a cute abdomen Flashcards
1
Q
Statements
A
Notes
2
Q
{{c1::Acute abdomen}} refers to a condition where symptoms and signs are primarily related to the {{c2::abdomen}}.
A
Acute abdomen requires careful evaluation, often necessitating repeated examination to decide if surgical intervention is needed.
3
Q
Clinical syndromes that usually require {{c1::laparotomy}} include {{c2::rupture}} of an organ and generalized {{c2::peritonitis}}.
A
Laparotomy is often essential in cases of organ rupture (e.g., spleen, ectopic pregnancy) or when peritonitis is present.
4
Q
A key sign of organ rupture is {{c1::shock}}, often accompanied by {{c2::abdominal swelling}}.
A
Shock indicates significant internal bleeding or trauma, which may require immediate surgical intervention.
5
Q
Peritonitis presents with {{c1::board-like abdominal rigidity}} and {{c2::no bowel sounds}}.
A
These signs are classic indicators of peritonitis, a condition that often requires emergency surgery.
6
Q
An {{c1::erect CXR}} may show {{c2::gas under the diaphragm}} in cases of perforated abdominal organs.
A
Free gas under the diaphragm on an erect chest X-ray suggests perforation, typically of the gastrointestinal tract.
7
Q
{{c1::Local peritonitis}} may not require laparotomy and can be managed with {{c2::drainage}} or antibiotics.
A
Conditions like diverticulitis or cholecystitis can cause localized peritonitis, which might be treated with less invasive methods.
8
Q
{{c1::Colic}} is characterized by {{c2::waxing and waning}} pain, often due to muscular spasm in a hollow viscus.
A
Unlike peritonitis, colic causes restlessness, and patients may be pacing around due to the intermittent pain.
9
Q
Tests for acute abdomen include {{c1::U&E}}, {{c2::FBC}}, and {{c2::amylase}} to help identify the underlying cause.
A
These tests help assess the patient’s metabolic state, organ function, and potential causes like pancreatitis.
10
Q
Preoperative management involves resuscitation, {{c1::imaging}}, and {{c2::IV antibiotics}} to stabilize the patient.
A
Before surgery, it is crucial to stabilize the patient to minimize anesthesia-related risks and prepare for potential complications.
11
Q
Always consider hidden diagnoses like {{c1::mesenteric ischemia}}, {{c2::acute pancreatitis}}, and {{c2::leaking AAA}} in cases of acute abdomen.
A
These conditions can present with non-specific symptoms but are life-threatening and require a high index of suspicion.
12
Q
{{c1::Shock}} in the context of an acute abdomen may indicate {{c2::rupture}} of an organ or severe {{c2::peritonitis}}.
A
Shock is a critical sign and often requires urgent surgical intervention to address the underlying cause.
13
Q
{{c1::Delayed rupture}} of the spleen can occur {{c2::weeks}} after trauma.
A
Patients with a history of blunt abdominal trauma should be monitored for delayed splenic rupture, which may present later.
14
Q
{{c1::Generalized peritonitis}} is characterized by {{c2::prostration}}, lying still, and a positive {{c2::cough test}}.
A
These signs suggest widespread inflammation within the abdominal cavity, often requiring immediate surgical exploration.
15
Q
{{c1::Acute pancreatitis}} can mimic peritonitis but typically does {{c2::not require}} a laparotomy.
A
Acute pancreatitis is an important differential diagnosis in patients presenting with an acute abdomen.
16
Q
Localized ileus with a {{c1::sentinel loop}} of gas on an AXR may indicate {{c2::peritoneal inflammation}}.
A
A sentinel loop on imaging suggests localized irritation of the peritoneum, often due to nearby infection or inflammation.
17
Q
{{c1::Laparoscopy}} can sometimes {{c2::avert open surgery}} in the management of acute abdomen.
A
Minimally invasive techniques like laparoscopy can be diagnostic and therapeutic, reducing the need for more invasive procedures.
18
Q
{{c1::Mesenteric ischemia}}, {{c2::acute pancreatitis}}, and {{c2::leaking AAA}} are often hidden diagnoses in acute abdomen cases.
A
These conditions can be easily missed due to their subtle presentation but are highly dangerous and require prompt recognition.
19
Q
{{c1::CT}} and {{c2::US}} are valuable imaging modalities in evaluating an acute abdomen, especially when surgery is being considered.
A
These imaging techniques help confirm diagnoses like perforation, abscess, or fluid collections that guide further management.
20
Q
In acute abdomen, {{c1::resuscitation}} before surgery is essential to avoid compounding {{c2::shock}}.
A
Proper stabilization of the patient before surgery reduces the risk of complications during and after the procedure.
21
Q
A {{c1::positive urine hCG}} in a woman with acute abdomen symptoms may indicate an {{c2::ectopic pregnancy}}.
A
Ectopic pregnancy is a critical differential diagnosis in women of childbearing age presenting with acute abdominal pain.
22
Q
{{c1::Ruptured ectopic pregnancy}} can lead to {{c2::life-threatening hemorrhage}} and requires immediate intervention.
A
Rapid diagnosis and treatment are critical to prevent severe blood loss and shock.
23
Q
{{c1::Guarding}} and {{c2::rebound tenderness}} are classic signs of {{c2::peritonitis}}.
A
These physical exam findings indicate irritation of the peritoneum, often due to infection or perforation.
24
Q
{{c1::Abscess formation}} in cases of localized peritonitis may require {{c2::drainage}}, either percutaneous or surgical.
A
Imaging, such as ultrasound or CT, is used to guide drainage and manage the infection.
25
{{c1::Colicky pain}} is typically due to {{c2::muscular spasm}} in a hollow organ and presents with {{c2::restlessness}}.
Colicky pain, often seen in conditions like ureteral stones or biliary colic, contrasts with the stillness of peritonitis.
26
{{c1::Erect CXR}} showing {{c2::gas under the diaphragm}} is suggestive of a {{c2::perforated viscus}}.
Free air in the abdomen indicates perforation, typically from the gastrointestinal tract, requiring urgent surgical attention.
27
{{c1::Appendicitis}} often presents with localized pain in the {{c2::right lower quadrant}} and may progress to {{c2::peritonitis}}.
Early diagnosis and surgical removal of the appendix are necessary to prevent complications like abscess or perforation.
28
{{c1::Sentinel loop}} on an AXR suggests localized {{c2::ileus}} due to peritoneal irritation.
The sentinel loop is a sign of a localized bowel obstruction or irritation, often near an inflamed organ like the pancreas.
29
{{c1::Leaking abdominal aortic aneurysm (AAA)}} presents with {{c2::back pain}}, hypotension, and a pulsatile abdominal mass.
This condition is life-threatening and requires immediate surgical intervention to prevent rupture and exsanguination.
30
{{c1::IV antibiotics}} are critical in managing {{c2::peritonitis}} to prevent the spread of infection and sepsis.
Early antibiotic administration can be life-saving, particularly in cases of bacterial peritonitis.
31
{{c1::Diabetic ketoacidosis (DKA)}} can present with {{c2::abdominal pain}} and mimics an acute abdomen.
DKA is a metabolic emergency often misinterpreted as a surgical abdomen but requires medical management.
32
{{c1::Myocardial infarction (MI)}} can present as an acute abdomen, particularly with {{c2::epigastric pain}}.
An MI should always be considered in patients with unexplained epigastric pain, especially in the elderly or those with risk factors.
33
{{c1::Pneumonia}} in the lower lobes can mimic {{c2::abdominal pain}} due to diaphragmatic irritation.
This type of referred pain can lead to a misdiagnosis of an acute abdomen, so a thorough chest exam is essential.
34
{{c1::Pancreatitis}} can cause severe {{c2::epigastric pain}} radiating to the back, often without the need for surgery.
Acute pancreatitis is primarily managed medically, although severe cases may require more intensive interventions.
35
{{c1::Ectopic pregnancy}} should always be excluded in women with acute abdomen using {{c2::serum or urine hCG}}.
This condition is a common and dangerous cause of abdominal pain in women of reproductive age.
36
{{c1::Perforated peptic ulcer}} typically presents with sudden, severe {{c2::epigastric pain}} and signs of peritonitis.
This is a surgical emergency, often requiring immediate laparotomy to prevent widespread peritonitis.
