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Rosens > 23. Abdo pain > Flashcards

23. Abdo pain Flashcards

1
Q

2 deadly conditions in the elderly causing abdo pain

A

AAA
acute mesenteric ischemia

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2
Q

MC 3 organ systems causing abdo pain

A

GI tract
GU
reproductive organs

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3
Q

Name 4 abdo structures that came from the foregut

A

stomach
duodenum
liver
gallbl
pancreas

assoc with upper abdo pain

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4
Q

Name 3 abdo structures that came from the midgut

A

small bowel
proximal colon
appendix

periumbilical pain

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5
Q

Name 2 abdo structures that came from the hindgut

A

distal colon
GU tract

assoc lower abdo pain

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6
Q

Name 5 populations at high risk for abdo pain badness

A

age >60
pregnant
previous surgery (esp bariatric)
recent instrumentation of GI tract
Immunocomp
known vascular disease
known abdo/pelvic malignancy

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7
Q

Name 8 causes of diffuse abdo pain

A

peritonitis
pancreatits
sickle cell crisis
early appy
mesenteric thrombosis
gastroenteritis
dissecting/rupt aneurysm
intestinal obstruction
dm
ibd
irritable bowel

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8
Q

Name 8 causes of RUQ abdo pain

A

Biliary colic
Cholecystitis
Gastritis
GERD
Hepatic abscess
Acute hepatitis
Hepatomegaly due to CHF
Perforated ulcer Pancreatitis
Retrocecal appendicitis
Myocardial ischemia
Appendicitis in pregnancy
RLL pneumonia

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9
Q

Name 8 causes of LUQ abdo pain

A

Gastritis
Pancreatitis
GERD
Splenic pathology
Myocardial ischemia
Pericarditis Myocarditis
LLL pneumonia
Pleural effusion

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10
Q

Name 8 causes of RLQ abdo pain

A

Appendicitis
Meckel’s diverticulum
Cecal diverticulitis
Aortic aneurysm
Ectopic pregnancy
Ovarian cyst
Pelvic inflammatory disease
Endometriosis
Ureteral calculi
Psoas abcess
Mesenteric adenitis Incarcerated/strangulated hernia
Ovarian torsion
Tubo-ovarian abscess
Urinary tract infection
Mittleschmerz

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11
Q

Name 8 causes of LLQ abdo pain

A

Aortic aneurysm
Sigmoid diverticulitis Incarcerated/strangulated hernia
Ectopic pregnancy
Ovarian torsion
Mittelschmerz
Ovarian cyst
Pelvic inflammatory disease
Endometriosis
Tubo-ovarian abscess
Ureteral calculi
Psoas abscess
Urinary tract infection

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12
Q

Name referred pain spot for ruptured spleen

A

L posterior shoulder

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13
Q

Name referred pain spot for perforated duodenal ulcer

A

R posterior sh

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14
Q

Name referred pain spot for acute pancreatitis or renal colic

A

flank/mid back

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15
Q

Name referred pain spot for biliary colic

A

just below scapula/true mid back pain

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16
Q

Name referred pain spot for uterine/rectal pain

A

low back, above sacrum

17
Q

Name the syndrome:
The diffuse, severe, colicky pain, occurring at regular (“timeable”)
intervals associated with severe nausea

A

SBO

18
Q

Name the syndrome:
The “pain out of proportion to examination” (i.e., severe pain that
is not readily reproduced with palpation) observed in patients with
mesenteric ischemia

A

mes ischemia

19
Q

Name the syndrome:
The radiation of pain from the epigastrium straight through to the
midback, almost invariably accompanied by nausea and vomiting

A

pancreatitis

20
Q

Name the syndromes (3):
The radiation of pain to the left shoulder, or independent pain in
the left shoulder

A

splenic path
diaphragmatic irritation
free intraperitoneal fluid

21
Q

Name the syndromes (2):
The onset of pain associated with syncope

A

AAA rupture
ruptured ectopic

22
Q

RF in perforated peptic ulcer, chronic mes ischemia

A

more common in smokers

23
Q

RF gastritis, PUD, pancreatitis, liver disease

A

aud

24
Q

cocaine use - what two abdo conditions is this RF for?

A

vascular path
pud

25
Q

How is true peritonitis determined?

A

Discomfort with releasing the peritoneum is visually noted, rather than asking the patient if their symptoms were worse with pressure or with release of pressure.

cough

drop heels to ground after being on toes

26
Q

Ancillary tests for abdo pain

A

BG
urinalysis
pregnancy test
POCUS
wbc
lipase
lactate

27
Q

imaging studies on 270

A
28
Q

Name 6 critical causes of abdo pain

A

ruptured ectopic
ruptured AAA
acute mesenteric ischemia
perforated viscus
massive GIB
acute MI

29
Q

Key decision points in diagnostic algorithm for abdo pain

A

?are they pregnant
?signs of shock
?high risk vascular disease/MI
?peritonitis
?tender upper/diffuse/lower abdo

30
Q

High risk features of a patient that may require further w/u in the ED

A

immunosuppression
advanced age
worsening abdo exam
continued pain requiring analgesia
inability to tolerate oral hydration
unstable living condition
poor access to f/u care

31
Q

Name 8 diagnoses of emergent abdo pain

A

gastric/esophageal or duodenal inflammation
acute appy
biliary tract disease
ureteral colic
diverticulitis
acute gastroenteritis
constipation and obstipation
intestinal obstruction
acute pancreatitis

32
Q
A

Rosens (62 decks)

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