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Flashcards in Interactive cases - Abdo Deck (61)
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1

What do you look for in the general inspection of an abdo exam?

- jaundice or pallor
- conjunctival pallor
- scarring

2

what do you look for in the hands?

- Asterixis
- Bruising
- Clubbing
- Dupuytren's contracture
- Erythema (pallor): janeway lesions, osler's nodes
- Leukonychia: hypoalbuminaemia

3

what do you look for in the forearms?

- AV fistulae
- current/previous renal replacement therapy

4

what do you look for in the head and neck?

- anaemia
- jaundice
- skin markings (jaundice, excoriation marks, spider naevi)
- oral exam: pigmentation, gum hypertrophy (cyclosporine causes this after renal replacement)

5

what do you look for in the chest inspection?

- gynaecomastia
- spider naevi
- hair loss
- pectus excavatum
- excoriation marks

6

what do you percuss for?

- organomegaly
- shifting dullness, bladder

7

what are the causes of hepatomegaly?

- Cancer
- Cirrhosis
- Cardiac (CCF, constrictive pericarditis)
- Infiltration (fatty, haemochromatosis, amyloidosis, sarcoidosis)

8

what are causes of liver disease?

- alcohol
- viral
- AI
- biliary disease
- drugs

9

what are the causes of splenomegaly?

H, H , I, I
- portal Hypertension (chronic liver disease)
- Haematological
- Infection
- Inflammation

10

what are the symptoms of a perforated AAA?

- epigastric pain radiating to back
- reduced BP
- reflex tachy

11

what are the differentials for epigastric pain originating in the stomach?

- peptic ulcer (NSAID use?)
- GORD
- gastritis (retrosternal pain, ETOH use)
- malignancy

12

what are the differentials for epigastric pain originating in the acute pancreatitis?

look for gallstone history and high amylase
- Acute: pain, high amylase (>1000)
- Chronic: pain, weight loss, loss of exocrine (diabetes), and endocrine (malabsorption) function, normal amylase, faecal elastase (low)

13

what is superior to epigastrium that can cause epigastric pain?

inferior MI

14

what is inferior to epigastrium that can cause epigastric pain?

ruptured AAA

15

what isright-lateral to epigastrium that can cause epigastric pain?

cholecystitis
hepatitis

16

What are RUQ pain differentials?

- Gall bladder: cholecystitis, cholangitis, gallstones
- Liver: hepatitis, abscess

17

what is superior to RUQ that can cause RUQ pain?

LUNGS
basal pneumonia

18

what is inferior to RUQ that can cause RUQ pain?

APPENDIX
appendicitis e.g. in pregnancy

19

what is left lateral to RUQ that can cause RUQ pain?

stomach, pancreas
peptic ulcer, pancreatitis

20

`what is right lateral to RUQ that can cause RUQ pain?

KIDNEY
pyelonephritis

21

what is RIF pain differentials?

- GI tract: appendicitis, mesenteric adenitis (esp in children following resp infection), colitis, malignancy
- Gynaecological: ovarian cyst rupture, twist, bleed, ectopic pregnancy
- Mittelschmerz: mid pain from follicle rupture

22

what are LIF pain differentials?

- GIT: diverticulitis, colitis, malignancy, sigmoid volvulus
- gynaecological: ovarian cyst rupture, twist, rupture, ectopic pregnancy, Mittelschmerz

23

What are the suprapubic pain differentials?

- cystitis
- urinary retention
- testicular torsion

24

what are diffuse pain differentials (surgical)?

- obstruction
- infection (peritonitis, gastroenteritis)
- inflammation (IBD)
- ischaemia (mesenteric ischaemia)

25

what are diffuse pain differentials (medical)?

- DKA (hypercalcaemia)
- Addison's (lead poisoning)
- Porphyria

26

what test do you have to do in any case of acute abdomen?

amylase
always get HIGH AMYLASE

27

what is the definition of SBP?

ascites neutrophil >250 cells/mm3

28

what do you check for if there is fluid causing abdominal distension?

Ascites
- check for shifting dullness
- check for features of liver disease which may be causing the ascites

29

what do you check for if there is flatus causing abdominal distension?

Obstruction
- nausea/ vomiting
- high pitched tinkling or absent bowel sounds
- previous surgeries (adhesions?)
- hernias

30

What is a transudate and the causes?

Transudate is caused by the failures
Causes:
- cirrhosis
- cardiac failure
- nephrotic syndrome