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Clasp; radiology and anatomy > Abdomen Masterclass > Flashcards

Abdomen Masterclass Flashcards

1
Q

Causes of LUQ pain?

A

Gastritis

Splenic disorders; abscess, rupture

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2
Q

Causes of RUQ pain?

A

Cholecystitis and biliary colic
Congestive hepatomegaly
Hepatitis or hepatic abscess
Perforated duodenal ulcer

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3
Q

Causes of RUQ/ LUQ pain?

A 
Acute pancreatitis 
Herpes zoster
Lower lobe pneumonia
Myocardial ischaemia
Radiculitis
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4
Q

Causes of LLQ pain?

A

Sigmoid diverticulitis

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5
Q

Causes of RLQ pain?

A

Appendicitis
Cecal diverticulitis
Meckel’s diverticulitis
Mesenteric adenitis

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6
Q

Causes of LLQ/RLQ pain?

A 
Abdominal or psoas abscess
Abdominal wall haematoma
Cystitis 
Endometriosis
Incarcerated or strangulated hernia 
IBS
Mittelscherz
PID
Renal stone
Ruptured AAA
Ruptured ectopic pregnanc
Torsion of ovarian cyst or teste
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7
Q

Causes of diffuse abdominal pain?

A 
Acute pancreatitis
DKA
Gastroenteritis
Intestinal obstruction 
Mesenteric ischaemia
Peritonitis
Sickle cell crisis
Spontaneous peritonitis
Typhoid fever
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8
Q

What are the top 5 causes of acute abdominal pain presentation?

A

1st: non-specific
2nd; appendicitis
3rd + 4th; bowel obstruction and urinary system disorder
5th: diverticulitis

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9
Q

What is an AXR commonly used for?

A 
Obstruction 
Perforation (pneumoperitoneum on erect CXR)
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10
Q

For what conditions is an MRI used?

A

Hepatobiliary
Small bowel
Pelvis

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11
Q

Symptoms of acute appendicitis?

A

Periumbilical pain, N+V

Localizes in RIF

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12
Q

How is acute appendicitis diagnosed?

A

CT and USS
1st line: USS
CT if inconclusive

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13
Q

What is acute diverticulitis?

A

Infection of diverticula (outpouchings of large bowel)

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14
Q

What are complications of acute diverticulitis?

A

Abscess
Obstruction
Perforation
Fistulae

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15
Q

What type of fistula is commonly assoc with acute diverticulitis complications?

A

Colovesical

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16
Q

Imaging pathway for acute diverticulitis?

A

Plain x-ray; exclude obstruction/ perforation

Diagnose with CT

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17
Q

What is acute cholecystitis diagnosed based on?

A

One local sign of inflammation (RUQ pain)
One sign of inflammation (fever, WCC, CRP_
Confirmatory imaging

18
Q

What can USS detect in the context of acute cholecystitis?

A

Gallstones
GB wall thickening
Local fluid

19
Q

Is a CT or MRCP preferred in investigation of acute cholecystitis?

A

MRCP

CT can be false -ve

20
Q

What is emphysematous cholecystitis?

A

Air in gallbladder wall

21
Q

Who commonly gets emphysematous cholecystitis?

A

Diabetics

22
Q

Treatment for acute cholecystitis?

A

Medial/ conservative
Percutaneous (IR)
Cholecystectomy

23
Q

What can cause a small bowel obstruction?

A

Adhesions
Cancer
Herniae
Gallstone ileus

24
Q

Symptoms of small bowel obstruction?

A

Vomiting
Pain
Distention

25
Q

Signs of small bowel obstruction?

A

Tinkling bowel sounds
Tenderness
Palpable loops

26
Q

What is the purpose of imaging in a small bowel obstruction?

A

Site
Cause
Severity
Complications (perforation, ischaemia)

27
Q

Initial investigation in a small bowel obstruction?

A

X-ray

BUT can miss fluid filled loops

28
Q

What is a key finding on CT in small bowel obstruction?

A

Transition from dilated bowel to normal bowel

This tells you where the issue is

29
Q

Causes of a large bowel obstruction?

A

Colorectal cancer
Volvulus
Diverticulitis

30
Q

Why is the state of the caecum important when diagnosing a large bowel obstruction?

A

If big; COULD POP

31
Q

What can result in a perforation in the GI tract?

A

Perforated ulcer
Diverticular
2nd to cancer
2nd to ischaemia

32
Q

What are the downfalls to AXR for perforation diagnosis?

A

May miss small pockets of gas

Does not show site origin

33
Q

Benefits of CT for perforation?

A

High sensitivity and specificity
Shows free fluid
Will show clues to site of origin: distribution of gas, defect in wall, localised inflammatory changes

34
Q

Causes of bowel ischaemia?

A

Arterial; 60-70%
Venous; 5-10%
Non occlusive hypoperfusion; 20-30%

35
Q

Symptoms of bowel ischaemia?

A

Severe abdo pain
Vomiting, diarrhoea, distention inconsistent
Borderline amylase, raised WCC, ACIDOTIC (ALWAYS CHECK LACTATE)

36
Q

DDx for bowel ischaemia?

A

Perf
Pancreatitis
Obstruction
Diverticulitis

37
Q

Imaging of choice for bowel ischaemia?

A

Biphasic CT; will determine if arterial or venous, site of occlusion and length of affected bowel

38
Q

Is gas surrounding the bowel in ischaemia an early or late sign?

A

LATE; THIS IS BAD

39
Q

What does gas in the portal vein suggests?

A

Imminent death; VVV serious

40
Q

How can a ruptured AAA be treated?

A

Aortic balloon for haemorrhage control

EVAR definitively

41
Q

Role of USS in acute abdo pain?

A

RUQ/ RIF pain

42
Q

Role of CT in acute abdo pain?

A

Primary imaging technique for acute abdo pain EXCEPT for acute cholecystitis/ appendicitis

Clasp; radiology and anatomy (6 decks)

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