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GI > Abdominal Emergencies > Flashcards

Abdominal Emergencies Flashcards

1
Q

What is Boerhaave syndrome?

A

Full-thickness tear in esophagus, actual penetration.

- increased intra-esophageal pressure.

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2
Q

Describe the form of pain of colicky pain

A

starts and stops abruptly, d/t muscular contractions of a hollow tube to relieve an obstruction bu forcing contents out

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3
Q

What is kehr’s sign?

A

pain from lower abdominal region radiates to shoulder or scapular causing a dull ache

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4
Q

What is melana?

A

dark tarry foul-smelling stools, upper GI bleed

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5
Q

Separation of lower and upper GI bleeds is defined as?

A

Upper: Proximal of Ligament of Treitz
Lower: Distal of Ligament of Treitz

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6
Q

Whats an ileus?

A

Disruption of the normal propulsive ability of the GI tact

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7
Q

Pigmented gallstones is composed of?

A

Bilirubin

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8
Q

+ Chvosteks sign and Trusseaus sign indicates?

A

hypocalcemia

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9
Q

Whats hematochezia?

A

Fresh bight red blood in or on stool

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10
Q

False-positive tox screen of amphetamines can be?

A

Asthma meds

Pseudoephedrine

Dexatrim

OTC nasal spray

Ritalin

Dexedrine

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11
Q

False-positive tox screen of cocaine can be?

A

Ampicillin

Amoxicillin

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12
Q

False-positive tox screen of opioids can be?

A

cough suppressants

poppy seeds

Quinine in tonic water

T3, pain meds

Amitriptyline

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13
Q

False-positive tox screen of Phencyclidine (PCP) can be?

A

Diazepam

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14
Q

False-positive tox screen of Tetrahydrocannabinol can be?

A

Ibuprofen

Ketoprofen

Naproxen

Phenergan

Riboflavin

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15
Q

Free air under the diaphragm indicates?

A

Bowel perforation

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16
Q

Air - fluid levels in the diaphragm indicate?

A

Small bowel obstruction

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17
Q

What dx do you think of in a pt presenting with acute a-traumatic abdominal pain?

A

Appendicitis

18
Q

MC early sign of appendicitis?

A

Peri-umbilical/central abdominal pain discomfort

19
Q

Imaging used for suspected appendicitis?

A

Graded compression US
- (good choice in pregnancy and <2 yrs old)

Abdominal CT

20
Q

Infectious agents causing cholecystitis?

A

AIDS

Cytomegalovirus

Cryptosporidium

21
Q

Is emergent surgery needed for cholecystitis?

A

No! Admit and start with: IV hydrate, NPO, antiemetics, analgesia, and referral for surgery

22
Q

What causes a dissecting/ruptured aorta?

A

blood passing through intimal tear causing separation of the intima from the medial layer

23
Q

PE/clinical presentation of dissecting/ruptured aorta?

A

Acute onset of severe, sharp, tearing, or ripping sensation.

Pain is out of proportion to PE.

24
Q

Back and abdominal pain caused by ascending or descending dissection?

A

Descending dissection

25
Q

CXR finding with pr w/ dissecting/ruptured aorta?

A

widened mediastinum

26
Q

Sources of upper GI bleeds?

A

peptic ulcer dz

erosive gastritis and esophagitis

esophageal/gastric varices

27
Q

PE findings up GI bleeds?

A

HyoTN

Tachy

Diaphoretic

Ascites

28
Q

Sources/causes of lower GI bleeds?

A

Diverticular dz (MC)

Vascular ectasia

Mesenteric ischemia

Meckles diverticulum

29
Q

Grossly abnormal vital signs can be found in?

A

Lower GI bleed

- however, vital signs may be masked by medications (BBs)

30
Q

Mesenteric venous thrombosis more common in what age group?

A

Younger age group

31
Q

Arterial embolism/thrombosis more common in what age group?

A

Elderly age group

32
Q

What is key for diagnosing mesenteric ischemia?

A

Early recognition!!!!

33
Q

Risk factor for mesenteric ischemia?

A

> 65 yrs
A.Fib
CHF
Recent MI

34
Q

Clinical presentation of mesenteric ischemia?

A

Rapid onset of severe periumbilical pain out of proportion to PE findings.
N/V
Distention w/ absence of bowel sounds
Mental status changes

35
Q

Top 3 etiology of pancreatitis?

A

Gallstones (MC in women)
Alcohol use/abuse (MC in men)
ERCP w/in 30 days —> procedure used to dx pancreatitis

36
Q

PE/Clinical presentation of pancreatitis?

A

Typically worse in a supine position, relieved sitting up with trunk flexed and knees drawn to the chest.

37
Q

Tx for pancreatitis?

A

Supportive

Correction of electrolyte imbalances: hypocalcemia and hypoalbuminemia

38
Q

MC stone in renal colic?

A

Calcium oxalate, present in the urinary tract

39
Q

PE/clinical presentation of renal colic?

A

Constantly pacing
Flank pain
N/V
Referred pain to testes

40
Q

Risk factors/MOI of a ruptured spleen?

A

Domestic violence
MVA
Infectious: mono, lymphoma, malaria
Blunt trauma: trampolines, contact sports, bicucle accidents

41
Q

PE/clinical presentation of a ruptured spleen?

A

L abdominal pain

L shoulder pain: Kehrs sign

GI (16 decks)

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