GI Emergencies and Abd Trauma Flashcards
(39 cards)
what age group is most likely to get appendicitis
10-19 year olds
What labs would be ordered for suspected acute apendicits
CBC CMP UA Pregnancy Imaging
What imaging would be ordered for suspected appendicitis
Adults: Ct abdomen and pelvis w/ contrast
Kids: US; if neg then CT
Pregnant: MRI
What is the initial treatment of appendicitis?
NPO IVF antiemetic pain meds preop abx
Cut that shit out
what is the best way to not miss acute appendicitis acting like a gastroenteritis or viral illness?
treat the patient
if normal CBC and abnormal UA keep appendicitis on ddx
what percent of all foreign body ingestions occur in children
80%
80-90 percent pass w/o need for intervention
What is the reason that the esophagus is the primary point of impaction
physiological areas of narrowing at UES, aortic arch, and diaphragmatic hiatus
there are also pathologies that narrow the esophagus
What are the hallmark symptoms of esophageal obstruction?
- drooling and inability to swallow saliva
- Fever abd pain, vomiting
What is the reason you would use imaging on a suspected esophageal impaction
if they were asymptomatic!!! don’t delay EGD
In what instance is a plain radiograph appropriate for foreign body ingestion
without suspicion of esophageal obstruction and history of ingestion of radio opaque object ie coin
When is a CT appropriate for foreign body ingestion
suspected perf
sharp/pointy object
suspected ingestion of narcotics in a condom or such
what factors inform the course of treatment for foreign object ingestion?
presence and severity of sx
type of object
location of object
When is an emergent <6hrs endoscopy indicated in foreign object ingestion
complete obstruction
disk batteries
sharp pointed objects
When is an urgent <24 hrs endoscopy indicated in foreign object ingestion indicated
all foreign objects in esophagus
What percent of hernias are inguinal hernias?
75%
what fraction of inguinal hernias are indirect?
2/3 — so if 75% of hernias are indirect and of those 2/3 are indirect, that is your majority choice if you like me and dumb
what are the three statuses of hernias
Reducible
incarcerated
strangulated
what type of hernia is the most common ventral hernia
epigastric
umbilical
1/4 of people will be born with or develop this kind of hernia
what is a direct inguinal hernia
passes DIRECTLY through a weakness in the transversalis fascia in the hesselbach triangle
What is an indirect inguinal hernia
passes through the femoral ring through a patent processus vaginalis
Which of the three hernia statuses is a surgical emergency
strangulated hernia
What is the treatment for a strangulated hernia
consult gen surge
broad spectrum IV abx
fluid resuscitation
pre op lab studies
when is an AAA diagnoses?
when diameter of AA exceeds 3.0 cm
where do AAA most commonly occur
in abdomen below renal arteries
