22- teen with abdominal pain

Question 1

pancreatitis presentation

Answer 1

May present with diffuse abdominal pain, but other patterns (such as epigastric or RUQ) are more common; band-like pain radiating to the back is highly suggestive.
Pain is constant and usually severe.

Nausea and vomiting are almost always present.
Low-grade fevers are common.

Causes of pancreatitis include gallbladder disease, infection, alcohol use, injury, certain medications, and inherited conditions.

Question 2

hepatitis presentation

Answer 2

h fever, malaise, diffuse or RUQ abdominal pain, nausea, and vomiting without diarrhea.

jaundice and a change in the color of their urine, hepatomegaly

Alcohol/risk taking (B and C), recent travel (A)

Question 3

acute gastroenteritis presentation

Answer 3

Vomiting is a common presenting complaint in acute gastroenteritis.
After a couple of days, diarrhea typically becomes the most pronounced symptom.
May reveal history of sick contacts.

Question 4

mesenteric adenitis

Answer 4

Inflammation of the mesenteric lymph nodes.
Has many causes and often presents like appendicitis.
Typical presentation is of RLQ pain with fever, vomiting, and diarrhea.

Question 5

cholecystitis presentation

Answer 5

RUQ pain, radiate to the shoulder.
constant and worse after eating, especially fatty foods.

Episodes may be intermittent (colicky) and accompanied by decreased appetite, nausea, and vomiting.

Murphy’s sign (increased pain upon palpation of the area when the patient takes a deep breath) is a finding specific for cholecystitis.

Question 6

mcburney point

Answer 6

an inch and a half and two inches from the anterior superior spinous process of the ilium on a straight line drawn from that process to the umbilicus

maximal tenderness point of appendicitis

Question 7

x-rays KUB good to detect…

Answer 7

Ileus (sometimes with air-fluid levels)
Fecaliths (seen with appendicitis)
Free air (with perforated viscus)
Malrotation of the intestines, and
Gall stones.

Question 8

CT scans in kids with abdominal pain

Answer 8

More sensitive and specific than a KUB, but also more expensive and difficult to obtain in children.

radiation children receive from CT scans.

look for abscesses and diagnose appendiciti

Question 9

Ultrasounds can help detect

Answer 9

Appendicitis

PID

Question 10

barium studies detect

Answer 10

IBD

intussception in smaller kids

Question 11

indications for hospitalizing a patient with PID

Answer 11

Pregnancy
Previous noncompliance
High fever
Intractable vomiting
Inability to exclude a surgical emergency
Inadequate response on oral therapy within 72 hours
Tubo-ovarian absces

Question 12

for women treated for PID, how long until improvement of symptoms

Answer 12

up to 3 days

if over- get a diagnostic lap