37
{{c1::Abdominal distension}} with absent bowel sounds suggests {{c2::bowel obstruction}} or {{c2::paralytic ileus}}.
Both conditions can present with similar symptoms but have different causes and management strategies.
38
{{c1::Rigler’s sign}}, seen on an AXR, indicates {{c2::free air}} on both sides of the bowel wall, suggestive of perforation.
Rigler’s sign is a key radiographic indicator of a perforated gastrointestinal tract.
39
{{c1::Cross-matching blood}} is essential before surgery in acute abdomen cases with potential {{c2::hemorrhage}}.
Ensuring adequate blood availability is crucial in managing patients who may require transfusions during surgery.
40
{{c1::Sickle-cell crisis}} can present with severe abdominal pain, mimicking {{c2::acute abdomen}}.
In sickle-cell patients, abdominal pain may be due to vaso-occlusive crises rather than a surgical emergency.
41
{{c1::Phaeochromocytoma}} can cause abdominal pain due to {{c2::hypertensive crises}} but is not a surgical abdomen.
This condition involves catecholamine-secreting tumors that lead to episodic hypertension and pain.
42
{{c1::Zoster (shingles)}} may present with abdominal pain before the {{c2::rash}} appears, mimicking an acute abdomen.
Zoster-related abdominal pain is due to nerve inflammation and should be differentiated from visceral causes.
43
{{c1::Periumbilical pain}} that migrates to the {{c2::right lower quadrant}} is a classic presentation of {{c2::appendicitis}}.
This migration of pain is due to the progression of inflammation in the appendix.
44
{{c1::Henoch-Schönlein purpura}} can cause abdominal pain due to {{c2::intestinal vasculitis}}, mimicking an acute abdomen.
This condition often presents with purpura, joint pain, and gastrointestinal symptoms, complicating the diagnosis.
45
{{c1::Lead colic}} presents with severe abdominal pain and is associated with {{c2::lead poisoning}}.
Lead colic is a rare cause of abdominal pain and requires a high index of suspicion, particularly in at-risk populations.
46
{{c1::Typhoid fever}} can cause {{c2::abdominal pain}} and mimic an acute abdomen due to {{c2::mesenteric lymphadenitis}}.
The abdominal pain in typhoid fever is typically accompanied by systemic signs like fever and malaise.
47
{{c1::Cholecystitis}} presents with right upper quadrant pain, often with {{c2::Murphy’s sign}} on examination.
Murphy’s sign is elicited by asking the patient to inhale while pressing under the right costal margin, causing pain if positive.
48
{{c1::Diverticulitis}} typically presents with {{c2::left lower quadrant}} pain and may lead to localized peritonitis.
The sigmoid colon is the most common site of diverticulitis, which can lead to abscess or perforation.
49
{{c1::Electrolyte imbalances}}, such as {{c2::hypokalemia}}, can cause ileus and mimic a bowel obstruction.
Electrolyte disturbances should be corrected to resolve the ileus and prevent further complications.
50
{{c1::Ultrasound}} is particularly useful in diagnosing {{c2::gallbladder disease}} and guiding drainage of abscesses.
Ultrasound is often the first-line imaging modality for evaluating biliary pathology and detecting fluid collections.
51
{{c1::Urinalysis}} is critical in excluding {{c2::urinary tract infection}} and {{c2::kidney stones}} in patients with abdominal pain.
Urinary tract pathology can present with lower abdominal pain and may be confused with gastrointestinal causes.
52
{{c1::Diverticulitis}} often presents with {{c2::left lower quadrant pain}} and may be accompanied by fever and leukocytosis.
Diverticulitis involves inflammation of diverticula in the colon, commonly the sigmoid, and can lead to complications like abscess or perforation.
53
{{c1::Rebound tenderness}} is a key sign of {{c2::peritonitis}}, indicating irritation of the peritoneal lining.
Rebound tenderness occurs when pain intensifies after pressure on the abdomen is quickly released.
54
{{c1::Murphy’s sign}} is positive when pain occurs upon palpation of the {{c2::right upper quadrant}} during inspiration, indicating cholecystitis.
This sign is useful in diagnosing gallbladder inflammation, typically caused by gallstones.
55
{{c1::Mesenteric ischemia}} presents with severe abdominal pain out of proportion to physical findings.
This condition is due to inadequate blood flow to the intestines and can lead to bowel necrosis if not treated promptly.
56
{{c1::Acute appendicitis}} often starts with vague periumbilical pain that later localizes to the {{c2::right lower quadrant}}.
The initial pain is due to visceral irritation, while later pain localizes as the parietal peritoneum becomes involved.
57
{{c1::Hyperactive bowel sounds}} followed by {{c2::silent abdomen}} may indicate bowel obstruction progressing to {{c2::paralytic ileus}}.
The transition from active to absent bowel sounds reflects worsening bowel function, often requiring surgical intervention.
58
{{c1::Upper GI perforation}} can cause {{c2::free air under the diaphragm}} visible on an erect CXR.
This finding is a key diagnostic clue in cases of perforated peptic ulcer disease.
59
{{c1::Pain radiating to the back}} is characteristic of {{c2::acute pancreatitis}} or an aortic aneurysm.
Both conditions can cause severe, deep-seated pain that radiates posteriorly, necessitating prompt evaluation and management.
60
{{c1::Abdominal pain with hypotension}} in an elderly patient may suggest a {{c2::leaking abdominal aortic aneurysm}}.
A leaking AAA is a vascular emergency that requires immediate surgical repair to prevent rupture and death.
61
{{c1::Shock with an acute abdomen}} may result from massive hemorrhage, often due to a ruptured {{c2::ectopic pregnancy}} or {{c2::splenic rupture}}.
Rapid identification and treatment of the source of bleeding are crucial to prevent further deterioration.
62
{{c1::Atypical myocardial infarction (MI)}} may present as {{c2::epigastric pain}}, especially in elderly or diabetic patients.
This presentation can be mistaken for a gastrointestinal issue, delaying appropriate cardiac treatment.
63
{{c1::Henoch-Schönlein purpura (HSP)}} can cause {{c2::abdominal pain}} due to vasculitis, often accompanied by a characteristic purpuric rash.
HSP affects small blood vessels, leading to gastrointestinal symptoms that may mimic surgical causes of abdominal pain.
64
{{c1::Peritonitis}} is suggested by a rigid, board-like abdomen and is often accompanied by {{c2::absent bowel sounds}}.
These physical exam findings indicate severe inflammation of the peritoneum, typically due to infection or perforation.
65
{{c1::Testicular torsion}} can present with lower abdominal pain, mimicking an acute abdomen, particularly in young males.
Testicular torsion is a urological emergency requiring prompt surgical intervention to save the testicle.
66
{{c1::Pancreatic pseudocysts}} can cause persistent epigastric pain and are a complication of {{c2::chronic pancreatitis}}.
These fluid-filled sacs can lead to pain, infection, or rupture and may require drainage or surgery.
67
{{c1::Laparotomy}} is often indicated in cases of {{c2::ruptured hollow viscus}}, such as a perforated bowel or stomach.
The primary goal of laparotomy is to repair the perforation and prevent widespread infection and sepsis.
68
{{c1::CT scanning}} is particularly useful for diagnosing {{c2::mesenteric ischemia}} and can help avoid unnecessary surgery.
CT can detect signs of bowel ischemia, such as bowel wall thickening and pneumatosis, providing a clear diagnosis.
69
{{c1::Pneumonia}} presenting with {{c2::abdominal pain}} is more common in the elderly and can be confused with an acute abdomen.
Diaphragmatic irritation in lower lobe pneumonia can cause referred pain to the abdomen, misleading the diagnosis.
70
{{c1::WBC count elevation}} in an acute abdomen suggests an {{c2::inflammatory or infectious}} process such as appendicitis or diverticulitis.
Leukocytosis is a common finding in abdominal infections and helps to differentiate between surgical and non-surgical causes.
71
{{c1::Kehr’s sign}} is left shoulder pain referred from {{c2::splenic injury}} or rupture.
This referred pain is due to irritation of the phrenic nerve, indicating possible splenic damage.
72
{{c1::Gastroenteritis}} can mimic an acute abdomen with symptoms like {{c2::diffuse abdominal pain}}, nausea, and vomiting.
Gastroenteritis is typically self-limiting but requires differentiation from more serious surgical conditions.
