SM02 Mini2 Flashcards
(43 cards)
stigmata
specific diagnostic signs of a dz
spider angioma
stigma of liver dz
found on skin of face, neck, arms, & upper trunk (area of superior vena cava)
swollen blood vessel just below surface of skin often w/spiderweb appearance
ascites
accumulation of fluid in peritoneal cavity
causes abdominal swelling
often caused by liver dz
cholecystitis
inflammation of the gallbladder
often secondary to cholelithiasis
acute abdomen
condition of severe abdominal pain caused by acute dz or injury to internal organs
perinotitis
inflammation of peritoneum
typically caused by bacterial infection via blood or organ rupture
McBurney’s point
1/3 distance from ASIS (anterior superior iliac spine) to umbilicus on the R lower abdomen
most commonly corresponds to base of appendix
rebound tenderness
pain that occurs or worsens after removal of pressure
reliable sign of peritoneal inflammation
pyelonephritis
inflammation of kidney & renal pelvis
usually caused by bacterial infection
most common causes of acute abdominal pain
acute appendicitis
nonspecific abdominal pain
urological origin
intestinal obstruction
what is the most likely diagnosis when pain worsens w/jolting movements?
peritonitis
important considerations of abdominal pain
- age
- onset: time & mode
- pain: location, radiation, severity
- duration: acute or chronic
- associated symptoms: nausea, emesis (color/quality/frequency), loss of appetite
- bowel movements: quality, color, frequency
- menstrual hx
vomiting w/parethesias, blurred vision, dysphagia, & muscle weakness is likely caused by?
food-borne toxins (food poisoning)
most acute diarrhea is caused by?
infectious origin
constipation is most commonly found in what patients?
elderly
opoid drug users
what qualifies constipation as chronic?
presence of symptoms for at least 12 weeks w/onset at least 6 months prior to diagnosis
- must have 2 or more of:
- hard lumpy stool
- straining
- sensation of incomplete evacuation
- anorectal obstruction
- loose stool are rare w/o laxative use
- insuffficient criteria for IBS
differentiation of chronic constipation v. IBS-C
abdominal pain or discomfort 3+ days per month in pervious 3 months w/onset 6+ months prior to diagnosis
- 2+ symptoms of:
- improvement of pain or discomfort upon defecation
- onset associated w/change in frequency of stool
- onset associated w/change in form or appearance of stool
when is constipation an alarming symptom?
- hematochezia
- family hx of colon CA
- IBD
- anemia
- positive fecal occult blood test
- unexplained weight loss of 10+ lbs
- refractory of treament
- new-onset w/o evidence of potential primary cause
abdominal exam prodecure
inspection
auscultation
percussion
palpation
what causes increased peristaltic sounds?
irritation of bowl, usually by toxins
can be heard during early obstruction
usually distinguishes diarrheal illness from obstruction
what causes abdominal rigidity?
reflex muscle spasm due to peritoneal irritation
may be unilateral & localized
hurts most upon movement
how is abdominal wall v. viseral organ pain differentiated?
palpate the abdomen in area of tenderness while patient raises head off pillow or feet off table
this raises the abdominal wall away from the organs
if tenderness if unchanged, likely disorder of abdominal wall
signs of acute appendicitis
shifting of pain form umbilicus to RLQ
abdominal movements are painful/doesn’t like to move torso
sudden onset of pain, loss of appetite, n/v/fever, in that order
hypoactive bowel sounds
severe tenderness w/rigidity
physical exam tests for acute appendicitis
Psoas: + if retrocecal appendix (64%)
Rovsing
obturator: + if pelvis appendix (32%)
