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Flashcards in Acute abdomen Deck (54):
1

MCC acute abdominal pain

unknown

2

diarrhea

3 or more watery stool per day
determine if acute or chronic (< or > 3 weeks)

3

lakes or streams

giardia, metronidazole

4

oysters

vibrio

5

rice

b cereus

6

eggs

salmonella

7

meat

campylobacter
e. coli
yersinia
staph
clostridium

8

most specific test for diarrhea

stool cultures

9

#1 cause of cyclic vomiting

weed

10

which is better amylase or lipase

lipase is more sepcific

11

mesenteric ischemia is MC associated with

A-fib

12

MC electrolyte deficiency caused from diarrhea

hypokalemia, below 2.5 admit
20 meq dose will raise K by .25, don' texceed 40 meq per hour

13

hx of travel with weird foods, think

E. Coli, travelers diarrhea
cipro
also for shigella

14

entamoeba tx

metro + iodoquinol

15

common anti-motility agents

-loperamide
-bismuth subsalicylate
-diphneoxylate and atropine

16

MCC infectious diarrhea in hospitalized pts

C. Diff, recent admission/recent anbx use (7-10 day after)+ diarrhea think this

17

C. Diff treatment

metro or vanco
if severe get a CT to rule out toxic megacolon

18

S/S constipation

-weight loss
-rectal bleed
-unexplained anemia
-diarrhea alone can not rule out constipation

19

pt complains of constipation, what should you do?

rectal exam
-fluids, fiber, exercise
-dulcolax
-enema for severe
-relistor for OIC

20

initial test for constipation
best test

abdominal series
CT w/IV and PO contrast

21

MCC esopageal perforation

intraluminal procedures (post endoscopy acute, severe, unrelenting pain)

22

initial test for esophageal perf
best test

CXR
CT

23

esophagela perf tx

-stat sx consult
-fluids and broad spectrum anbx (zosyn, ceftriaxone, clinda, flagyl)

24

FB, plain films are good at finding
CT

radioopaque
non radioopaque

25

who should you call if FB is above sternal notch?
Below?

ENT laryngoscopy
surgical consult

26

PUD is usually relieved by

-eating food
-anatacids

27

how to evaluate a possible PUD

CXR may show free air
gold standard is endoscopy

28

how to tx ulcers?

-PPI (azole)
-if pt has C diff treat with triple therapy (flagyl/amox, clarithromycin, PPI)

29

MCC of pancreatitis

-gallstones
-etoh

30

how does pancreatitis present?

mid-epigastric pain radiating to back, constant exacerbated in supine position

31

what tests should you order for suspected pancreatitis

-lipase
-CT

32

pancreatitis tx

-IVF
-NPO
-pts w/pseudocyst or abscess start imipenem-cilastatin or cipro/flagyl

33

who gets cholecystitis

female
fat
forty
fertile
rapid weight loss

34

acute cholecystitis presentation

-pain > 5 hours in RUQ
-+ Murphy's sign

35

ascending cholangitis presents with

-charcot's triad

36

initial test to order for possible cholangitis
best

-US
-HIDA

37

ascending cholangitis tx

-surgery
-uncomplicated ceftriaxone/flagyl
-septic clinda, genta, ampicillin

38

when can you d/c biliary colic

after 4-6 hours of no symptoms

39

acute appendicitis signs

bump (jump when pt goes over bumps in road)
pts don't want to move

40

initial appendicitis test
best

US
CT w/PO and IV contrast

41

appendicitis tx

-sx
-zosyn

42

anbx for d/c diverticulitis
admitting

keflex or augmentin
ceftriaxone + flagyl

43

do diverticulitis pts need to be admitted?

No, as long as they tolerate PO meds and are not septic or vomiting

44

MCC SBO
LBO

adhesions
cancer

45

how to dx intestinal ostruction

CBC > 20,000 suspect abscess or gangrene
flat and upright xray intially
CT IV/PO is test of choice

46

how to tx intestinal obstruction

-NG tube
-ceftoxamine/ceftriaxone plus clinda/flagyl/zosyn/ampicillin

47

strangulated hernia tx

-sx consult
-IV fluids
-analgesia
-cefoxin or zosyn

48

mesenteric ischemia

-common in a-fibbers
-superior mesenteric artery
-pain out of proportion to PE

49

best test for mesenteric ischemia

CT angio
-give papaverine

50

emesis suggests

upper GI bleed

51

melena suggests

source proximal to right colon

52

hematochezia suggests

distal colorectal lesion

53

weight loss think

malignancy

54

vomiting or retching think

mallory weiss tear