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PNP DNP > Abdominal > Flashcards

Abdominal Flashcards

1
Q

Epigastric Pain

A

PUD, GERD, gallbladder disease, pancreatitis, trauma, idiopathic

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2
Q

Periumbilical

A

Functional abdominal pain, abdominal migraine, Strep pharyngitis, gastroenteritis, appendicitis, carbohydrate intolerance, lactase deficiency

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3
Q

RLQ pain

A

ovarian torsion, appendicitis, PID, ectopic pregnancy, Mittelschmerz, R lower lobe pneumonia, inguinal hernia, iliopsoas abscess, ovarian cyst, testicular torsion

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4
Q

LLQ pain

A

constipation, ovarian cyst, testicular torsion

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5
Q

Suprapubic pain

A

UTI, constipation, urinary retention, hydrometrocolpos

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6
Q

Abdominal Pain Red Flags

A

Bleeding, peri-rectal disease, involuntary weight loss, persistent vomiting, deceleration of linear growth, acholic stools, unexplained fever, dysphagia, persistent RUQ or RLQ pain, pain that wakes child from sleep, arthritis, nocturnal diarrhea, family Hx

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7
Q

Extra-abdominal Causes of Abdominal Pain

A

Pneumonia (visceral innervation), Strep pharyngitis, reproductive tract disease (STI, cyst, ectopic pregnancy, etc.), diabetic ketoacidosis, sickle cell disease

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8
Q

Guarding

A

Peritonitis, appendicitis, cholecystitis

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9
Q

No bowel sounds

A

Peritonitis, infarcted bowel

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10
Q

Palpable mass

A

Tumor, cyst, intussusception

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11
Q

Nutritional status

A

Wt, Ht, edema, anemia

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12
Q

Extra-abdominal features

A

Arthritis, uveitis, rash (erythema nodosum on shins, pyoderma granulosum)

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13
Q

Abdominal distention

A

Peritonitis, obstruction

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14
Q

Visible bowel loops

A

Intussusception, obstruction

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15
Q

High-pitched bowel sounds

A

Obstruction

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16
Q

Acute Abdomen

A

Crying, irritability, bloody stools, fever, hypothermia (heralds sepsis), omphalitis, severe pain

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17
Q

RUQ

A

Biliary: cholecystitis, cholelithiasis, cholangitis
Hepatic: hepatitis, hepatic abscess
Others: pneumonia, PE, pancreatitis, PUB, retrocecal appendicitis

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18
Q

LUQ

A

Splenic: splenic infarct, splenic laceration
Cardiac: myocardial infarction, pericarditis
Others: pneumonia, PE, pancreatitis, PUD, diaphragmatic hernia

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19
Q

Epigastric

A

Gastric: PUD, gastritis
Pancreatic: pancreatitis
Biliary: cholecystitis, cholelithiasis, cholangitis

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20
Q

RLQ

A

Colonic: appendicitis, cecal diverticulitis, cecal volvulus
GU: nephrolithiasis, ovarian torsion, PID, ectopic pregnancy, testicular torsion, inguinal hernia
Other: mesenteric adenitis

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21
Q

LLQ

A

Colonic: sigmoid diverticulitis
GU: nephrolithiasis, ovarian torsion, PID, ectopic pregnancy, testicular torsion, inguinal hernia
Other: abdominal aortic aneurysm

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22
Q

Gallbladder pain

A

RUQ to upper back

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23
Q

R subcostal pain

A

Liver and GB

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24
Q

Pain relieved by vomiting

A

SBO

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25
Q

Anorexia

A

SBO, appendicitis, cholecystitis

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26
Q

Comorbid diabetes

A

Pancreatitis

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27
Q

Acute pain with Hx of Afib

A

Mesenteric ischemia

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28
Q

Appendicitis

A

Periumbilical pain localizing to RLQ, anorexia, nausea, fever.
Rebound tenderness, Psoas sign highly predictive

