Exam 3 Abdominal Pain Flashcards Preview

Q4 EM Surg > Exam 3 Abdominal Pain > Flashcards

Flashcards in Exam 3 Abdominal Pain Deck (31)
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1
Q

Characteristics of Visceral pain? (3)

A

Dull, ache, colic
Poorly localized, periumbilical
Distention or spams of hollow organ

2
Q

Characteristics of Parietal (Somatic) pain? (3)

A

Sharp
Well demarcated
Peritoneal irritation/Somatic innervation

3
Q

Characteristics of Referred pain? (2)

A

Distant site, somatic, similar nn level

Aching, perceived near body surface

4
Q

Sharp/localized pain a/w? (3)

A

ischemia, inflamm, stretch of peritoneum

5
Q

Dull/diffuse pain a/w?

A

Visera: wall of hollow organs, capsules of solid organs

6
Q

Obstruction presents as? (8)

A
Pain
Anorexia
Bloating
N/V
Obstipation
High-pitched or no BS
Tympany percussion
Dilated proximal bowel loops
7
Q

Emergencies? (7)

A
Perforation
Ruptured AAA or Ectopic
Obstruction
Toxic mega colon
Appendicitis
Ovarian torsion
Acute mesenteric ischemia
8
Q

Urgent? (5)

A
Cholecystitis/Cholangitis
Pancreatitis
Hepatitis
Diverticulitis
PUD/Gastritis
9
Q

Abd pain labs? (6)

A
CBC w/ diff
CMP
LFT: AST/ALT, Alk Phos, Total Bili
Amyl, Lipase
UA!
Preggo
10
Q

Abd pain imagining? (3)

A

XRay
CT (better for obstruction)
US

11
Q

Abd pain exam should include? (8)

A
Vitals
Appearance/level of discomfort
Position while in pain
Movement or lack of
Eyes
Lungs
Heart
Abd
12
Q

Abd pain ABDOMINAL exam should include?

A
Inspection
BS
Percussion
Palp noting guarding/rigidity
RECTAL
PELVIC
13
Q

Abd pain ABX?

A

Cefazolin
Cefotin
Cefotetan
Ampicillin-Sulbactam (UNASYN)

14
Q

Abd pain DDX: RUQ? (9)

A
Cholecyctitis
Cholangitis
Biliary colic
Pancreatitis
Hepatitis
PNA
Abscess
Hepatic congestion
Budd-Chiari
15
Q

Abd pain DDX: LUQ? (6)

A
Spleen abscess or inflamm
Gastritis
Gastric ulcer
Pancreatitis
PNA
MI
16
Q

Abd pain DDX: RLQ? (8)

A
Appendicitis
Salpingitis
Ectopic preg
Inguinal hernia
Nephrolithiasis
IBD
Mesenteric adenitis
Tiflitis/Cecitis
17
Q

And pain DDX: LLQ? (8)

A
Diveriticulitis
Salpingitis
Overian cyst rupture
Ectopic preg
Inguinal hernia
Nephrolithiasis
IBS
IBD
18
Q

Epigastric pain DDX? (9)

A
PUD
GE reflux
Esophagitis
Hiatal hernia
Gastritis
Pancreatitis
MI
Pericarditis
AAA
19
Q

Periumbilical pain DDX? (4)

A

Early appendicitis
Gastroenteritis
Bowel obstr
AAA

20
Q

Low Mid Abd pain DDX? (2)

A

Bladder distention

Cystitis

21
Q

Diffuse abd pain DDX? (8)

A
Gastroenteritis
Mesenteric Ischemia
Metabolic
Malaria
FMF
Peritonitis
IBD
Obstruction
22
Q

Appendicitis primary imaging?

A

CT

23
Q

Mesenteric Adenitis is?

Presents?

Tx?

A

Inflamm of mesenteric lymph nodes

Mimics appendicitis

No surgery needed

24
Q

Typhlitis is?

Presents?

Tx?

A

Inflammation of the cecum from necrotizing enterocolitis

Mimics appendicitis

Abx
Surgery only if complicated

25
Q

SBO Extraluminal causes? (6)

A
Adhesions
CA
Hernia
Bands
Malrotation
Abscess
26
Q

SBO Intrinsic causes? (4)

A

Intussception
CA
Crohn’s
Inflamm/Ischemic strictures

27
Q

SBO initial management?

A

NG tube
IV fluids w/ e-
Serial exams: physical, imaging
Surgery if sxs worsen, peritoneal signs, unresolved w/ NG tube

28
Q

Acute Abd Pain management? (6)

A
NPO
IV NS
Pain meds
No NSAIDS
PPI
Phenergan/Zofran
29
Q

Pain meds for acute abd pain?

A

Dilaudid
Morphine Sulfate
Demerol
Toradol (renal stones)

30
Q

Pain before vomiting U a/w?

Pain after vomiting U a/w?

A

surgical abd

non-surgical illness

31
Q

Pain lasting > 6 hrs should be considered what?

A

acute abd until proven otherwise