Eval of Ab Pain Flashcards Preview

Block 7 - GI > Eval of Ab Pain > Flashcards

Flashcards in Eval of Ab Pain Deck (21):
1

What organs in the retroperitoneal can cause abdominal symptoms?

head, neck and body of pancreas, not tail duodenum except first part ascending and descending colon kidneys, ureter, bladder adrenal glands aorta and IVC rectum

2

What patterns of pain suggest an abdominal source?

irritation of diaphragm can go to shoulders biliary pain to right scapula renal pain to flank or butt uterine pain to low back

3

sudden, sharp, and well localized pain

perforation

4

dull, intermittent, colicky pain

obstruction

5

constant, poorly localized pain

infection

6

pain out of proportion to physical exam

ischemia, retroperitoneal inflamation (pancreatitis, pyelonephritis, aortic dissection), intestinal obstruction

7

What are the three most common mechanisms that result in abdominal pain?

distension of hollow viscus soilage of peritoneum ischemia

8

What characterizes visceral vs. parietal pain?

visceral - non specific and poorly localized, midline at dermatome of specific organ's innervation parietal - better localized, at location of initiating cause

9

What does diffuse abdominal pain suggest?

peritonitis

10

What is an acute vs a surgical abdomen?

acute - onset w/i 24 hrs, may or may not be surgery surgical - pancreatitis is not, perforated viscus is

11

What findings on clinical examination indicate a "surgical abdomen"?

virgin abdomen w small bowel obstruction, absent or high pitched sounds on auscultation appendicitis, peritonitis, complicated acute pancreatitis, acute diverticulitis (LLQ pain), mesenteric ischemia, AAA

12

How should the auscultation part of the exam be performed?

auscultate before percussing listen for at least two minutes

13

What is Rovsing's sign?

rebound tenderness when hand withdrawn from LLQ and increased pain at McBurney's point --> appendicitis

14

What does Psoas sign suggest?

retroperitoneal dz from abscess, bleed, or adenopathy

15

What does the obdurator sign suggest?

pelvic inflammation

16

What symptoms warrant a CBC?

check hematocrit or hemoglobin before surgery to see if transfusion necessary leukocytosis indicates more intervention needed

17

When should electrolytes be checked?

if a pt is vomiting

18

What symptoms warrant checking lactic acid?

small bowel obstruction and prior hx of operations - elevation indicates vascular compromise of bowel

19

When should an abdominal sonogram be ordered?

gallbladder pathology

20

What symptoms warrant a CT?

can drain perf appendicitis w/o peritonitis evaluate female pelvis or diverticulitis

21

What signs and symptoms indicate small bowel obstruction?

hyperactive bowel sounds, eating makes it worse