case 3 overv Flashcards
(15 cards)
bowel obstruction/
risks factors/sx/signs
risks factors=Prior abd. sgery (SBO in particular)
sx= mouth NV ;
anus : no stool or flatus passing;
chged BM; Hematochezia
severe crampy abdominal pain +
signs=Abd. Distention (++ in LBO;—in SBO);
hypERactive or hyPOactive bowel sounds
bowel obstruction/important imaging tests
Abdominal radiographs = ck to see the luminal air
CT scan
AAA/
demo;risks factors/
sx=1/
signs=3
demo=male;
risks factors=smoking
sx=+ abdominal pain
signs=Orthostatic hypotension +
Pulsatile abd mass +
Decr. LE lower extremity pulses
AAA/important imaging tests
Abdominal CT scan
ck= to c the diff types of fluids involved
Appendicitis
/demo;risks factors
/sx/signs
/demo=;risks factors=
sx=Migration of pain from periumbilical region to RLQ
/signs=
Appendicitis/important tests
FREQUENT Clinical exam = to track the evolution of the pain
CT scan= u can see inflammation
Bowel ischemia: Acute mesenteric ischemia
risks factors= 2 os/sx/signs
risks factors=
pump: HEART/Afib; valvular heart dZ; heart failure;
fluid itself:BLOOD hypercoagulable state
sx=Abrupt onset pain
signs=Pain out of proportion to exam
Bowel ischemia: Acute mesenteric ischemia/
important tests
CT angiography
Bowel ischemia: Ischemic colitis
/demo;risks factors=3/sx/signs
demo=60+;
risks factors=ck
VASCULAR =>low-flow
Vascular dz;
MI or
=> vasodilation:sepsis=>hypotension
sx=hematochezia; hint: ischemic colitis is bloody!!
diarrhea
Bowel ischemia: Ischemic COLitis
/important imaging tests
Colonoscopy
ck: colitis=> explore the colon
why colonoscopy/ ischemic colitis <=> bloody stool=> u need to know where does that come from
AMI: mesenteric ischemia (small bowel)=> CT scan to locate which area in general
periumbilical pain/
DO-NOT-MISS dx
AAA
BO
appendicitis
bowel ischemia by AMI (acute) or ischemic colitis
ck=ischemia and inflammation
LBO=large bowel obstruction
disease Finger print:#
3
LBO=large bowel obstruction
dz Finger print/#1
Abdominal distention
ck: large bowel when they get filled, they push the rest of the belly=> abd distention
LBO=large bowel obstruction
dz Finger print/#2
Abdominal distention+
any of the following:
ROS: vomiting; = blocked=> that is a way to get stuff out
constipation; = blocked => O out
PE:incr. .bowel sounds; = blocked=> poop is yelling to come out
hx: prior surgery
LBO=large bowel obstruction
dz Finger print/#3
ROS: or vomiting
hx: prior surgery
PE: Incr. bowel sounds +
