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Year 3 - MedEd Lectures > Acute Abdomen > Flashcards

Acute Abdomen Flashcards

1
Q

How does Appendicitis typically present?

A

Acute Umbilical pain that radiates to the RIF

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2
Q

What is Rovsing’s Sign?

A

Pain is greater in the RIF when the LIF is pressed

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3
Q

What is Cope’s Sign?

A

Pain on passive flexion and internal rotation of the hip

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4
Q

What is the Psoas Sign?

A

Pain on extension of the hip

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5
Q

How should you investigate a possible case of Appendicitis?

A

Bloods - Leukocytosis, Raised CRP

USS

CT

Alvarado Score

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6
Q

How should you manage a case of Appendicitis?

A

Appendicectomy

Metronidazole, Cefotaxime

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7
Q

Which complications can occur as a result of Appendicits?

A

Perforation

Appendix Mass

Appendix Abscess

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8
Q

What do:

Diverticulosis

Diverticular Disease

Diverticulitis

mean?

A

Diverticulosis - The presence of Diverticulae

Diverticular Disease - The complications from Diverticulosis

Diverticulitis - Acute infection and inflammation of diverticulae

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9
Q

How does Diverticulitis typically present?

A

Bloody Diarrhoea

LIF Pain

Fever

Urinary Symptoms

Mainly >60yo

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10
Q

How would you investigate a suspected case of Diverticular Disease?

A

Bloods - FBC, Clotting

Barium Enema (Only in chronic)

Flex Sig/Colonscopy

CT (Acute)

Erect AXR

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11
Q

How should you manage an Acute case of Diverticulitis?

A

IV Hydration

Bowel Rest

Surgery may be indicated (Hartmann’s, Primary Anastomosis)

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12
Q

How should you treat Chronic Diverticular Disease?

A

Soluble, high-fibre diet

Anti-Inflammatories (mesalazine)

Surgery may be indicated (Hartmann’s, Primary Anastomosis)

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13
Q

What is Hartmann’s Procedure?

A

Removal of the diseased bowel and an end-colostomy formation with an anorectal stump.

Used when Primary Anastomosis is not possible.

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14
Q

What are the main complications of Diverticular Disease?

A

Diverticulitis

Faecal Peritonitis

Fistula

Peri-Colic Abscess

Colonic Obstruction

Perforation

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15
Q

Define ‘Hernia’.

A

Protrusion of part of an organ through the wall of the cavity in which it is contained.

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16
Q

How do Inguinal and Femoral hernias typically present?

A

Lump in the groin

Groin Pain

Vomiting

Scrotal Swelling

17
Q

What are the signs of a strangulated hernia?

A

Tender, red, colicky Abdo pain, distension, vomiting

18
Q

How do you determine whether an Inguinal hernia is Direct or Indirect?

A

Reduce the Hernia

Place a finger over the deep-inguinal ring, just above the midpoint of the inguinal ligament

Ask the patient to cough, if it re-appers, it must be direct.

19
Q

How would you investigate a hernia?

A

Usually a clinical diagnosis

USS

20
Q

Why are Femoral Hernias more commonly operated on than Inguinal Hernias?

A

Higher risk of strangulation

21
Q

How does Acute Pancreatitis typically present?

A

Epigastric Pain

Pain relieved when sitting forward

Radiation to the back

Worse on movement

Hx of gallstones & alcohol

22
Q

What are the main causes of Pancreatitis?

A

GET SMASHED

Gallstones

Ethanol

Trauma

Steroids

Mumps, Malignancy

Autoimmune

Scorpion Venom

Hypercalcaemia, Hyperlipidaemia, HyperPTH

ERCP

Drugs

23
Q

What signs might you see on examination of a patient with Pancreatitis?

A

Cullen’s

Grey-Turner’s

Both due to retroperitoneal bleeding

24
Q

How would you investigate Acute Pancreatitis?

A

Amylase

USS (Gallstones)

Erect CXR/AXR

CT

25
Q

How do you assess the severity of Acute Pancreatitis?

A

Modified Glasgow Score

26
Q

How do you manage a case of Acute/Chronic Pancreatitis?

A

Fluid Balance, Catheter & NG Tube, Analgesia

ERCP

Surgery if complications are severe

27
Q

How does Chronic Pancreatitis typically present?

A

Recurrent Epigastric Pain

Relieved on Sitting Forward

WL, Bloating, Steattorhoea

28
Q

How would you investigate Chronic Pancreatitis?

A

Faecal Elastase

AXR

ERCP/MRCP

29
Q

How might Intestinal Obstruction present?

A

Diffuse Pain

Constipation

Vomiting

Abdominal Distension

30
Q

What can cause Intestinal Obstruction?

A

Adhesions from surgery

Malignancy

Volvulus

Ileus

31
Q

What might you observe on examination of a patient with Intestinal Obstruction?

A

Distension

Pyrexia

High-Pitched, tinkling bowel sounds

Absent bowel sounds

32
Q

How do you investigate a suspected case of Intestinal Obstruction?

A

Bloods

Plain AXR

CT

Normal Bowel = 3/6/9 Small/Large/Caecum

33
Q

How do you treat Bowel Obstruction?

A

Drip & NG Tube

Conservative if a causative Volvulus shows signs of decompression. Laparotomy if peritonitic

34
Q

How does Acute Intestinal Ischaemia present?

A

Sudden onset diffuse Abdominal Pain

35
Q

How would you investigate a suspected case of Intestinal Ischaemia?

A

AXR - Perforation, Megacolon

Angiography - Blockages

ECG - MI/AF

36
Q

How might Chronic Intestinal Ischaemia present?

A

Intermitten gut claudication

Post-prandial pain (after eating)

PR Bleeding

WL

Year 3 - MedEd Lectures (29 decks)

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