Abdominal Flashcards
Hypokalemia
Think of intestinal pseudo-obstruction
Drugs r/t malabsorption
Anticholinergics, Xenecal
Where to percuss for Spleen
Traube’s space
Sign of abdominal malignancy
Sister Mary Joseph’s nodule
7 Fs for distention
Fat, Feces, Fluid, Flatus, Fibroids, Fetus, Fatal tumor
Grey Turner’s sign
Ecchymosis to the flanks
R/t hemorrhagic pancreatitis or strangulated bowel
Cullen’s sign
Bluish discoloration of umbilicus 2/to hemoperitoneum
Pain is initially periumbilical or epigastric; colicky; later localized to RLQ often at McBurney's point \+Aaron \+Rovsing \+Markle \+McBurney
Appendicitis
Pain is sudden or gradual; generalized or localized, dull or sever and unrelenting; guarding; pain on deep inspiration
+Blumberg
+Markle
+Ballance signs
Peritonitis
Pain is severe, unrelenting RUQ or epigastric pain; may be referred to right sub-scapular area
+Murphy sign
Cholecystitis
Pain is dramatic, sudden, excruciating LUQ, ,epigastric or umbilical; may be present in one or both flanks; may be referred to left shoulder and penetrate to back
+Grey Turner
+Cullen sign
Pancreatitis
Pain to lower quadrant, worse on left
C/o N/V, fever, suprapubic tenderness on palpation
Salpingitis
Pain to lower quadrant, increases with activity
C/o tender adnexa and cervix, cervical discharge
Pelvic inflammatory disorder
Pain to epigastric region, radiating down left side of abdomen especially after eating; may be referred to back
C/o flatulence, borborygmus, diarrhea, dysuria, tenderness on palpation
Diverticultis
Abrupt RUQ pain, referred to shoulders
Abdominal free air and distention
Tenderness to epigastrium or RUQ
Rigid abdominal wall
Perforated gastric or duodenal ulcer
Pain is abrupt, severe, colicky, spasmodic; referred to epigastrium and umbilicus
Distention, minimal rebound tenderness, vomiting
Intestinal obstruction
Pain referred to hypogastrium and umbilicus
C/o distention, vomiting, guarding
Volvulus
Pain is steady, throbbing midline over aneurysm; may penetrate to back, flank
N/V, abdominal mass, bruit
Leaking abdominal aneurysm
Episodic pain, severe, RUQ or epigastrium lasting 15 minutes to several hours
Anorexia, vomiting, jaundice
Biliary stones, colic
Intense pain to flank; extending to groin and genitals; may be episodic
Fever, hematuria
+Kehr sign
Renal calculi
Pain to lower quadrant, referred shoulder pain
Spotting, irregular menses, mass on bimanual pelvic examination
+Kehr
+Cullen
Ectopic pregnancy
Pain to lower quadrant, steady, increases with cough or motion
Vomiting, low fever, anorexia, tenderness on pelvic exam
Ruptured ovarian cyst
Intense pain to LUQ, radiating to left shoulder
May worsen with foot of bed elevated
Shock, pallor, lower temperature
Splenic rupture
Burning pain
Peptic ulcer
Cramping pain
Biliary colic, gastroenteritis
Colicky
Appendicitis with impacted feces; renal stone
Aching
Appendiceal irritation
Knifelike
Pancreatitis
Ripping tearing
Aortic dissection
Gradual pain
Infection
Sudden pain
Duodenal ulcer, acute pancreatitis, obstruction, perforation
Aaron sign
Pain or distress in heart or stomach on palpation of McBurney’s point
Appendictis
Ballance sign
Fixed dullness to percussion in left flank and dullness in right flank on change of position
Peritoneal irritation
Blumberg sign
Rebound tenderness
Peritoneal irritation; appendicitis
Cullen sign
Ecchymosis around umbilicus
Hemoperitoneum; pancreatitis; ectopic pregnancy
Dance sign
Absence of bowel sounds in RLQ
Intussusception
Grey Turner sign
Ecchymosis of flanks
Hemoperitoneum; pancreatitis
Kehr sign
Abdominal pain radiating to left shoulder
Spleen rupture; renal calculi; ectopic pregnancy
Markle sign
Heel jar
Peritoneal irritation; appendicitis
McBurney sign
Rebound tenderness, sharp pain to point when palpated
Appendicitis
Romberg-Howship
Pain down medial aspect of thigh to knees
Strangulated obturator hernia
Rovsing
RLQ pain intensified by LLQ abdominal palpation
Peritoneal irritation; appendicite
