Differentials for acute presentations - Abdominal pain Flashcards Preview

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Flashcards in Differentials for acute presentations - Abdominal pain Deck (13):
1

 

 

What are life threatening causes of acute abdominal pain?

 

  • Peritonitis
  • AAA
  • Ischaemic bowel
  • Medical causes (DKA, Pneumonia, MI, Addisonian crisis)

2

 

 

How would you explore acute abdominal pain?

 

 

SOCRATES

 

3

 

 

What would you want to ask about on systemic enquiry in someone with acute abdominal pain?

 

  • How patient feels
  • Fever
  • Gastro - nausea, vomiting, bowel habit, blood/malaena, weight loss
  • Urological - dysuria, urinary frequency
  • Gynae - LMP, PV discharge, contraception, chance of pregnancy

4

 

 

What would you as about on PMH in someone with acute abdominal pain?

 

  • Happened before
  • Other medical conditions
  • Previous surgery - particularly abdominal

5

 

 

What would you want to ask about on social history?

 

  • Smoking
  • Alcohol

6

 

 

What would you look for on examinaion in someone with acute abdominal pain?

 

  • Inspect - movement with resps, grey turners/cullen's sign, scars
  • Guarding/rebound tenderness
  • Murphy's/Rovsig's sign
  • Liver/spleen/kidneys/AAA
  • Hernias
  • Percussion tenderness
  • Bowel sounds
  • External genetalia/PR if indicated

7

 

 

What bloods would you want to do in someone with acute abdominal pain?

  • FBC
  • U+E's
  • CRP
  • LFTs
  • Amylase
  • INR/G&S
  • Cap glucose
  • Mg2+/PO4-
  • VBG

8

 

 

What bedside tests would you consider doing in someone with acute abdominal pain?

 

  • NEWS
  • ECG
  • Urine dipstick
  • Urine BHCG

9

 

 

What imaging sould you consider doing in someone with  acute abdominal pain?

 

  • Erect CXR
  • AXR
  • Fast Scan
  • USS/CT abdo/pelvis

10

 

 

What structured approach would you take to determining what investigations you are going to do in someone with acute abdominal pain?

 

  • Bloods/Bedside
  • Orifices
  • X-rays/Imaging
  • ECG
  • Specific tests

11

 

 

What are surgical causes of acute abdominal pain?

  • Peritonitis/perforation
  • Ruptured AAA
  • Appendicitis
  • Gallstone disease
  • Acute pancreatitis
  • Diverticulitis
  • Renal colic
  • Bowel obstruction
  • Acute mesenteric ischaemia
  • Testicular torsion
  • Ischaemic colitis
  • Volvulus
  • Strangulated hernia
  • Meckels diverticulum
  • Mesenteric adenitis
  • Adhesions
  • Hepatic abscess
  • Psoas abscess

12

 

 

What are medical causes of acute abdominal pain?

 

  • Gastritis
  • Peptic ulcer
  • Pyelonephtritis
  • Gastroenteritis
  • COnstipation
  • Crohn's Disease/UC
  • MI
  • Pneumonia
  • SC crisis
  • DKA
  • IBS
  • Budd-chiari syndrome
  • Addisonian crisis
  • Hypercalcaemia
  • Acute intermittent porphyria
  • Hepatitis

13

 

 

What are gynaecological causes of Acute abdominal pain?

 

  • Ectopic pregnancy
  • Ovarian Torsion
  • Acute salpingitis/PID
  • Ovarian cyst rupture
  • Pregnancy
  • Fitz-hugh-curtis syndrome
  • Endometriosis