73
{{c1::Serum amylase levels}} are elevated in {{c2::acute pancreatitis}}, making it a key diagnostic test.
Elevated amylase, especially when combined with clinical findings, strongly suggests pancreatitis.
74
{{c1::Abdominal pain and bloody diarrhea}} may indicate {{c2::inflammatory bowel disease (IBD)}}, such as Crohn’s disease or ulcerative colitis.
IBD flares can present as acute abdomen and may require urgent intervention if complicated by perforation or severe inflammation.
75
{{c1::Pain worsening after eating}} is characteristic of {{c2::mesenteric ischemia}}, especially in patients with cardiovascular risk factors.
This postprandial pain is due to the increased demand for blood flow to the intestines during digestion, which is compromised in mesenteric ischemia.
76
{{c1::Bowel sounds}} that are {{c2::hyperactive}} early in obstruction followed by {{c2::silence}} suggest progression to bowel strangulation.
The progression from hyperactive to absent sounds indicates worsening bowel viability, often requiring urgent surgical intervention.
77
{{c1::Diabetes}} may complicate the clinical picture by presenting with {{c2::atypical abdominal pain}}, masking conditions like DKA or ischemic bowel.
In diabetic patients, abdominal pain should prompt evaluation for metabolic disturbances and vascular events.
78
{{c1::Murphy’s sign}} can help distinguish {{c2::cholecystitis}} from other causes of right upper quadrant pain.
A positive Murphy’s sign, especially with fever and leukocytosis, strongly indicates cholecystitis, often related to gallstones.
79
{{c1::Narcotic addiction}} may present with {{c2::opioid-induced constipation}}, mimicking bowel obstruction in an acute abdomen.
Chronic opioid use slows bowel motility, leading to severe constipation and abdominal pain that can be mistaken for an obstruction.
80
{{c1::Urine hCG test}} is critical in ruling out {{c2::ectopic pregnancy}} in women of reproductive age presenting with abdominal pain.
An undiagnosed ectopic pregnancy can be life-threatening if it ruptures, making this test essential in acute abdominal evaluations.
81
{{c1::Porphyria}} can present with {{c2::severe abdominal pain}} and is a non-surgical cause of acute abdomen, often misdiagnosed.
Acute porphyria attacks are due to a buildup of porphyrins, leading to neurological and abdominal symptoms, often requiring specific biochemical tests for diagnosis.
82
{{c1::Abdominal guarding}} is a sign of {{c2::peritonitis}} and indicates involuntary tensing of abdominal muscles.
Guarding occurs as a protective response to prevent movement of the inflamed peritoneum, suggesting severe underlying pathology.
83
{{c1::Cullen’s sign}}, a bluish discoloration around the umbilicus, indicates {{c2::hemoperitoneum}} often associated with acute pancreatitis or ectopic pregnancy.
Cullen’s sign reflects blood in the peritoneal cavity and is a late sign of severe intra-abdominal bleeding.
84
{{c1::Grey Turner’s sign}} is bruising of the flanks and suggests {{c2::retroperitoneal hemorrhage}}, such as from acute pancreatitis.
This sign indicates severe intra-abdominal bleeding and is associated with high mortality if not promptly addressed.
85
{{c1::Acute urinary retention}} can present as lower abdominal pain and mimic {{c2::acute abdomen}}.
This condition is often caused by obstruction or neurological disorders and can be relieved with catheterization.
86
{{c1::Hiccups}} persisting in a patient with an acute abdomen may indicate {{c2::diaphragmatic irritation}}.
Persistent hiccups can be a subtle sign of conditions like subphrenic abscess or diaphragmatic peritonitis.
87
{{c1::Ectopic pregnancy}} should be suspected in a woman of childbearing age with {{c2::unilateral abdominal pain}} and a positive pregnancy test.
Rupture of an ectopic pregnancy is a surgical emergency due to the risk of severe internal bleeding.
88
{{c1::Volvulus}} presents with sudden onset of {{c2::colicky abdominal pain}}, distension, and vomiting, typically in elderly patients.
Volvulus involves the twisting of the bowel on itself, leading to obstruction and possibly ischemia, requiring urgent surgical intervention.
89
{{c1::Biliary colic}} is characterized by right upper quadrant pain that often radiates to the {{c2::right shoulder}} or back.
Biliary colic is due to gallstones obstructing the cystic or common bile duct, and the pain is often episodic and triggered by fatty meals.
90
{{c1::Inguinal hernia}} can present as acute abdomen if it becomes {{c2::incarcerated}} or {{c2::strangulated}}.
A strangulated hernia is a surgical emergency as it can lead to bowel necrosis due to compromised blood flow.
91
{{c1::Murphy’s sign}} is assessed by palpating the right upper quadrant during {{c2::inspiration}}, which causes pain in cholecystitis.
It is a specific sign for gallbladder inflammation, differentiating it from other causes of upper abdominal pain.
92
{{c1::Trauma history}} should raise suspicion of {{c2::spleen or liver rupture}} in a patient with an acute abdomen.
Even minor trauma can result in delayed rupture of solid organs like the spleen, leading to life-threatening hemorrhage.
93
{{c1::Perforated peptic ulcer}} often presents with sudden, severe {{c2::epigastric pain}} and rigidity of the abdomen.
The release of gastric contents into the peritoneal cavity causes chemical peritonitis, necessitating emergency surgery.
94
{{c1::Bowel ischemia}} can present with {{c2::metabolic acidosis}} and severe abdominal pain, often out of proportion to physical findings.
Ischemia leads to tissue necrosis, which releases lactic acid, contributing to metabolic acidosis.
95
{{c1::Right lower quadrant pain}} in a young woman could be due to {{c2::appendicitis}} or a {{c2::ruptured ovarian cyst}}.
Both conditions can present similarly, but a careful history and examination, along with imaging, can help differentiate them.
96
{{c1::Diabetic ketoacidosis (DKA)}} can present as {{c2::abdominal pain}}, nausea, and vomiting, mimicking an acute abdomen.
DKA is a life-threatening condition in diabetics, where lack of insulin leads to high blood glucose and ketone production, causing systemic symptoms.
97
{{c1::Hypovolemia}} is a common cause of shock in surgical patients, often due to {{c2::blood loss}}.
Assessing hypovolemia is critical, with symptoms including rapid pulse, low blood pressure, and reduced urine output.
98
In cases of Class I blood loss (<750mL), the pulse remains {{c1::<100 bpm}}, and blood pressure is {{c2::normal}}.
Class I blood loss represents a mild stage, where the body compensates effectively without significant changes in vital signs.
99
{{c1::Class III}} blood loss (1500-2000mL) is characterized by a pulse >120 bpm and {{c2::confusion}} as a mental state.
This stage of blood loss indicates a severe reduction in blood volume, leading to marked physiological changes.
100
The presence of free air under the diaphragm on an erect CXR suggests {{c1::bowel perforation}}, commonly from a {{c2::peptic ulcer}}.
This is a critical finding that often requires immediate surgical intervention to prevent peritonitis.
101
In cases of hypovolemic shock, treat immediately with {{c1::crystalloid}} and {{c2::blood}} to restore circulating volume.
Prompt fluid resuscitation is vital to prevent organ failure and stabilize the patient before surgery.
102
Pain localized to the {{c1::right lower quadrant (RLQ)}} can indicate appendicitis, whereas pain in the {{c2::epigastrium}} may suggest pancreatitis or peptic ulcer disease.
The location of abdominal pain helps narrow down potential diagnoses based on common patterns.
103
{{c1::Class IV}} blood loss (>2000mL) typically results in a pulse >140 bpm and {{c2::lethargy}} or unconsciousness.
This represents a life-threatening stage of hemorrhagic shock where immediate intervention is critical.
104
Causes of abdominal pain in the {{c1::right upper quadrant (RUQ)}} include cholecystitis, hepatitis, and {{c2::pneumonia}}.
RUQ pain is commonly associated with hepatobiliary disorders, but conditions like pneumonia can also refer pain to this area.
105
{{c1::Left lower quadrant (LLQ)}} pain could indicate conditions like {{c2::diverticulitis}} or ectopic pregnancy.
LLQ pain is commonly associated with diverticulitis in older adults and gynecological issues in women of childbearing age.
106
{{c1::Left upper quadrant (LUQ)}} pain can be caused by splenic issues such as {{c2::splenic rupture}} or infarction.
The spleen is the primary organ in the LUQ, and trauma or hematological issues can lead to pain in this area.
107
In Class II blood loss (750-1500mL), the pulse is typically {{c1::100-120 bpm}}, and patients may feel {{c2::anxious}}.
Class II represents moderate blood loss, where compensatory mechanisms start to fail, leading to noticeable symptoms.
108
{{c1::Abdominal X-rays (AXR)}} showing a {{c2::sentinel loop}} may indicate localized ileus or early bowel obstruction.
A sentinel loop is a segment of bowel that appears distended and can indicate localized inflammation or irritation.
109
{{c1::Erect chest X-rays (CXR)}} are particularly useful for detecting {{c2::free air}} under the diaphragm, a sign of bowel perforation.
Erect CXR is a standard investigation when bowel perforation is suspected due to its ability to reveal free air.
110
{{c1::Estimating blood loss}} is essential in assessing the severity of hypovolemic shock, using parameters like pulse rate, BP, and urine output.
Accurate estimation guides treatment decisions, such as fluid replacement and need for blood transfusion.
111
{{c1::Crystalloid fluids}} are recommended initially in treating hypovolemic shock, with the addition of {{c2::blood products}} if needed.
Crystalloids like saline or Ringer's lactate are used first to expand blood volume, followed by blood transfusions in severe cases.
112
{{c1::Class III}} blood loss results in a pulse pressure of {{c2::<20 mmHg}}, indicating severe hypovolemia.
Pulse pressure is the difference between systolic and diastolic blood pressure and narrows as shock progresses.
113
{{c1::Bowel perforation}} often presents with {{c2::severe, sudden-onset abdominal pain}} and requires immediate surgical intervention.
Perforation leads to peritonitis, a life-threatening condition that can quickly progress if untreated.
114
{{c1::Ruptured spleen}} can cause LUQ pain and is often accompanied by signs of {{c2::hypovolemic shock}}, such as tachycardia and hypotension.
Splenic rupture is a common cause of internal bleeding, especially following trauma, and needs rapid diagnosis and treatment.
115
A {{c1::positive Murphy's sign}} suggests {{c2::cholecystitis}}, characterized by pain upon palpation of the RUQ during inspiration.
This test helps differentiate cholecystitis from other causes of RUQ pain.
116
{{c1::Bowel obstruction}} may cause colicky abdominal pain and is often diagnosed with {{c2::AXR showing dilated bowel loops}}.
Bowel obstruction leads to a buildup of gas and fluids proximal to the blockage, visible on abdominal X-ray.
117
{{c1::Colicky pain}} suggests an obstruction in a hollow viscus like the bowel, ureter, or bile duct and is typically {{c2::waxing and waning}} in nature.
Colicky pain differs from peritonitis because it causes restlessness, and the patient may move around to find relief.
118
A key clinical sign of {{c1::peritonitis}} is a {{c2::board-like abdominal rigidity}} with guarding and absent bowel sounds.
Peritonitis causes severe inflammation of the peritoneum, leading to marked abdominal rigidity.
119
In the presence of {{c1::local peritonitis}}, imaging such as {{c2::ultrasound or CT}} is recommended to identify abscesses or fluid collections.
Local peritonitis may not always require surgery; imaging can guide percutaneous drainage when abscesses are present.
120
{{c1::Ectopic pregnancy}} should be considered in females with lower abdominal pain, especially if they present with {{c2::shock}}.
Ectopic pregnancy can rupture, causing internal bleeding and presenting with signs of shock, requiring emergency intervention.
121
{{c1::Acute pancreatitis}} can mimic peritonitis but typically does not require a laparotomy; instead, {{c2::serum amylase}} should be checked to confirm the diagnosis.
Acute pancreatitis causes similar signs to peritonitis but is managed conservatively with fluids and supportive care.
122
A {{c1::positive cough test}} is indicative of {{c2::peritonitis}}.
The cough test helps in the diagnosis of peritonitis by eliciting pain upon coughing, indicating irritation of the peritoneum.
123
{{c1::Myocardial infarction}} can present with {{c2::abdominal pain}} and must be ruled out in any acute abdomen case, especially in elderly patients.
Abdominal pain from myocardial infarction is often referred and can be confused with gastrointestinal causes.
124
In cases of {{c1::large bowel obstruction}}, patients may present with {{c2::distension, constipation,}} and crampy abdominal pain.
Large bowel obstruction typically leads to significant distension and altered bowel habits, often requiring imaging for diagnosis.
125
{{c1::Erect CXR}} can reveal {{c2::gas under the diaphragm}}, a sign of a perforated viscus like a peptic ulcer.
The presence of gas under the diaphragm is a critical radiographic finding that indicates the need for urgent surgical intervention.
126
{{c1::Right upper quadrant (RUQ)}} pain is most commonly associated with {{c2::gallbladder and liver pathology}}, such as cholecystitis or hepatitis.
RUQ pain patterns are crucial in diagnosing hepatobiliary diseases, often confirmed by ultrasound or liver function tests.
127
{{c1::Rebound tenderness}} is a clinical sign of {{c2::peritoneal irritation}}, typically seen in conditions like appendicitis or diverticulitis.
Rebound tenderness occurs when pressure applied to the abdomen is released quickly, causing sharp pain, indicative of peritoneal inflammation.
128
{{c1::Tachycardia}} and {{c2::hypotension}} are signs of significant blood loss in conditions like a ruptured ectopic pregnancy or splenic rupture.
These signs indicate that the body is in shock, often due to internal hemorrhage, requiring immediate resuscitation.
129
In the acute abdomen, a {{c1::rigid abdomen}} with absent bowel sounds is suggestive of {{c2::perforation or peritonitis}}.
This combination of findings is a surgical emergency, often necessitating laparotomy to correct the underlying cause.
130
The main feature of {{c1::shock}} in surgical patients is {{c2::hypovolemia}}, often due to acute blood loss.
Hypovolemic shock is life-threatening and requires prompt identification and treatment, usually with fluid and blood replacement.
131
{{c1::Fluid resuscitation}} is critical in managing hypovolemic shock, especially when blood loss exceeds {{c2::750mL}}.
Early and aggressive fluid management is necessary to restore hemodynamic stability in patients with significant blood loss.
132
In assessing hypovolemic shock, a pulse rate of {{c1::>140 bpm}} indicates {{c2::Class IV}} blood loss (>2000mL).
Class IV shock represents severe blood loss, requiring immediate intervention, often with both fluids and blood products.
133
A {{c1::confused or lethargic}} mental state is indicative of {{c2::Class III or IV}} hypovolemic shock.
Altered mental status in shock suggests inadequate cerebral perfusion, often due to severe blood loss.
134
{{c1::Anxiety}} and a {{c2::narrowed pulse pressure}} are early signs of {{c1::Class II}} hypovolemic shock (blood loss 750-1500mL).
These symptoms reflect the body's initial compensatory mechanisms to maintain perfusion despite moderate blood loss.
135
A respiratory rate of {{c1::>35/min}} is a feature of {{c2::Class IV}} hypovolemic shock, indicating severe respiratory compensation.
Tachypnea in shock is a response to acidosis and hypoxia due to inadequate oxygen delivery to tissues.
136
In cases of hypovolemic shock, {{c1::urine output}} of less than {{c2::20mL/h}} suggests severe dehydration or blood loss.
Low urine output is a late sign of shock, indicating significant hypoperfusion of the kidneys.
137
The presence of {{c1::Rigler's sign}} on an abdominal X-ray suggests {{c2::free air}} in the abdomen, typically from a perforated viscus.
Rigler's sign is a radiologic finding where both sides of the bowel wall are visible due to air on both sides, indicating perforation.
138
{{c1::Crossmatching blood}} is essential in the management of patients with {{c2::suspected significant blood loss}}.
Preparing for potential transfusion by crossmatching ensures that compatible blood is available if needed urgently.
139
{{c1::Pneumonia}} can present with abdominal pain, especially in the {{c2::right lower quadrant (RLQ)}}, mimicking appendicitis.
This is particularly common in children, where the lower lung infection causes referred pain to the abdomen.
140
{{c1::Erect chest X-ray}} can show a pneumoperitoneum, identified by {{c2::air beneath the diaphragm}}.
