Severe Upper Abdo Pain Flashcards Preview

Jason's MD2 Surgery Rotation > Severe Upper Abdo Pain > Flashcards

Flashcards in Severe Upper Abdo Pain Deck (26):
1

2 out of 3 findings needed for pancreatitis

abdo pain
lipase
CT findings

2

most sensitive LFTs for gall stones?

ALT
AST

3

what do you need to see on RUQ ultrasound

bile duct 4-5mm
gall bladder wall thickness

4

how does gallstones cause pancreatitis?

autoactivation/digestion of pancreas from it's own enzymes

5

pancreatitis characterised how?

mild - no organ failure
mod - transient organ failure
Severe- persistant organ failure

6

useful blood test for pancreatitis to characteritics?

CRP, if over 150 or 200, mod, severe.

7

good scoring system for pancreatitis?

modified glasgow

8

only thing to modify outcome in severe pancreatitis?

ICU - for lots of fluids

9

normal urine output?

0.5ml/kg/hour

10

abdo structures that can be damaged by pancreatitis?

left colon

11

if they have cholangitis from gall stone, how to treat early with?

ERCP

12

early complications of acute pancreatitis?

SIRS - hypoxia, renal failure

13

SIRS is:

temp (>38)
WBC (high or low)
tachy (>10
RR (>20)

14

SIRS vs. sepsis?

SIRS is non-infectious

15

MODS is?

multi-organ dysfunction syndrome

16

blood tests for sepsis?

procalcitonin

17

if getting Fi02, what is p02 should be?

Fi02 times 5

18

non-invasive ventilation are?

BIPAP - bi-level to force air INTO lung
CPAP -continuous positive pressure both ways

19

non-invasive good for what kind of respiratory failure?

Type 2, more for ventilatory

20

acute complications of pancreatitis on CT?

pancreatic necrosis
infected
fluid collections (becomes pseudocyst)
Walled off fluid

left colon infarct
splenic vein thrombosis?

21

Abx for pancreatitis?

only if has cholangitis
or infective necrosis

22

what ABx for pancreatitis if you use them?

meropenem

23

enteral or TPN better for pancreatitis?

enteral

24

most common yeast and mould?

yeast - candida
mould - aspergillus

25

risk factors for invasive candida

surgery
immunosuppression
ICU admission
invasive lines
TPN
malnutrition
blood transfusions

26

abdo pain + hypotension

pancreatitis
perforated peptic ulcer
AAA

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