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29
Q

Bowel Obstruction / SBO

A

Abdominal distention, nausea, anorexia, constipation

Distention is highly predictive

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30
Q

Cholecystitis

A

Periumbilical pain location to RUQ, anorexia, nausea, fever

Murphy sign is highly predictive

31
Q

Diverticulitis

A

LLQ pain, fever

LLQ pain is highly predictive

32
Q

Ectopic pregnancy

A

Abdominal pain, amenorrhea, vaginal bleeding

Cervical motion tenderness, lateralizing pain are highly predictive

33
Q

Mesenteric ischemia

A

Abdominal pain out of proportion with exam findings, nausea, anorexia

34
Q

Pancreatitis

A

Abdominal pain radiating to back, N/V

Grey-Turner or Cullen sign suggest necrotizing pancreatitis

35
Q

Perforated Viscus

A

Severe, generalized abdominal pain, peritoneal sign

36
Q

Peptic Ulcer Disease (PUD)

A

Epigastric pain associated with eating

37
Q

Ovarian torsion

A

sudden onset of severe, unilateral lower abdominal pain, nausea
Known history of ovarian cyst or mass increases likelihood

38
Q

Ruptured AAA

A

Abdominal pain and/or back pain with a pulsatile abdominal mass
Pulsatile mass is highly predictive

39
Q

Ureterolithiasis

A

Acute onset flank pain radiating to groin, nausea

Can mimic ruptured AAA

40
Q

Surgical Scar

A

Obstruction, perforated viscus

41
Q

Ecchymosis

A

Retroperitoneal bleed

42
Q

Grey-Turner (flanks)

A

Acute pancreatitis, retroperitoneal hematoma, ruptured ectopic pregnancy

43
Q

Cullen (umbilicus)

A

Ectopic pregnancy, acute pancreatitis, retroperitoneal hematoma

44
Q

Fox (inguinal)

A

Traumatic injury to pancreas, kidneys, aorta, ascending/descending colon

45
Q

Bryant (scrotal)

A

Ruptured AAA

46
Q

Abdominal distention

A

Obstruction, ascites

47
Q

Vesicular Rash (dermatomal)

A

Zoster

48
Q

Elevated WBC

A

Appendicitis, mesenteric ischemia, SBO, pancreatitis

Doesn’t R/O, just gives hints

49
Q

C-Reactive Protein

A

Perforated appendix

50
Q

Procalcitonin

A

Stimulated by bacterial infection

Complicated appendicitis and intestinal ischemia/necrosis

51
Q

D Dimer

A

Trauma, malignancies, venous thromboembolism, and aortic dissection
Mesenteric ischemia

52
Q

Intestinal Fatty Acid Binding Protein (I-FABP)

A

Small intestine epithelium

Intestinal injury or mucosal barrier disruption d/t poor mesenteric blood flow or ischemia

53
Q

Lactate

A

Liver can’t convert all of what tissues are releasing d/t anaerobic glycolysis.
Vascular causes of abdominal pain d/t decreased tissue perfusion and hypoxia

54
Q

Serum Lipase/Amylase and LFT

A

In epigastric pain, r/o pacnreatitis
Lipase increases later than amylase
False elevation w/ impaired renal function
ALT/AST elevation with gallstones and gallstone pancreatitis

55
Q

Dx appendicitis

A

CT or U/S

56
Q

Dx bowel obstruction

A

Xray

57
Q

Dx Cholecystitis

A

U/S

58
Q

Dx Diverticulitis

A

CT

59
Q

Dx Ectopic pregnancy

A

Transvaginal U/S

60
Q

Dx Mesenteric ischemia

A

CTA

61
Q

Dx Pancreatitis

A

CT

62
Q

Dx Perforated viscus

A

Xray

63
Q

Dx Ovarian torsion

A

Pelvic U/S with Doppler

64
Q

Dx Renal/ureteral colic

A

Spiral CT w/o contrast

65
Q

Dx Ruptured AAA

A

U/S

66
Q

XRay - Air under diaphragm

A

Perforated viscus

Artifact of recent laproscopy

67
Q

XRay - Air fluid levels (strong of pearls, stack of coins)

A

SBO

68
Q

XRay - appedicolith/fecalith

A

Appendicitis

69
Q

XRay - Double Bubble

A

Malrotation with midgut volvulus

70
Q

XRay - Sentinel Loop Sign

A

Acute pancreatitis (L), acute appendicitis (R), acute cholecystitis (R), diverticulitis (L)

71
Q

XRay - target/crescent lucency

A

Intussusception

72
Q

XRay - Bent Inner Tube

A

Sigmoid volvulus

73
Q

XRay - Coffee Bean

A

Cecal or sigmoid volvulus

PNP DNP (2 decks)

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