Air under the diaphragm on an erect CXR is a classic sign of gastrointestinal perforation, requiring surgical intervention.
141
{{c1::Intra-abdominal abscesses}} can often be managed with {{c2::percutaneous drainage}} guided by ultrasound or CT.
This minimally invasive approach avoids the need for more extensive surgery and is often effective in resolving localized infections.
142
{{c1::Abdominal pain}} associated with {{c2::restlessness}} and inability to stay still is characteristic of {{c1::colic}} rather than peritonitis.
Colic pain, due to spasm in hollow organs, typically causes patients to move around to find a comfortable position.
143
{{c1::CT imaging}} is particularly useful in diagnosing {{c2::mesenteric ischemia}} or other causes of an acute abdomen that might not be evident on physical exam.
CT scans can reveal vascular issues, bowel infarction, and other critical conditions that are difficult to diagnose clinically.
144
Patients with {{c1::acute cholecystitis}} usually present with {{c2::RUQ pain}}, fever, and a positive Murphy's sign.
Murphy's sign is elicited by palpating the right upper quadrant during deep inspiration, causing pain if the gallbladder is inflamed.
145
{{c1::Diverticulitis}} typically presents with {{c2::left lower quadrant (LLQ)}} pain, often accompanied by fever and a change in bowel habits.
This condition involves inflammation of the diverticula in the colon and can lead to complications like abscesses or perforation.
146
{{c1::Erect chest X-ray (CXR)}} is important in diagnosing an {{c2::acute perforation}} by detecting free air under the diaphragm.
The presence of air under the diaphragm is a hallmark sign of gastrointestinal perforation, often requiring surgical intervention.
147
{{c1::Hypovolemic shock}} can lead to {{c2::decreased urine output}}, often less than 20 mL/h in severe cases.
Low urine output is a sign of inadequate renal perfusion due to severe blood loss or dehydration.
148
{{c1::Class III}} hypovolemic shock is associated with a {{c2::pulse rate above 120 bpm}} and significant blood loss (1500-2000mL).
Tachycardia is a compensatory mechanism to maintain cardiac output in response to decreased circulating blood volume.
149
{{c1::Pneumonia}} can present with abdominal pain, particularly in the {{c2::right lower quadrant}}, sometimes mimicking acute appendicitis.
Referred pain from the inflamed lung pleura to the abdomen can mislead the diagnosis, especially in pediatric patients.
150
{{c1::Splenic rupture}} often presents with {{c2::left upper quadrant (LUQ)}} pain and signs of hypovolemic shock.
LUQ pain combined with shock symptoms in a trauma patient should raise suspicion for splenic injury.
151
{{c1::Pain that worsens with movement}} and is associated with guarding is characteristic of {{c2::peritonitis}}.
In peritonitis, any movement that stretches the peritoneum causes significant discomfort, leading to patients lying still.
152
{{c1::Free air}} on an erect abdominal X-ray, detected as a visible line under the diaphragm, suggests a {{c2::hollow organ perforation}}.
Perforation of the bowel or stomach can lead to pneumoperitoneum, a surgical emergency.
153
{{c1::Class II}} hypovolemic shock, with a blood loss of 750-1500mL, is often indicated by a {{c2::narrow pulse pressure}}.
Narrowed pulse pressure occurs as the body attempts to maintain blood pressure despite decreasing blood volume.
154
{{c1::Tachypnea}} is a compensatory response in {{c2::Class III}} and IV hypovolemic shock, typically with respirations > 30/min.
Increased respiratory rate helps to compensate for metabolic acidosis and hypoxia due to inadequate perfusion.
155
In assessing blood loss, a {{c1::systolic blood pressure below 90 mmHg}} typically indicates {{c2::Class III}} or IV hypovolemic shock.
Hypotension is a late but critical sign of shock, indicating that compensatory mechanisms are failing.
156
{{c1::Gastric or duodenal perforation}} is often indicated by {{c2::sudden onset severe epigastric pain}} and signs of peritonitis.
Perforation leads to the leakage of gastric contents into the peritoneal cavity, causing chemical peritonitis and severe pain.
157
{{c1::Mesenteric ischemia}} should be suspected in patients with {{c2::severe abdominal pain out of proportion to physical findings}}.
This condition occurs due to inadequate blood supply to the intestines, often leading to infarction if not treated promptly.
158
{{c1::Acute pancreatitis}} may mimic other causes of an acute abdomen but does not usually require {{c2::laparotomy}}.
Pancreatitis causes severe upper abdominal pain and systemic symptoms, but is typically managed with supportive care rather than surgery.
159
{{c1::Appendicitis}} typically presents with pain that begins near the umbilicus and later localizes to the {{c2::right lower quadrant (RLQ)}}.
The migration of pain is due to the inflammation progressing to involve the parietal peritoneum in the RLQ.
160
In the context of an acute abdomen, {{c1::guarding and rigidity}} on physical exam are strong indicators of {{c2::peritoneal irritation}}.
These signs suggest that the underlying condition has led to significant inflammation of the peritoneum, often necessitating surgery.
161
{{c1::Shock}} associated with acute abdominal conditions is often due to {{c2::hypovolemia}} from internal bleeding or fluid loss.
Recognizing the cause of shock is crucial for proper management, including fluid resuscitation and possible surgical intervention.
162
{{c1::Colicky pain}} that causes the patient to move around to find relief is typically seen in {{c2::bowel obstruction}} or ureteric colic.
Unlike peritonitis, where the patient lies still, colicky pain is due to spasms in a hollow organ, leading to restlessness.
163
{{c1::Perforated peptic ulcer}} may present with sudden, severe {{c2::epigastric pain}} that radiates to the back.
The onset of perforation is usually abrupt, and it leads to chemical peritonitis, necessitating immediate surgical intervention.
164
{{c1::Rebound tenderness}} is a sign of {{c2::peritoneal inflammation}} and indicates the need for further evaluation for conditions like appendicitis or perforation.
Rebound tenderness occurs when the inflamed peritoneum is compressed and then rapidly released, causing sharp pain.
165
{{c1::Ectopic pregnancy}} should be suspected in women of childbearing age presenting with {{c2::lower abdominal pain and shock}}.
A ruptured ectopic pregnancy is a gynecological emergency that requires rapid surgical intervention to control bleeding.
166
{{c1::Acute cholecystitis}} commonly presents with {{c2::right upper quadrant (RUQ) pain}} that may radiate to the shoulder or back.
Inflammation of the gallbladder often causes referred pain due to irritation of the diaphragm.
167
{{c1::Diverticulitis}} typically causes pain in the {{c2::left lower quadrant (LLQ)}}, often associated with fever and localized peritonitis.
The pain is due to inflammation or infection of the diverticula, small pouches that can form in the colon.
168
{{c1::Leukocytosis}} (increased white blood cell count) is a common finding in patients with {{c2::acute appendicitis}} or other inflammatory abdominal conditions.
An elevated WBC count reflects the body’s inflammatory response to infection or inflammation.
169
{{c1::Inguinal hernia}} with severe pain and tenderness may indicate {{c2::strangulation}}, requiring urgent surgical intervention.
Strangulation occurs when the blood supply to the herniated tissue is compromised, leading to tissue necrosis.
170
{{c1::Acute mesenteric ischemia}} often presents with {{c2::severe, diffuse abdominal pain}} but minimal findings on physical examination.
This discrepancy between pain and physical signs is due to ischemia of the intestines without early peritoneal irritation.
171
{{c1::Perforated diverticulum}} is suggested by LLQ pain, fever, and {{c2::signs of peritonitis}}, often requiring surgical intervention.
The perforation allows bowel contents to leak into the abdominal cavity, leading to generalized peritonitis.
172
{{c1::Acute pancreatitis}} is associated with elevated {{c2::serum amylase or lipase}} levels, often three times the normal level.
These enzyme levels are important markers for diagnosing pancreatitis, although clinical correlation is necessary.
173
{{c1::Gallstone ileus}} can lead to {{c2::small bowel obstruction}} and typically presents with crampy abdominal pain and vomiting.
Gallstone ileus occurs when a gallstone passes into the bowel through a fistula and obstructs the intestine.
174
{{c1::Cullen’s sign}} (periumbilical bruising) is an indicator of {{c2::intra-abdominal hemorrhage}} often associated with acute pancreatitis or ruptured ectopic pregnancy.
