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Flashcards in The acute abdomen Deck (32)
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1
Q

What is an acute abdomen

A

Abdominal pain which has been around for less than 10 days

Causing severe morbidity or threat to life

2
Q

Who does it present to?

A
GP
A&E
General surgeons
Gynae
General Medicine
3
Q

What are some of the common causes of acute abdomen

A
Non-specific abdominal Pain (1/3rd of patients)
Acute appendicitis
Intestinal obstruction
Urological causes
Gallstone disease
Diverticular disease of the colon
Trauma 
Malignancy
Perforated ulcer
Pancreatitis
IBS
Bacterial and viral infections
Gynae things
4
Q

What are the ages for women of child-bearing age?

A

10-55

5
Q

What are some of the less common causes of acute abdomen

A

Ruptured or symptomatic AAA
IBD
Medical causes
Ischemic gut

6
Q

What is Munchhausen’s syndrome

A

Attention - making something up

7
Q

What are drug seekers?

A

Typically women who want morphine who are manipulating

8
Q

3 types of abdominal pain

A

Visceral
Parietal
Extra-abdominal

9
Q

5 associated symptoms of abdominal pain

A
Nausea/ Vomiting
Burping 
Heartburn / indigestion
Change in bowel habit 
PR blood / mucus
10
Q

In what condition will the pain totally disappear?

A

Renal colic

11
Q

What are the 9 regions of the abdomen

A
Right and Left Hypochondrian
Epigastric
Right and Left Lumbar 
Umbilical 
Right and Left iliac fossa
Suprapubic
12
Q

What questions do you ask about vomit?

A
Colour
Green or foodstuff
Projectile
Blood
Coffee
13
Q

What is golden yellow vomit

A

Digested bile

14
Q

What colour is digested bile

A

Green

15
Q

What is localised peritonism

A

Localised pain and guarding

16
Q

What is peritonitis

A

Refers to pain in all 4 quadrants

17
Q

What does generalised peritonitis

A

Board like

Usually perforated duodenal ulcer

18
Q

Describe the bowel sounds in ileus

A

Absent

19
Q

What is the common analgesia given?

A

IV morphine with anti-emetic

IV paracetamol

20
Q

What is Cullen’s sign

A

Periumbilical bruising often with Pancreatitis

21
Q

What are initial investigations for abdomen?

A
Bloods: FBC,LFT,UE, CRP, Ca, Lactate, Coag
AMYLASE!!!!!
ABGs
Plain radiology
AXR and erect if possible CXR
Or straight to CT
22
Q

Why is amylase so important to do?

A

Pancreatitis

23
Q

What do we look for with an erect chest

A
Free air under diaphragm 
First line and very useful if abnormal 
Lateral decubitis if too ill to stand 
Excludes pneumonia 
Useful as a preoperative investigation
24
Q

What is the gold standard scanning for acute abdomen

A

CT scanning - less mortality and decreased hospital stay is done early

25
Q

Who is US very useful for?

A

Children and women with pelvic pain or RUQ or RIF pain

26
Q

What are the 3 most important things to look for

A

Exclude pancreatitis

AAA

27
Q

What patients go straight to surgery

A

ruptured AAA
ischaemic guts
Faecal peritonitis

28
Q

Who does not go to theatre?

A

Nobody with pancreatitis

Nobody with DKA

29
Q

What are 5 types of colonic emergencies

A
Obstruction
Volvulus
Acute diverticulitis
Toxic colitis
Perforations (stercoral, iatrogenic, anastomotic)
30
Q

How is a volvulus managed

A

Decompress using rigid sigmoidoscope

31
Q

What is typhilitis

A

A condition common in patients on chemotherapy

32
Q

What is a Hartmann’s procedure

A

surgical resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy. It was used to treat colon cancer or diverticulitis.

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