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Emergency Medicine > Unit 3 Lecture 4 > Flashcards

Unit 3 Lecture 4 Flashcards

(71 cards)

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1
Q

dull, aching, colicky and poorly localized pain

A

visceral pain

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2
Q

sharp, well localized pain

A

parietal pain

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3
Q

referred pain to the right scapula

A

gallbladder

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4
Q

referred pain to the umbilicus

A

appendix

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5
Q

referred pain to the left scapula

A

stomach

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6
Q

condition with a rapidly worsening prognosis in the absence of surgical intervention

A

surgical abdomen/generalized peritonitis

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7
Q

signs of obstruction

A

anorexia, bloating, N/V, obstipation, high pitched or absent bowel sounds, tympany on percussion

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8
Q

extrinsic causes of SMO (3)

A

adhesions, hernia, volvulus

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9
Q

intrinsic causes of SMO (5)

A

congenital malformations, atresia/stenosis, neoplasm, inflammatory stricture, radiation enteritis

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10
Q

obstruction of normal bowel lumen causes (5)

A

intussusception, gallstones, feces, bezoar, traumatic intramural hematoma

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11
Q

signs of perintonitis

A

sick appearing, rebound tenderness, pain with light palpation, diminished BS

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12
Q

Testing for suspected bowel obstruction

A

abd. plain films or CT

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13
Q

testing for suspected peritonitis

A

US (esp in children) or CT

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14
Q

Signs of sepsis/shock

A

fever, tachycardia, hypotension, mental confusion

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15
Q

what is a “top priority” in treating acute adbominal pain while waiting for surgical intervention?

A

IV fluids

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16
Q

Causes of RUQ pain

A

hepatitis, cholecystitis, cholangitis, biliary colic, pancreatitis, budd-chiari syndrome, PNA, subdiaphargmatic abscess

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17
Q

sxs of acute cholecystitis

A

severe RUQ pain, infrascapular radiation, N/V

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18
Q

PE of acute cholecystitis

A

RUQ pain, +Murphy’s sign, low grade fever

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19
Q

Labs for acute cholecystitis

A

leukocytosis, ^ bili, ^alk phos, ^amylase

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20
Q

test of choice for acute cholecystitis

A

U/S

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21
Q

Tx of acute cholecystitis

A

IV fluids, 1st/2nd gen cephalosporins, cholecystectomy within 3 days of sx onset, percutaneous drainage for extremely high risk patients (to save surgery until pt is stable)

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22
Q

triangle of calot

A

common hepatic duct, cystic duct, and cystic artery

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23
Q

what type of choledocho is the most common? (primary or secondary)

A

secondary

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24
Q

cause of choledocho

A

gallstones

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25
sxs of choledocho
RUQ pain
26
PE of choledocho
RUQ pain +jaundice**
27
DX of choledocho
U/S
28
labs of choledocho
^serum bili, ^alk phos
29
tx of choledocho
ERCP
30
cause of cholangitis
ascending bacterial infection due to obstruction of the biliary ducts
31
most common cause of cholangitis
choledocho
32
charcot's triad
RUQ, fever, jaundice (cholangitis)
33
reynold's pentad
charcot's+ AMS and hypotension (cholangitis)
34
dx of cholangitis
ERCP (dx and tx), ^LFTs, leukocytosis
35
tx of cholangitis
fluid/electrolytes, abx, ERCP or PTC
36
KUB showing localized ileus and bi-basilar atelectasis
pancreatitis
37
causes of epigastric pain
PUD, GERD, gastritis, pancreatitis, MI, pericarditis, ruptured aortic aneurysm
38
causes of pancreatitis
gallstones, EtOH, obstruction, hypercalcemia
39
sxs of pancreatitis
epigastric pain with radiation to back, N/V
40
PE of pancreatitis
fever, tachycardia, hypotension, paralytic ileus, grey turner's sign, culen's sign
41
labs of pancreatitis
^amylase and lipase | amylase peaks within 12hours; lipase is better but may take a few days to peak
42
tx of pancreatitis
ICU, NPO, IV fluids, NGT, foley cath, serial labs, pain management, surgery (ERCP with stent placement)
43
sxs of pancreatic psudocyst
upper abd pain/asx, N/V, early satiety, jaundice
44
PE of pancreatic pseudocyst
abd tenderness, palpable firm area
45
test of choice for pancreatic pseudocyst
CT
46
tx of pancreatic pseudocyst
most resolve spontaneously, cystgastrostomy
47
most common type of gastric CA
adenocarcinoma
48
risk factors for gastric CA
diet, H. pylori, chronic gastric inflammation, gastric polyps, EtOH, tobacco
49
sxs of gastric CA
vague epigastric discomfort, indigestion, early satiety, abd pain with vomiting
50
PE of gastric CA
virchow's nodes, sister mary joseph's, jaundice, ascites, palpable adb mass (late in ds)
51
dx of gastric CA
upper endoscopy with bx
52
complications of gastric CA
bleeding, obstruction, perf
53
tx of gastric CA
surgical resection
54
causes of LUQ pain
splenic abscess/infarct/rupture, gastritis, gastric ulcer, pancreatitis
55
sxs of splenic abscess
fever, LUQ pain with or without splenomegaly
56
cause of splenic abscess
endocarditis
57
sxs of splenic infarct
LUQ pain without fever
58
tx of splenic abscess
IV abx, eval for splenectomy
59
tx of splenic infarct
uncomplicated-analgesia/monitor | complicated-eval for splenectomy
60
causes of RLQ pain
appendicitis, salpingitis, ectopic pregnancy, inguinal hernia, femoral hernia, nephrolithiasis, IBD, mesenteric adenitis
61
PE of abd wall hernia
reducible bulge/small mass (exam while supine and standing)
62
dx of abd wall hernia
PE, U/S, or CT
63
complications of abd wall hernia
incarceration, strangulation, recurrence, obesity
64
tx of abd wall hernia
observation, tension free repair
65
hesselbach's triangle
inguinal ligament, inferior epigastric vessels, lateral margin of the rectus sheath
66
evisceration
rupture of all layers and extrusion of abd viscera
67
dehiscence
partial or total disruption of any or all layers of the operative wound
68
most common post op day a/w dehiscence
between 5th-8th
69
pain control for acute abd pain
dilaudid, morphine sulfate, demerol, toradol
70
what PPI can be given IV
protonix
71
antiemetics for acute abd pain
phenergan or zofran

Emergency Medicine (6 decks)

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