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Symptoms > 040315 abd pain > Flashcards

040315 abd pain Flashcards

1
Q

Murphy’s sign

A

having pt breathe in (place hand under costal margin)

positive in cholecystitis

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2
Q

differential for upper abdominal pain

A 
choledocholithiasis
acute pancreatitis
peptic ulcer
GERD
pyeloneprhitis
ascending cholangitis
MI
cancer
hepatitis
aortic dissec
bowel obstruction
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3
Q

what diagnostic tests could you get for upper abd pain?

A

CBC
lipase (pancreatitis?)
UA

EGD

EKG

US
XR of abdomen for free air (perforated ulcer)

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4
Q

cholelithiasis

A

stones in gallbladder

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5
Q

cholangitis

A

stone at ampulla of Vater

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6
Q

choledocholithiasis

A

stone in common bile duct

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7
Q

cholecystitis

A

stone in cystic duct

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8
Q

biliary colic

A

when gallstone blocks cystic duct-gallbladder contraction induces pain

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9
Q

intestinal tract has sympathetic supplies (for pain) at what levels?

A

T8-L2

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10
Q

kidney has sympathetic supplies (for pain) at what leveL?

A

T10-L1

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11
Q

L1 is what body part?

A

groin

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12
Q

T10 is what body part?

A

umbilicus

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13
Q

small intestine has sympathetic supplies (for pain) at what level?

A

T8-T10

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14
Q

lactate test can be used to assess

A

shock? ischemia?

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15
Q

gallbladder and biliary tree-imaging modality of choice

A

US (CT and MRI can be used though to eval for complications)

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16
Q

XR can look for

A

air, or obstruction in abdomen

17
Q

when should you NOT do a CT of abdomen or pelvis with contrast

A

when creatinine is elevated

18
Q

air in bowel wall is called

A

pneumotosis (due to ischemia)

19
Q

sudden onset pain in medicine is usually due to

A

something got blocked or perforated

20
Q

abd pain and unexplained hypotension-differential?

A

intra abdominal hemorrhage (aortic aneurysm, ectopic pregnancy, splenic rupture)

sepsis (acute mesenteric ischemia, appendicitis, etc)

other (adrenal insufficiency, diabetic ketoacidosis, MI)

21
Q

pain out of proportion to examination

A

acute mesenteric ischemia

22
Q

what laboratory tests can you do to diagnose acute mesenteric ischemia

A

lactate

WBC

23
Q

what imaging tests can you do to diagnose acute mesenteric ischemia

A 
CT (insensitive)
CT angiography (highly sensitive, specific)
catheter angiography (gold standard)
24
Q

tx for acute mesenteric ischemia

A

embolectomy if early or bowel removal

25
Q

appendix can be imaged via

A

US

26
Q

supine films are sensitive or insensitive for free air

A

insensitive (need instead an upright or decubitus)

27
Q

in female pt presenting w abd pain, what imaging is best?

A

US (in case there’s preg)

28
Q

imaging-black bubbles?

A

colon diverticula–air filled

29
Q

imaging for appendicitis

A

US for children and preg women

otherwise CT for adults

30
Q

imaging for ovarian torsion

A

US

Symptoms (18 decks)

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