The bruising is caused by blood tracking along fascial planes to the skin surface.
175
{{c1::Grey-Turner’s sign}} (flank bruising) is another sign of {{c2::retroperitoneal hemorrhage}}, seen in severe cases of pancreatitis or trauma.
Like Cullen’s sign, it indicates deep bleeding, usually requiring aggressive resuscitation and possibly surgery.
176
{{c1::Murphy's sign}} is positive in cases of {{c2::acute cholecystitis}}, where the patient experiences pain upon palpation of the RUQ during inhalation.
This sign is used to identify inflammation of the gallbladder when the diaphragm pushes the inflamed gallbladder against the examiner's fingers.
177
{{c1::McBurney's point}} tenderness is a classic sign of {{c2::acute appendicitis}}, located one-third of the distance from the anterior superior iliac spine to the umbilicus.
This point represents the approximate location of the base of the appendix and is often tender in appendicitis.
178
{{c1::Rovsing's sign}} refers to RLQ pain elicited by palpation of the LLQ, indicating {{c2::acute appendicitis}}.
This occurs because the palpation increases pressure in the peritoneum, transmitting the pain to the inflamed appendix.
179
{{c1::Kehr's sign}} is left shoulder pain caused by {{c2::splenic rupture}} and is due to diaphragmatic irritation by blood in the peritoneal cavity.
Kehr's sign is a classic symptom of referred pain due to irritation of the phrenic nerve by peritoneal blood.
180
{{c1::Boerhaave syndrome}} is characterized by {{c2::esophageal rupture}} following forceful vomiting, leading to chest pain and subcutaneous emphysema.
This is a surgical emergency due to the risk of severe mediastinitis and sepsis.
181
{{c1::Rigler's sign}} is the visualization of both sides of the bowel wall on an abdominal X-ray, indicating {{c2::pneumoperitoneum}}.
This sign is often seen in cases of bowel perforation where free air is present in the abdominal cavity.
182
{{c1::Obturator sign}} is pain on passive internal rotation of the hip, suggestive of {{c2::pelvic appendicitis}}.
This sign indicates irritation of the obturator internus muscle, often by an inflamed appendix located in the pelvis.
183
{{c1::Psoas sign}} is positive when there is pain on extension of the right hip, indicating {{c2::retrocecal appendicitis}}.
This sign occurs because the inflamed appendix lies close to the psoas muscle, which is stretched during hip extension.
184
{{c1::Leukopenia}} (low white blood cell count) in the setting of acute abdominal pain may suggest a severe, often late-stage {{c2::infection or sepsis}}.
Leukopenia is sometimes seen in overwhelming infections or when bone marrow suppression occurs.
185
{{c1::Volvulus}} is a cause of intestinal obstruction, where a segment of the bowel twists around its mesentery, commonly affecting the {{c2::sigmoid colon or cecum}}.
Volvulus leads to bowel ischemia and obstruction, often requiring surgical intervention.
186
{{c1::Charcot's triad}} consists of RUQ pain, jaundice, and fever, indicating {{c2::ascending cholangitis}}.
This triad is a hallmark of cholangitis, an infection of the biliary tree, often requiring urgent biliary drainage.
187
{{c1::Referred pain}} to the right shoulder in cases of {{c2::diaphragmatic irritation}} is due to the shared innervation of the diaphragm and shoulder by the phrenic nerve.
This is commonly seen in conditions like subdiaphragmatic abscesses or splenic injury.
188
{{c1::Abdominal guarding}} and {{c2::rigidity}} are signs of peritonitis, indicating diffuse inflammation of the peritoneum often due to perforation.
Guarding and rigidity are involuntary muscle contractions in response to peritoneal irritation, often necessitating surgical exploration.
189
{{c1::Ischemic bowel}} presents with severe, out-of-proportion pain and may be accompanied by {{c2::metabolic acidosis}} and elevated lactate levels.
This condition is due to reduced blood flow to the intestines, requiring prompt diagnosis and often surgical intervention to prevent bowel necrosis.
190
{{c1::Pain out of proportion}} to physical findings is a classic symptom of {{c2::mesenteric ischemia}}, a critical condition that requires prompt diagnosis.
Mesenteric ischemia can be easily missed because the physical exam might not show severe signs despite the patient's significant pain.
191
{{c1::Courvoisier's sign}} indicates an enlarged, non-tender gallbladder in the presence of jaundice, suggesting {{c2::malignancy (e.g., pancreatic cancer)}} rather than gallstones.
This sign helps differentiate between obstructive jaundice caused by a tumor versus gallstones, as tumors are more likely to cause painless jaundice.
192
{{c1::Grey Turner's sign}} refers to bruising of the flanks and is associated with {{c2::retroperitoneal hemorrhage}} or acute pancreatitis.
This sign indicates bleeding within the retroperitoneal space, often a sign of severe acute pancreatitis or trauma.
193
{{c1::Cullen's sign}} is periumbilical bruising seen in cases of {{c2::hemorrhagic pancreatitis}} or ruptured ectopic pregnancy.
Cullen's sign indicates internal bleeding that tracks along tissue planes to the periumbilical area.
194
{{c1::Ileus}} is characterized by {{c2::absence of bowel sounds}} and distention, typically caused by non-mechanical factors such as infection, electrolyte imbalance, or post-surgery.
Unlike bowel obstruction, ileus results from a lack of peristalsis rather than a physical blockage.
195
{{c1::Diverticulitis}} presents with LLQ pain, fever, and {{c2::altered bowel habits}}, often requiring antibiotics and sometimes surgical intervention if complications arise.
Diverticulitis involves inflammation or infection of diverticula in the colon, commonly causing localized pain in the left lower quadrant.
196
{{c1::Perforated peptic ulcer}} often presents with sudden-onset, severe epigastric pain and {{c2::free air under the diaphragm}} on an erect CXR.
This condition is a surgical emergency as it can lead to peritonitis and requires prompt recognition and intervention.
197
{{c1::Obstruction of the bowel}} can present with {{c2::colicky pain}}, distention, vomiting, and failure to pass gas or stool, known as obstipation.
Bowel obstruction can be due to various causes, including adhesions, hernias, or tumors, and may require surgical management.
198
{{c1::Peptic ulcer disease}} complications include perforation, hemorrhage, and {{c2::gastric outlet obstruction}}, requiring endoscopy and possibly surgery.
Complications of PUD can lead to severe outcomes and require different management strategies based on the specific complication.
199
{{c1::Lactate levels}} are used to assess the severity of {{c2::mesenteric ischemia}}, with elevated levels indicating tissue hypoxia and poor perfusion.
High lactate levels are a marker of anaerobic metabolism, often due to inadequate blood supply, necessitating urgent intervention.
200
{{c1::Aortic dissection}} can mimic an acute abdomen but typically presents with {{c2::severe, tearing chest or back pain}} and can lead to rapid hemodynamic instability.
Aortic dissection involves a tear in the aortic wall, causing life-threatening hemorrhage, often misdiagnosed as other acute conditions.
201
{{c1::Biliary colic}} is characterized by RUQ pain that radiates to the back or right shoulder, often triggered by {{c2::fatty meals}}.
Biliary colic occurs when a gallstone temporarily obstructs the cystic duct, leading to pain as the gallbladder contracts.
202
{{c1::Hepatitis}} often presents with RUQ pain, jaundice, and {{c2::elevated liver enzymes}}, reflecting liver inflammation or damage.
Hepatitis can be caused by viral infections, alcohol, or toxins, leading to liver inflammation and systemic symptoms.
203
{{c1::Fitz-Hugh-Curtis syndrome}} involves RUQ pain due to perihepatitis and is associated with {{c2::pelvic inflammatory disease (PID)}}.
This syndrome is caused by the spread of infection from the pelvic organs to the liver capsule, leading to inflammation and pain.
204
{{c1::Ureteral stones}} present with severe, colicky flank pain that radiates to the groin, often accompanied by {{c2::hematuria}}.
Ureteral stones cause intense pain as they pass through the urinary tract, often necessitating imaging and pain management.
205
{{c1::Superior mesenteric artery (SMA) syndrome}} involves compression of the duodenum between the SMA and aorta, leading to {{c2::postprandial pain}} and vomiting.
