Chapter 16: Gastrointestinal and Urologic Emergencies

Question 1

Discuss

Name the abdominal solid organs

Answer 1

Liver, spleen, pancreas, kidneys, ovaries/testes

Question 2

Discuss

Name abdominal hollow organs

Answer 2

Stomach, gallbladder, bladder, intestines, uterus, ureter, fallopian tubes

Question 3

Discuss

Normal adult urine production

Answer 3

1.5-2 L/day

Question 4

Discuss

Peritoneum

Answer 4

Internal lining of the abdominal cavity. Parietal lines cavity itself and Visceral lines organs

Question 5

Discuss

Peritonitis

Answer 5

Anything in the peritoneum other than peritoneal fluid can cause irritation. Can cause ileus.

Question 6

Discuss

Ileus

Answer 6

Paralysis of intestinal peristalsis, causing abdominal distention. Consequence is emesis.

Question 7

Discuss

Acute abdomen

Answer 7

Sudden onset of abdominal pain, often severe. Untreated can be fatal.

Question 8

Discuss

Diverticulitis

Answer 8

Inflammation of small weakened pockets in the colon wall filled with feces.

Question 9

Discuss

Cholecystitis

Answer 9

Inflammation of the gallbladder, often accompanied by fever

Question 10

Discuss

Abdominal pain vis a vis parietal and visceral peritoneum

Answer 10

Parietal supplied by same nerves as skin, so pain is localized. Visceral supplied by autonomic, only deep pain from stretching, sometimes referred pain.

Question 11

Discuss

Location of pain: appendicitis

Answer 11

RLQ, navel, rebouding pain

Question 12

Discuss

Location of pain: cholecystitis

Answer 12

RUQ, right shoulder

Question 13

Discuss

Location of pain: ulcer

Answer 13

upper midab, upper back

Question 14

Discuss

Location of pain: Diverticulitis

Answer 14

LLQ

Question 15

Discuss

Location of pain: AAA

Answer 15

Lower back and lower Q’s

Question 16

Discuss

Location of pain: Cystitis

Answer 16

Retropubic

Question 17

Discuss

Location of pain: Kidney infection

Answer 17

Costovetebral angle

Question 18

Discuss

Location of pain: Kidney stone

Answer 18

Right or left flank radiating to genitalia

Question 19

Discuss

Location of pain: Pancreatitis

Answer 19

Upper ab and back

Question 20

Discuss

Location of pain: Pneumonia

Answer 20

Referred pain to upper ab

Question 21

Discuss

Location of pain: Hernia

Answer 21

Anywhere in ab

Question 22

Discuss

Location of pain: Peritonitis

Answer 22

Anywhere in ab

Question 23

Discuss

Causes of acute abdomen

Answer 23

Ulcers, gallstones, pancreatitis, appendicitis, gastrointestinal hemorrhage, esophagitis, esophageal varices, Mallory-Weiss syndrome, gastroenteritis, hemorrhoids

Question 24

Discuss

Ulcers

Answer 24

Most peptic ulcers a result of H. pylori infection or chronic use of NSAIDs. Burning or gnawing pain that subsides after eating and reemerges 2-3 hrs after.

Question 25

# Discuss Gallstones

Answer 25

Can lead to cholecystitis

Question 26

# Discuss Pancreatitis

Answer 26

Caused by gallstone, alcohol abuse, other diseases.

Question 27

# Discuss Appendicitis

Answer 27

Rebound tenderness is classic

Question 28

# Discuss Esophagitis

Answer 28

from infection or acids

Question 29

# Discuss Esophageal varices

Answer 29

Pressure on esophageal blood vessles increases as portal system gets clogged from liver damage. Eventually the vessels burst and bleed into esophagus.

Question 30

# Discuss Mallory-Weiss syndrome

Answer 30

Tears in the mucosa at the junction of the stomach and esophagus, usually after violent coughing/retching. Produces hematemesis, possibly melena.

Question 31

# Discuss Gastroenteritis

Answer 31

Acute gastroenteritis is infection combined with diarrhea, nausea, emesis. Noninfectious gastroenteritis has same hallmarks. Diarrhea is primary symptom.

Question 32

# Discuss Hemorrhoids

Answer 32

Swelling and inflammation of blood vessles around rectum

Question 33

# Discuss Cystitis

Answer 33

Bladder inflammation, often from infection (UTI).

Question 34

# Discuss Uremia

Answer 34

Inability to remove urea from the body

Question 35

# Discuss Kidney stone

Answer 35

Blocking ureter can cause swelling kidney, pain can be intense and radiate to groin

Question 36

# Discuss Kidney failure

Answer 36

Acute (reversible) and chronic (irreversible from hypertension and diabetes). S/S: * AMS * lethargy * nausea * headache * cramps * edema in extremities and face.

Question 37

# Discuss AAA

Answer 37

Abdominal aortic aneurysm. Often get back pain from tearing of peritoneum. Often describe pain uniquely as "tearing". ACUTE ABDOMEN + S/S SHOCK NEEDS PROMPT TRANSPORT.

Question 38

# Discuss Hernia

Answer 38

Protrusion of organ through a hole into a cavity where it doesn't belong. Reducible: can be pushed back in. Incarcerated: may become compressed and lose blood supply, called strangulation, a serious emergency.

Question 39

# Discuss S/S serious hernia

Answer 39

* Formerly reducible becomes incarcerated * pain at hernia site, tenderness upon palpation * blue or red skin over hernia.

Question 40

# Discuss Method for palpating abdomen with pain

Answer 40

Palpate quadrants clockwise beginning with one AFTER location of pain.

Question 41

# Discuss What should not be given to acute abdomen pt's?

Answer 41

Do not give anything by mouth

Question 42

# Discuss Guarding

Answer 42

Involuntary muscle spasms of abdominal wall; an effort to protect the inflamed abdomen

Question 43

# S/S Cystitis

Answer 43

* Lower Q pain, * urgent urination, * pain around bladder