Exam 3 Abdominal Pain Flashcards Preview

Q4 EM Surg > Exam 3 Abdominal Pain > Flashcards

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

Characteristics of Visceral pain? (3)

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

2

Characteristics of Parietal (Somatic) pain? (3)

Sharp
Well demarcated
Peritoneal irritation/Somatic innervation

3

Characteristics of Referred pain? (2)

Distant site, somatic, similar nn level
Aching, perceived near body surface

4

Sharp/localized pain a/w? (3)

ischemia, inflamm, stretch of peritoneum

5

Dull/diffuse pain a/w?

Visera: wall of hollow organs, capsules of solid organs

6

Obstruction presents as? (8)

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

7

Emergencies? (7)

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

8

Urgent? (5)

Cholecystitis/Cholangitis
Pancreatitis
Hepatitis
Diverticulitis
PUD/Gastritis

9

Abd pain labs? (6)

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

10

Abd pain imagining? (3)

XRay
CT (better for obstruction)
US

11

Abd pain exam should include? (8)

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

12

Abd pain ABDOMINAL exam should include?

Inspection
BS
Percussion
Palp noting guarding/rigidity
RECTAL
PELVIC

13

Abd pain ABX?

Cefazolin
Cefotin
Cefotetan
Ampicillin-Sulbactam (UNASYN)

14

Abd pain DDX: RUQ? (9)

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

15

Abd pain DDX: LUQ? (6)

Spleen abscess or inflamm
Gastritis
Gastric ulcer
Pancreatitis
PNA
MI

16

Abd pain DDX: RLQ? (8)

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

17

And pain DDX: LLQ? (8)

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

18

Epigastric pain DDX? (9)

PUD
GE reflux
Esophagitis
Hiatal hernia
Gastritis
Pancreatitis
MI
Pericarditis
AAA

19

Periumbilical pain DDX? (4)

Early appendicitis
Gastroenteritis
Bowel obstr
AAA

20

Low Mid Abd pain DDX? (2)

Bladder distention
Cystitis

21

Diffuse abd pain DDX? (8)

Gastroenteritis
Mesenteric Ischemia
Metabolic
Malaria
FMF
Peritonitis
IBD
Obstruction

22

Appendicitis primary imaging?

CT

23

Mesenteric Adenitis is?

Presents?

Tx?

Inflamm of mesenteric lymph nodes

Mimics appendicitis

No surgery needed

24

Typhlitis is?

Presents?

Tx?

Inflammation of the cecum from necrotizing enterocolitis

Mimics appendicitis

Abx
Surgery only if complicated

25

SBO Extraluminal causes? (6)

Adhesions
CA
Hernia
Bands
Malrotation
Abscess

26

SBO Intrinsic causes? (4)

Intussception
CA
Crohn's
Inflamm/Ischemic strictures

27

SBO initial management?

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

28

Acute Abd Pain management? (6)

NPO
IV NS
Pain meds
No NSAIDS
PPI
Phenergan/Zofran

29

Pain meds for acute abd pain?

Dilaudid
Morphine Sulfate
Demerol
Toradol (renal stones)

30

Pain before vomiting U a/w?

Pain after vomiting U a/w?

surgical abd

non-surgical illness

31

Pain lasting > 6 hrs should be considered what?

acute abd until proven otherwise