This rare condition occurs due to a reduction in the angle between the aorta and SMA, compressing the duodenum and causing symptoms.
206
{{c1::Torsion of ovarian cysts}} presents with sudden onset of unilateral lower abdominal pain, often associated with {{c2::nausea and vomiting}}.
Ovarian torsion is a gynecologic emergency where the ovary twists around its ligamentous supports, cutting off blood supply and causing severe pain.
207
{{c1::Pneumoperitoneum}} is most commonly caused by a perforated viscus and is often detected on an erect CXR by the presence of {{c2::free air under the diaphragm}}.
Pneumoperitoneum indicates the presence of air in the peritoneal cavity, usually requiring urgent surgical intervention.
208
{{c1::Murphy's sign}} is positive when there is pain upon palpation of the RUQ during inspiration, indicative of {{c2::acute cholecystitis}}.
This clinical sign is used to detect inflammation of the gallbladder, often caused by gallstones blocking the cystic duct.
209
{{c1::Rovsing's sign}} is positive when palpation of the LLQ causes pain in the RLQ, suggesting {{c2::appendicitis}}.
This sign indicates irritation of the peritoneum, where pressure applied to the left side indirectly increases pressure on the inflamed appendix.
210
{{c1::Blumberg's sign}}, also known as rebound tenderness, is suggestive of {{c2::peritonitis}} when pain increases upon releasing pressure from the abdomen.
Rebound tenderness is a classic sign of peritoneal inflammation, indicating the need for urgent medical evaluation.
211
{{c1::Kehr's sign}} refers to left shoulder pain due to {{c2::splenic rupture}}, caused by irritation of the diaphragm.
This referred pain occurs because the diaphragm and shoulder share the same nerve supply, the phrenic nerve.
212
{{c1::McBurney's point}} tenderness is located two-thirds of the way from the umbilicus to the anterior superior iliac spine, indicating {{c2::acute appendicitis}}.
This point is a key anatomical landmark used to diagnose appendicitis based on localized pain in the RLQ.
213
{{c1::Mesenteric ischemia}} often presents with severe abdominal pain that is disproportionate to physical findings and may be associated with {{c2::bloody stools}}.
This condition involves reduced blood flow to the intestines, leading to tissue damage and requiring prompt diagnosis and treatment.
214
{{c1::Abdominal aortic aneurysm (AAA) rupture}} typically presents with sudden onset of severe abdominal or back pain and may be associated with {{c2::hypotension and syncope}}.
Rupture of an AAA is a life-threatening emergency requiring immediate surgical intervention to prevent fatal hemorrhage.
215
{{c1::Ectopic pregnancy}} often presents with lower abdominal pain, vaginal bleeding, and {{c2::positive urine hCG}} but no intrauterine pregnancy on ultrasound.
Ectopic pregnancy is a surgical emergency, as the developing embryo can rupture the fallopian tube, leading to severe hemorrhage.
216
{{c1::Intussusception}} is a condition where one segment of the intestine telescopes into another, often presenting with {{c2::intermittent abdominal pain}} and a palpable "sausage-shaped" mass.
This condition is most common in children and can lead to bowel obstruction or ischemia, requiring urgent intervention.
217
{{c1::Peptic ulcer disease}} can cause perforation leading to peritonitis, which presents with {{c2::sudden, severe epigastric pain}} and a rigid abdomen.
Perforated peptic ulcers allow gastric contents to spill into the peritoneal cavity, causing inflammation and requiring emergency surgery.
218
{{c1::Boerhaave syndrome}} involves a spontaneous rupture of the esophagus, typically following forceful vomiting, and may present with {{c2::severe chest pain and subcutaneous emphysema}}.
This is a surgical emergency, as esophageal rupture can lead to mediastinitis, a potentially fatal condition if not treated promptly.
219
{{c1::Acute pancreatitis}} commonly presents with severe epigastric pain radiating to the back, and elevated levels of {{c2::serum amylase or lipase}} confirm the diagnosis.
Acute pancreatitis is often caused by gallstones or chronic alcohol use and can lead to serious complications such as necrosis or organ failure.
220
{{c1::Cecal volvulus}} is the twisting of the cecum around its mesentery, often presenting with {{c2::acute right lower quadrant pain and bowel obstruction}}.
Cecal volvulus is a rare cause of bowel obstruction that requires surgical intervention to untwist the bowel and prevent ischemia.
221
{{c1::Gallstone ileus}} is a rare form of bowel obstruction caused by a gallstone entering the intestinal tract, often presenting with {{c2::crampy abdominal pain and vomiting}}.
This condition occurs when a large gallstone erodes through the gallbladder into the bowel, obstructing the intestinal lumen, often at the ileocecal valve.
222
{{c1::Murphy's sign}} is positive when there is {{c2::inspiratory arrest}} on palpation of the right upper quadrant, suggesting acute cholecystitis.
This sign is used to diagnose inflammation of the gallbladder, often due to gallstones.
223
{{c1::Obturator sign}} is positive when internal rotation of the right hip causes {{c2::RLQ pain}}, suggesting appendicitis.
The pain is due to irritation of the obturator muscle, which can occur if the appendix is located in the pelvis.
224
{{c1::Psoas sign}} is positive when there is RLQ pain on {{c2::extension of the right thigh}}, indicating inflammation of the appendix.
This test stretches the iliopsoas muscle, which may be irritated by an inflamed appendix.
225
{{c1::Cullen's sign}} is the presence of {{c2::periumbilical bruising}}, often indicating hemorrhagic pancreatitis or ruptured ectopic pregnancy.
Cullen's sign results from retroperitoneal or intra-abdominal bleeding.
226
{{c1::Grey Turner's sign}} is the presence of {{c2::flank bruising}}, indicative of retroperitoneal hemorrhage, often due to pancreatitis.
This sign suggests severe hemorrhagic pancreatitis and is a poor prognostic indicator.
227
{{c1::Courvoisier's sign}} is characterized by a palpable, non-tender gallbladder in the presence of {{c2::jaundice}}, often indicating pancreatic or biliary malignancy.
This sign suggests that jaundice is due to an extrinsic cause like a tumor, rather than gallstones.
228
{{c1::Rigler's sign}}, seen on an abdominal X-ray, indicates {{c2::free air}} on both sides of the bowel wall, suggesting pneumoperitoneum.
This sign is typically seen in cases of bowel perforation, requiring urgent surgical intervention.
229
{{c1::Lloyd's sign}} is positive when there is pain upon percussion over the {{c2::costovertebral angle}}, suggesting renal pathology such as pyelonephritis or renal colic.
This test is used to identify inflammation or infection of the kidneys or ureters.
230
{{c1::Dance's sign}} is the absence of bowel sounds in the RLQ, often associated with {{c2::intussusception}}.
Dance's sign is an important finding in pediatric patients with intussusception, where a part of the intestine telescopes into another part.
231
{{c1::Jar sign}} refers to increased abdominal pain when the patient is asked to {{c2::cough or jump}}, indicating peritonitis.
This sign is used to diagnose generalized peritoneal irritation, which may require urgent surgical exploration.
232
{{c1::Bororygmi}} is the term used to describe {{c2::hyperactive bowel sounds}}, which can indicate early bowel obstruction.
Hyperactive bowel sounds are often heard before the bowel becomes obstructed or during episodes of diarrhea.
233
{{c1::Guarding}} refers to the involuntary tensing of abdominal muscles in response to {{c2::peritoneal irritation}}, suggesting underlying pathology.
Guarding is a key sign of peritonitis and often accompanies other signs such as rebound tenderness.
234
{{c1::Referred pain}} to the shoulder may indicate diaphragmatic irritation, often due to {{c2::splenic injury or ectopic pregnancy}}.
The phenomenon occurs due to the shared nerve pathways of the diaphragm and shoulder (phrenic nerve).
235
{{c1::Boas' sign}} is the presence of hyperesthesia (increased sensitivity) below the right scapula, often associated with {{c2::acute cholecystitis}}.
Boas' sign is a less commonly used sign, but it can be indicative of gallbladder inflammation.
236
{{c1::Succussion splash}} is a physical exam finding heard on auscultation when shaking the patient's abdomen, indicating {{c2::gastric outlet obstruction}}.
The splash sound results from fluid and gas in a distended stomach, suggesting delayed gastric emptying.
