Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPD F2014 > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Referred pain

A
  • pain arising from an internal organ but located at a different site : abdominal or chest wall, shoulder, jaw,
  • ie Right Shoulder pain may be from acute cholelithiasis ( Gall bladder stones ), testicular pain may be from renal colic or appendicitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Grey Turner

A
  • Massive non-traumatic ecchymosis ( bruising ) on abdomen , and flank from infiltration of extraperitoneal tissue
  • Associated with hemorrhagic pancreatitis ,
  • Retroperitoneal hematoma Also strangulated bowel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cullen’s

A
  • Blue color at umbilicus secondary to hemoperitoneum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ileus : Inhibition of peristalsis

A

Causes :

  • peritonitis
  • mesenteric thrombosis
  • enterocolic ulceration
  • Total Obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Auscultation of abnormal bruits

A
  • Listen over abdominal aorta : Bruit if aneurysm ( use Bell )
  • Bruits over renal , iliac , femoral arteries
  • Due to turbulent blood flow in a dilated , or constricted , or torturous vessel
  • Renal : renal artery stenosis , heard as a systolic murmur like sound above and slightly to left of Umbilicus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Abnormal liver

A

Hepatomegaly

  • early Cirrhosis
  • Hepatocellular Carcinoma
  • Cholangiocarcinoma
  • Lymphoma,
  • Liver metastasis
  • Adenoma,Hemangioma
  • Abscess, Cysts ,
  • Congestive Heart Failure

Tenderness

  • Hepatitis
  • Infection
  • Inflammation
  • Congestive heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Gall bladder and ducts

A
  • May be tender if inflamed or calculi
  • Enlarged: carcinoma of gall bladder
  • Enlargement with jaundice : Cancer of head of pancreas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Splenomegaly

A
  • Infiltrative Diseases : • Lymphoma,
  • Metastatic cancer,
  • Amyliodosis,
  • Gaucher’s disease ,
  • Myeloproliferative diseases with extramedullary hematopoiesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Abnormal kidneys

A
  • Costovertebral tenderness ( CVAT ) : place hand over area of kidney and strike your hand with your fist : tenderness is abnormal , due to infection , calculi
  • Palpable kidney: Malignancy , Hydronephrosis, cysts
  • Bilateral enlargement , palpable abdominally suggest polycystic kidney disease ( PCOD )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Blood in stool

A

Lower GIT: Hematochezia -> Bright Red Blood per Rectum

Etiology ( Cause ) :

  • Hemorrhoids ; on tissue , or wiping , on stool
  • Colon tumors
  • Diverticular disease
  • Ulcerative colitis

Upper GI bleeding

  • Melena ; Black Tarry stool
  • May be malodorous from the blood
  • Etiology : Upper GI Tract : Ulcers , Varices , Mallory Weiss Tears ( mucosal esophageal tear after vomiting ) , Duodenal erosions , Tumor, Vascula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Radiation of ab pain

A

Pain of aortic aneurysm, renal and pancreatic pain - may radiate to the back.

Renal colic - may radiate to the groin.

Diaphragmatic irritation (often due to peritonitis - may cause shoulder tip pain.

Gallbladder pain - may radiate to **scapula. **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

NON-GIT causes of acute ab pain

A
  • Ectopic pregnancy – lower abdominal pain, missed period, positive pregnancy test, nausea/vomiting and/or diarrhea
  • Dissecting/rupture aortic aneurysm – tearing pain in flank or back, nausea/vomiting and/or dizziness, hemodynamically compromised
  • Renal colic – loin to groin pain, dysuria and/or hematuria, nausea and vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Caues of chronic ab pain

A
  • Inflammatory bowel disease - generalized abdominal pain, diarrhea (may be bloody), weight loss
  • Peptic ulcer disease – epigastric pain which may be related to meals, bloating and abdominal distension, heartburn
  • Diverticulosis – left lower quadrant pain, constipation, rectal bleeding, fever and unwell when complicated by diverticulitis
  • Irritable bowel syndrome (a diagnosis by exclusion) – generalized abdominal pain, bloating, changeable bowel habit,
  • Non-specific abdominal pain
  • GI/ovarian malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diffuse ab pain

A
  • Peritonitis
  • Septicemia
  • Diabetic acidosis
  • Sickle cell crisis: starts extrab becomes ab)
  • Gastroenteritis
  • Ovarian cancer
  • Intestinal obstruction: start diffuse then becomes localized
  • Opiate withdrawal
  • Shingles
  • Munchhausen syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

nl galbladder

  • Look hyper-echoic (hyper-echogenic) structure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

