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Résidence - FM Learner > 1. Abdominal Pain > Flashcards

1. Abdominal Pain Flashcards

1
Q

Name cardiac DDX : Abdominal Pain (5)

A
  • ACS
  • Pericarditis
  • Aortic dissection
  • Mesenteric ischemia
  • Sickle cell crisis
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2
Q

Name pulmonary DDX : Abdominal Pain (2)

A
  • Pneumonia
  • Embolus
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3
Q

Name Biliary DDX : Abdominal Pain (3)

A
  • Cholecystitis
  • Cholelithiasis
  • Cholangitis
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4
Q

Name GASTRIC DDX : Abdominal Pain (4)

A
  • Esophagitis
  • Gastritis
  • Peptic ulcer
  • Small-bowel mass or obstruction
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5
Q

Name COLONIC DDX : Abdominal Pain (7)

A
  • Appendicitis
  • Colitis
  • Diverticulitis
  • IBD
  • Bowel obstruction
  • Peritonitis
  • Celiac disease
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6
Q

Name HEPATIC DDX : Abdominal Pain (3)

A

Hepatitis
Abscess, mass

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7
Q

Name PANCREATIC DDX : Abdominal Pain (2)

A

Pancreatitis, mass

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8
Q

Name RENAL DDX : Abdominal Pain (3)

A

Cystitis
Nephrolithiasis
Pyelonephritis

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9
Q

Name SPLENIC DDX : Abdominal Pain (1)

A

Abscess

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10
Q

Name SPLENIC DDX : Abdominal Pain (8)

A
  • Ectopic pregnancy
  • Ovarian mass
  • Ovarian torsion
  • PID
  • Fibroids
  • Endometriosis
  • Ovulatory pain
  • Ruptured ovarian cyst
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11
Q

Name ABDOMINAL WALL DDX : Abdominal Pain (3)

A
  • Herpes zoster
  • Muscle strain
  • Hernia
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12
Q

Name METABOLIC DDX : Abdominal Pain (6)

A
  • Uremia
  • DKA
  • Porphyria
  • Adrenal insufficiency
  • Narcotic withdrawal
  • Heavy metal poisoning
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13
Q

Name PSYCH DDX : Abdominal Pain (6)

A

IBS

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14
Q

Describe hx : Abdominal pain (7)

A
  • Acute vs. Chronic
  • Fever, stools (diarrhea, bloody), vomiting (bilious, bloody)
  • Malignancy (early satiety, weight loss, night sweats, changes in stools)
  • Alcohol, smoking, drugs
  • NSAIDs
  • Past surgeries (obstruction)
  • Females (pregnancy), Vaginal bleeding/discharge, LMP
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15
Q

Describe physical exam : Abdominal pain (5)

A
  • Vitals
  • Chest/Lung
  • Abdo
  • Pelvic/Genital exam
  • Rectal exam
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16
Q

Describe investigations : Abdominal pain (6)

A
  • Labs (eg. CBC, ALT/AST, amylase/lipase, lytes (glucose, creat), UA, bhCG)
  • Ultrasound
  • X-ray (CXR, AXR)
  • Endoscopy/Colonoscopy
  • ERCP
  • Urea breath test
17
Q

Describe choice of imaging in abdominal pain

A
  • Ultrasound (gallbladder, gyne) if RUQ/suprapubic
  • Otherwise, CT
    Consider IV contrast for RLQ, non-localized (r/o appendicitis)
    Consider Oral + IV contrast LLQ (r/o sigmoid diverticulitis)
18
Q

Describe use of X-ray

A
  • Free air (if upright), Perforation
  • Calcifications : 10% of gallstones, 90% of kidney stones, and 5% appendicoliths
  • Multiple dilated loops of the bowel and air-fluid levels, Bowel obstruction or paralytic ileus
19
Q

Name life-threatening dx of acute pelvic pain in women (3)

A
  • Ectopic pregnancy
  • Appendicitis
  • Ruptured ovarian cyst
20
Q

Name fertility-threatening dx of acute pelvic pain in women (3)

A
  • PID
  • Ovarian Torsion
21
Q

Name redflags of abdominal pain in children (8)

A
  • Fever (after onset of vomiting or pain)
  • Bilious vomiting
  • Bloody diarrhea
  • Absent bowel sounds
  • Voluntary guarding
  • Rigidity
  • Rebound tenderness
  • ** Do not forget testis **
22
Q

Name DDX of abdominal pain if : < 1 yo

A
  • Common: Colic, constipation, GERD, food protein allergy
  • Urgent: Acute gastroenteritis, malrotation without volvulus, pyloric stenosis
  • Emergent: Trauma (abuse), midgut volvulus, NEC, omphalitis, incarcerated hernia, intussusception
23
Q

Name DDX of abdominal pain if : 1 - 5 yo

A
  • Common: UTI, constipation
  • Urgent: Acute gastroenteritis, HSP, pneumonia, Meckel diverticulum
  • Emergent: Trauma, appendicitis, asthma
24
Q

Name DDX of abdominal pain if : 5 - 12 yo

A
  • Common: UTI, constipation, functional
  • Urgent: Acute gastroenteritis, IBD, HSP, pneumonia
  • Emergent: Trauma, appendicitis, gonadal torsion, DKA, asthma
25
Q

Name DDX of abdominal pain if : > 12 yo

A
  • Urgent: Gastroenteritis, IBD, pneumonia, hepatitis, pancreatitis, nephrolithiasis, PID
  • Emergent: Trauma, appendicitis, gonadal torsion, ectopic pregnancy, DKA, asthma
26
Q

Describe : Investigation in children with abdominal pain

A
  • Consider urinalysis, CBC, pregnancy test, ESR/CRP
  • Consider ultrasound prior to proceeding with abdominal CT
27
Q
A
28
Q

Elderly are at an increase risk of which ddx of abdominal pain ?

A
  • holecystitis
  • pancreatitis
  • diverticulitis
  • obstructions (adhesions, malignancy)
29
Q
A

Résidence - FM Learner (36 decks)

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