237
{{c1::Traube's space}} is a region on the left lower chest that is usually resonant on percussion; dullness here may suggest {{c2::splenomegaly}}.
Percussion dullness in Traube's space can be an indicator of an enlarged spleen, which may be associated with various pathologies.
238
{{c1::Hernia}} can present as a painful lump in the abdomen or groin, with the risk of {{c2::strangulation}} leading to bowel ischemia.
Hernias can become surgical emergencies if the bowel becomes trapped and loses its blood supply.
239
{{c1::Volvulus}} typically presents with abdominal distension, pain, and {{c2::obstipation}}, indicating bowel obstruction.
Volvulus involves the twisting of a segment of bowel, often requiring surgical intervention to prevent ischemia.
240
{{c1::Perforated duodenal ulcer}} may present with sudden, severe epigastric pain and {{c2::rigid abdomen}}, a classic sign of peritonitis.
Perforation allows gastric contents to spill into the peritoneal cavity, causing inflammation and often requiring emergency surgery.
241
{{c1::Ischemic colitis}} presents with crampy lower abdominal pain and {{c2::bloody diarrhea}}, often in elderly patients with vascular disease.
This condition results from reduced blood flow to the colon, leading to tissue damage.
242
{{c1::Ogilvie's syndrome}} involves acute {{c2::colonic pseudo-obstruction}} without mechanical blockage, presenting with abdominal distension and pain.
It is often seen in hospitalized or debilitated patients and may require decompression if conservative management fails.
243
{{c1::Spigelian hernia}} is a rare lateral ventral hernia, presenting with localized pain and a mass in the {{c2::lower abdomen}}.
Due to its location, a Spigelian hernia can be easily missed on physical examination and may require imaging for diagnosis.
244
{{c1::Meckel's diverticulum}} often presents with painless rectal bleeding in children, and complications may include {{c2::diverticulitis or obstruction}}.
Meckel's diverticulum is a congenital abnormality that can mimic appendicitis or cause gastrointestinal bleeding.
245
{{c1::Paralytic ileus}} is characterized by {{c2::absence of bowel sounds}} and diffuse abdominal pain, often following surgery or in critically ill patients.
Unlike mechanical obstruction, paralytic ileus results from a functional inhibition of bowel motility.
246
{{c1::Carcinoid syndrome}} can present with flushing, diarrhea, and {{c2::right-sided heart valvular lesions}}, often due to a carcinoid tumor in the gastrointestinal tract.
This syndrome occurs when a carcinoid tumor secretes serotonin and other vasoactive substances.
247
{{c1::Diverticulitis}} commonly presents with left lower quadrant pain, fever, and {{c2::leukocytosis}}, often requiring antibiotics and sometimes surgery.
Inflammation of diverticula in the colon can lead to abscess formation, perforation, or fistulas.
248
{{c1::Splenic abscess}} presents with left upper quadrant pain, fever, and {{c2::splenomegaly}}, often requiring percutaneous drainage or splenectomy.
Splenic abscesses are rare but serious, often secondary to infections such as endocarditis.
249
{{c1::Hemoperitoneum}} is the presence of blood in the peritoneal cavity, often presenting with {{c2::hypotension and abdominal distension}} following trauma.
It is a surgical emergency, typically requiring rapid fluid resuscitation and exploratory laparotomy.
250
{{c1::Peritoneal carcinomatosis}} often presents with diffuse abdominal pain, weight loss, and {{c2::ascites}}, associated with advanced malignancy.
This condition occurs when cancer spreads throughout the peritoneal cavity, leading to widespread metastases.
251
{{c1::Gastrointestinal perforation}} may present with sudden onset of severe pain and signs of {{c2::sepsis}}, such as fever and tachycardia.
Perforation allows contents from the gastrointestinal tract to enter the peritoneal cavity, causing widespread infection.
252
{{c1::Hemobilia}} is bleeding into the biliary tree, often presenting with right upper quadrant pain, jaundice, and {{c2::melena}}.
It may result from trauma, liver biopsy, or tumors, and often requires angiography for diagnosis and treatment.
253
{{c1::Tubo-ovarian abscess}} presents with lower abdominal pain, fever, and {{c2::cervical motion tenderness}}, often related to pelvic inflammatory disease (PID).
This condition is a serious complication of PID and requires antibiotic therapy, sometimes combined with surgical drainage.
254
{{c1::Mesenteric ischemia}} typically presents with sudden, severe abdominal pain out of proportion to physical findings and {{c2::bloody stools}}.
This condition results from reduced blood flow to the intestines, leading to ischemic damage and often requiring surgical intervention.
255
{{c1::Gallstone ileus}} is a rare cause of small bowel obstruction, presenting with abdominal pain, vomiting, and {{c2::air in the biliary tree}}.
It occurs when a gallstone passes into the bowel through a biliary-enteric fistula, causing obstruction.
256
{{c1::Acute pancreatitis}} presents with severe epigastric pain radiating to the back, nausea, vomiting, and {{c2::elevated serum amylase or lipase}}.
Pancreatitis is often caused by gallstones or alcohol abuse, and management includes supportive care and addressing the underlying cause.
257
{{c1::Ectopic pregnancy}} presents with unilateral pelvic pain, vaginal bleeding, and {{c2::positive hCG test}}; it can rupture and cause life-threatening hemorrhage.
Ectopic pregnancy is an emergency requiring prompt diagnosis and treatment, often via surgical or medical management.
258
{{c1::Acute cholecystitis}} presents with right upper quadrant pain, fever, and {{c2::Murphy's sign}}, often requiring cholecystectomy.
This condition is usually due to gallstone obstruction of the cystic duct, leading to inflammation of the gallbladder.
259
{{c1::Appendicitis}} typically presents with periumbilical pain that later localizes to the {{c2::right lower quadrant}} (McBurney's point), often accompanied by nausea and fever.
It is the most common cause of acute abdomen requiring surgery, typically an appendectomy.
260
{{c1::Intestinal obstruction}} can present with crampy abdominal pain, vomiting, and {{c2::absence of flatus or bowel movements}}, requiring imaging to confirm.
Common causes include adhesions, hernias, and tumors, with treatment often requiring surgical intervention.
261
{{c1::Pneumoperitoneum}} is characterized by the presence of {{c2::free air under the diaphragm}} on an erect chest X-ray, often indicating perforation of a hollow viscus.
This finding is a surgical emergency and requires prompt exploratory laparotomy.
262
{{c1::Acute diverticulitis}} presents with left lower quadrant pain, fever, and {{c2::leukocytosis}}, sometimes complicated by abscess or perforation.
Diverticulitis is inflammation of diverticula in the colon and may require antibiotics, drainage, or surgery.
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{{c1::Splenic rupture}} presents with left upper quadrant pain, hypotension, and {{c2::Kehr's sign}} (referred pain to the left shoulder), often following trauma.
Splenic rupture is a life-threatening condition requiring urgent surgical evaluation and possible splenectomy.
264
{{c1::Pelvic inflammatory disease (PID)}} presents with lower abdominal pain, fever, and {{c2::cervical motion tenderness}}, often related to sexually transmitted infections.
PID can lead to complications like tubo-ovarian abscess or infertility and requires prompt antibiotic treatment.
265
{{c1::Sigmoid volvulus}} presents with abdominal distension, pain, and {{c2::coffee bean sign}} on abdominal X-ray, indicating a twisted bowel segment.
Sigmoid volvulus is a cause of large bowel obstruction and often requires surgical or endoscopic detorsion.
266
{{c1::Pseudomembranous colitis}} presents with diarrhea, abdominal pain, and {{c2::fever}}, often following antibiotic use, and is associated with Clostridioides difficile infection.
Diagnosis is confirmed with stool toxin assay or PCR, and treatment includes stopping the offending antibiotic and starting targeted therapy.
267
{{c1::Biliary colic}} presents with episodic right upper quadrant pain, often after eating fatty meals, without {{c2::fever or jaundice}}, caused by gallstones.
Unlike cholecystitis, biliary colic is due to temporary obstruction of the cystic duct without inflammation, managed with analgesia and elective cholecystectomy.
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{{c1::Acute gastritis}} presents with epigastric pain, nausea, and {{c2::hematemesis}} in severe cases, often related to NSAID use or alcohol.
Acute gastritis is inflammation of the stomach lining and is managed with proton pump inhibitors and cessation of the offending agent.