Acute cholecystitis

  • Thickening of gallbladder wall
  • Fluid surrounding wall of gallbladder

Murphy’s sign: below right costal margin in mid-clavicular line, insert tips of fingers while patient takes a deep breath
(+) sign: tenderness & a sudden cessation of inspiratory effort (patient gasps) –inflamed gall bladder

  1. Boa’s sign
  • lightly scratch skin right below right scapula
  • (+) sign: uncomfortable sensation perceived by scratching
    • Note: do NOT always see sign even if they DO have it
17
Q

Gallstones

A
  • can be asx but RUQ pain = cholecystitis
  • most common presentations are biliary colic (56%) and acute cholecystitis (36%). Other presentations include pancreatitis, obstructive jaundice, cholangitis, empyema and gallstone ileus.
18
Q

Acute cholecystitis

A
  • “fair, fat, fertile, female and forty’ is only part of the story. Typically related to gallstones disease. Other risk factors include:
  • Increasing age.
  • +ve family history.
  • Sudden weight loss - e.g., after obesity surgery.
  • Loss of bile salts - e.g., ileal resection, terminal ileitis.
  • Diabetes - as part of the metabolic syndrome.
  • Oral contraception-particularly in young women.
  • Right upper quadrant or epigastric pain
  • Pain steady, severe, prolonged without improvement
  • Radiate to the right back
  • Often precipitated by fatty food ingestion an hour or so prior
  • Associated symptoms of nausea, vomiting, anorexia fever
  • On examination - appears ill, lie still, fever, tachycardia
  • Tender Right upper quadrant with guarding
  • Acalculous cholecystitis – occurs in critically ill patient and has a high morbidity and mortality
  • C&C:
    • Gangrenous cholecystitis
    • Cholecystoenteric fistula
    • Emphysematous cholecystitis
19
Q

Peripheral signs of Ab disease: Hands

A
  • Clubbing – Shamroth’s sign; (chronic liver dz, chronic diarrhea, heart & lung dz chronic hypoxemia + inflam)
  • Koilonychia – spoon nails; indicate Fe deficiency anemia, Plummer-Vinson syndrome
  • Leukonychia – white spots on nails; indicate Vit deficiency or liver pathology; hypoalbuminemia d/t nephrotic syndrome, protein malabsorption/wasting
  • Dupuytren’s contracture – fibrotic bands across ring & little finger into palms; due to advanced liver cirrhosis
  • Pallor of nails
  • Palmar erythema – flushing of palm; due to incr estrogen levels as a result of liver pathology, portal HTN
  • Flapping tremor (asterixis) – w/arms stretched & hands flexed; indicates (hepatic encephalopathy d/t liver cirrhosis -> unable to metab NH4; renal failure -> azotema; hypercapnia; Wilson’s diease)
20
Q

Peripheral signs of Ab Dz: Mouth

A
  • Fetor hepatica – smell of ammonia in hepatic encephalopathy
  • Glossitis – smooth beefy tongue – inflam + loss of papillae due to Vit deficiencies (A, B complex, C) o Candidiasis – white patch that can scrape off
  • Ulcerations – Crohn’s dz
  • Pigmentations – Peutz Jegher syndrome, familiar polyposis
  • Leukoplakia – pre-malignant white patch; can’t scrape
21
Q

Colour discoloration in ab

A
  • Bruises – periumbilical color change & bluish discoloration of flanks; seen in hemorrhagic pancreatitis & due to intraperitoneal hemorrhage
  • Cullen’s sign – hematoma around umbilicus; seen in hemorrhagic pancreatitis
  • Grey Turner’s sign – hematoma on flanks; seen in hemorrhagic pancreatitis
  • Melanin – racial; seen in Addison’s disease & pregnancy
  • Heavy metals – iron (seen in haemochromatosis or bronze diabetes) or arsenic
  • Jaundice – lemon yellow (in haemolytic anaemia) to green (in obstructive jaundice)
22
Q

Acute appendicitis

A
  • Tenderness & rebound tenderness in right iliac fossa (McBurney’s point)
  • Rovsing’s sign: pain in right iliac fossa when applying pressure in left iliac fossa
23
Q

Friction rubs

A
  • Listen 
over
 hepatic 
and
 splenic
 areas
  • Grating 
sounds 
with 
respiratory
 variation‐
inflammation 
of 
the
 peritoneal 
surface disease

24
Q

Venous hum

A
  • listen over epigastric and umbilical area (porta hepatis)
  • soft 
humming
 noise
 with 
both
 diastolic

 and
 systolic 
components‐increased
 collateral
 circulation between 
porta l
and 
systemic
 systems‐
hepatic 
cirrhosis


CPD F2014 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions