. splenic injury
  5. splenic abscess
  6. reflux
  7. dissecting aortic aneurysm
  8. thoracic causes
  9. pyelonephritis
  10. nephrolithiasis
  11. hiatal hernia (strangulated paraesophageal hernia)
  12. boerhaave syndrome
  13. mw tear
  14. splenic artery aneurysm
  15. colon disease
22
Q

ddx of LLQ

A
  1. diverticulitis
  2. sigmoid volvulus
  3. perforated colon
  4. colon cancer
  5. uti
  6. small bowel obstruction
  7. IBD
  8. nephrolithiasis
  9. pyelonephritis
  10. fluid accumulation from aneurysm or perforation
  11. referred hip pain
  12. gyne
  13. rarely appendicitis
23
Q

ddx of RLQ

A
  1. Appendixitis
  2. LLQ
  3. mesenteric lymphadenitis
  4. cecel diverticulitis
  5. meckels diverticulum
  6. intussusception
24
Q

ddx of epigastric

A
  1. PUD
  2. gastritis
  3. MI
  4. pancreatitis
  5. biliary colic
  6. gastric volvulus
  7. MW tear
25
Q

nonsurgical causes of abdominal pain

A
  1. GE
  2. DKA
  3. sickle cell crisis
  4. rectus sheath hematoma
  5. acute porphyria
  6. kidney stone
  7. pyelonephritis
  8. hepatitis
  9. pancreatitis
  10. pneumonia
  11. MI
  12. C. dificile colitis
26
Q

ddx of AIDs and abdominal pain

A
  1. all common causes
  2. CMV (MC)
  3. Kaposi sarcoma
  4. Lymphoma
  5. TB
  6. MAI
27
Q

pain specific to dermatome

A

early zoster before vesicles erupt

28
Q

cholecystitis pain usually refers to

A

right subscapular and epigastric

29
Q

appendicitis pain usually refers to

A

early: periumbilical
rare: testicular

30
Q

diaphragmatic irritation refers to

A

Shoulder pain and KEHR’S sign on the left

due to:

  1. spleen
  2. perforated ulcer
  3. abscess
31
Q

pancreatitis/ca refers to

A

back

32
Q

rectal disease refers to

A

small of the back

33
Q

nephrolithiasis pain refers to

A

testicular pain/flank pain

34
Q

rectal pain refers to

A

midline small of the back

35
Q

small bowel pain refers to

A

periumbilical pan

36
Q

uterine pain refers to

A

midline small of back

37
Q

abdominal pain out of proportion to exam

A

mesenterich ischemia must be ruled out

38
Q

hypotention and pulsatile abdominal mass

A

ruptured AAA

39
Q

fever, LLQ pain, change in bowel habits

A

Diverticulitis

40
Q

endocrine causes of abdominal pain

A
  1. DKA
  2. Addisonian crisis
41
Q

chandelier sign associated with

A

PID

42
Q

22 yr old f with acute onset of lower abdomial pain, hypotension, tachycardia, adenexal mass, free fluid on vaginal US

A

ectopic pregnancy

Surgical Recall (168 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions