ECEs: Chest, abdo, pelvis Flashcards Preview

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Flashcards in ECEs: Chest, abdo, pelvis Deck (133)
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1

What is the DDx for abdo pain in the RUQ?

Hepatitis
Biliary colic, Cholecystitis/Cholangitis
Pancreatitis
Pneumonia, Pleural effusion, PE
DEADLY: Chole, pancreatitis, PE

2

What is the DDx for abdo pain in the LUQ?

Pancreatitis
Gastritis
Pneumonia, Pleural effusion, PE
DEADLY: Pancreatitis, PE

3

What is the DDx for abdo pain in the RLQ?

Appendicitis
Ectopic pregnancy, PID, tubo-ovarian abscess, ovarian torsion
Testicular torsion, epidiymitis, orchitis
Renal colic
DEADLY: ectopic pregnancy

4

What is the DDx for abdo pain in the LLQ?

Diverticulitis
Ectopic pregnancy, PID, tubo-ovarian abscess, ovarian torsion
Testicular torsion, epidiymitis, orchitis
Renal colic
DEADLY: Diverticulutis, ectopic pregnancy

5

What is the DDx for epigastric abdo pain?

Gastritis, dyspepsia, PUD, duodenitis
Pancreatitis
ACS (Cardiac)
DEADLY: Pancreatitis, ACS

6

What is the DDx for periumbilical abdo pain?

Colitis, Perforation, Obstruction
Aortic dissection, AAA
DEADLY: ... all except colitis.

7

What is the DDX for suprapubic abdo pain?

UTI, renal colic
Obstruction
Deadly: none.

8

What is the DDx for R or L flank abdo pain?

Colitis, perforation, Obstruction
Renal colic, pyelonephritis
AAA
DEADLY: Perforation, obstruction, AAA

9

What are the risk factors for ruptured ectopic pregnancy?

Hx of STI/PID
Recent IUD
previous ectopic
Fallopian tube surgery, tubal ligation
Smoking

10

What are the risk factors for ruptured AAA?

Elderly, HTN/DM, smoking, trauma

11

What are the risk factors for pancreatitis?

EtOH, biliary pathology

12

What is the classic clinical presentation of cholangitis?

Charcot's triad: fever, RUQ pain, jaundice

13

What are the risk factors for mesenteric ischemia?

Elderly, CAD, CHF, dehydration, infection

14

What are the risk factors for bowel obstruction?

Operative or malignant history, elderly

15

What are the risk factors for bowel perforation?

Risk factors for diverticulitis or ulcer; malignancy; instrumentation (eg colonoscopy)

16

What are the risk factors for complicated diverticulitis?

Elderly, low-fibre diet, Western population

17

What would you elicit on Hx for acute abdo pain?

OPQRST
Associated Sx: N/V, fever, chills; BM; urinary Sx; pelvic discharge/bleeding

18

What labs would you order for acute abdo pain?

CBC, lytes, BUN/Cr, LFTs, lipase, lactate, B-hCG
Consider: CK, troponin

19

What imaging & other Ix would you order for acute abdo pain?

ECG, CXR, consider bedside US
Consider formal US (biliary, ectopic, AAA); consider CT abdo/pelvis

20

How do you acutely manage acute abdo pain, in general?

ABCs
Analgesics
Anti-emetics
NPO; consult surgery as needed

21

What is the "deadly six" DDx for acute chest pain?

PET MAT:
Pulmonary embolism
Esophageal rupture/mediastinitis
Tension pneumothorax
Myocardial infarction
Aortic dissection
Tamponade

22

What are the cardiac causes of acute CP?

DEADLY: MI, aortic dissection, tamponade
Pericarditis, Myocarditis, Endocarditis

23

What are the respiratory causes of acute chest pain?

DEADLY: PE, tension pneumo
Pneumonia
Pleural effusion
Acute chest syndrome (sickle cell)
Lung or mediastinal mass

24

What are the GI causes of acute chest pain?

DEADLY: Esophageal rupture/mediastinitis
Esophagus: Mallory-Weiss tear, esophageal spasm
Stomach: GERD, ulcer
Pancreas: pancreatitis
GB: biliary colic, cholecystitis, cholangitis

25

What is dyspepsia?

sensation of pain or discomfort in the upper abdomen, often recurrent. Not specific to etiology (can be recurent postprandial, could be MI, could be ulcer).
(may be described as indigestion, gassiness, early satiety, postprandial fullness, gnawing, or burning)

26

What are the MSK, neuro, & psych causes of acute chest pain?

Intramuscular pain
Rib pathology
Herpes zoster
Rib pathology
None deadly.

27

What history do you want to elicit for acute chest pain?

OPQRST, cardiac risk factors, PE risk factors, recent trauma, neuro Sx

28

What parts of the physical exam are important for acute chest pain?

General appearance
Cardiac & resp exams
Neuro screen
Vitals, Pulse

29

What are the initial Ix for acute chest pain?

Tests: ECG, CXR; consider CT pulmonary angio
Labs: CBC, lytes, abdo panel, cardiac markers; consider D-dimer

30

What are the cardiac markers? (bloodwork)

CK and TnI (Creatine kinase & troponin I)