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GI - 2 > Abdominal Pain > Flashcards

Abdominal Pain Flashcards

1
Q

1 condition that presents with EPIGASTRIC pain?

A

Abdominal Aortic Aneurysm (AAA)

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2
Q

What are some risk factors for AAA?

A

Atherosclerosis, Male, Smoker

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3
Q

AAA are usually found incidentally and are asymptomatic. As they expand, what presents?

A

Pulsations in abdomen

Pain in chest/back/scrotum

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4
Q

For AAA, what is a precursor to rupture?

A

PAIN

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5
Q

What is a diagnostic test to screen and to document size of AAA?

A

Abdominal US

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6
Q

The risk of rupture for AAA increases as the AAA > __

A

5 cm

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7
Q

AAA rupture occurs spontaneously and presents with what symtpoms?

A

Hypotension

Pain

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8
Q

If an AAA causes Aortic Dissection, what will be seen on CT?

A

False lumen

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9
Q

Symptoms of Aortic Dissection?

A

Tearing chest pain and widened mediatsinum

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10
Q

Tearing chest pain with a widened mediastinum suggests?

A

Aortic Dissection

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11
Q

Hypotension and epigastric abdominal pain suggests?

A

AAA rupture

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12
Q

5 DDX for RLQ pain?

A 
Appendicitis
Ectopic Pregnancy
Ovarian Torsion
Ogilvie Syndrome
Meckel's Diverticulum
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13
Q

Appendicitis is usually initiated by?

A

Obstruction of appendix – fecalith, neoplasm, etc.

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14
Q

What are 2 times when appendicitis can have atypical presentation?

A 
Elderly = mild pain and symptoms
Pregnancy = uterus displaces appendix
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15
Q

What is the most common cause of maternal death during 1st trimester?

A

Ectopic pregnancy

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16
Q

3 risk factors for an ectopic pregnancy?

A

PID
Ruptured appendix
Prior tubal surgery – most common site

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17
Q

Symptoms of an ectopic pregnancy?

A

Sudden, severe lower quadrant pain

- blood accumulates in peritoneum = hypotension

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18
Q

Diagnostic results with an ectopic pregnancy?

A

(+) pregnancy test with NO intrauterine pregnancy on transvaginal US

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19
Q

What is Ovarian Torsion associated with and what side is commonly affected?

A

Ovarian enlargement

- RIGHT side

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20
Q

Symptoms of Ovarian Torsion?

A

Sudden, severe unilateral abdominal pain AFTER EXERTION

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21
Q

Sudden, severe pain after exertion could indicate?

A

Ovarian Torsion

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22
Q

Ovarian Torsion is an ischemic condition, what diagnostic test can diagnose it?

A

Transvaginal US with doppler

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23
Q

Acute Colonic Pseudo-obstruction is known as?

A

Ogilvie Syndrome

24
Q

Ogilvie Syndrome

A

SPONTANEOUS massive dilation of cecum or right colon

25
Q

What parts of the colon and what patients are usually affect with Ogilvie Syndrome?

A

Right colon/cecum

ICU patients

26
Q

Ogilvie syndrome involves massive dilation of colon without obstruction. A diameter greater than ___ is at risk for perforation

A

10-12 cm

27
Q

Ogilvie syndrome should start with conservative treatment. Describe it.

A
  • Place rectal tube
  • STOP drugs that slow GI motility
    = monitor size every 12 hours
28
Q

Once Ogilvie syndrome involves the colon diameter > 12 cm, what should the treatment be?

A

Colonoscopic decompression

Surgery

29
Q

Meckel’s Diverticulum can mimc?

A

Appendicitis

30
Q

How do you diagnose Meckel’s Diverticulum?

A

Meckel’s scan

= Technetium-99m scan

31
Q

What is a Technetium - 99m scan and what does it diagnose?

A

Nuclear medicine up-taken in tissue

= Meckel’s Diverticulum

32
Q

1 condition that can cause LLQ pain?

A

Diverticulitis

33
Q

Symptoms of Diverticulitis?

A

LLQ pain, N/V, constipation that progresses to loose stools due to the inflammation

34
Q

What diagnostic tests should you NOT do for Diverticulitis and why?

A

Endoscopy or Barium Enema

= risk of perforation

35
Q

4 complications of Diverticulitis?

A

Abscess
Perforation
Fistula
Stricture

36
Q

2 conditions that can cause Periumbilical pain?

A

Acute Mesenteric Ischemia

Chronic Mesenteric Ischemia

37
Q

Acute Mesenteric Ischemia arises how?

A

Inadequate blood flow through the mesenteric A.’s

–> ischemia and gangrene of bowel wall

38
Q

Main sign of Acute Mesenteric Ischemia?

A

Pain out of proportion to tenderness

39
Q

Pain that is out of proportion to tenderness could indicate?

A

Acute Mesenteric Ischemia

40
Q

Chronic Mesenteric Ischemia arises how?

A

Long-standing Atherosclerotic disease

–> gradual reduction in blood flow

41
Q

Symptoms of Chronic Mesenteric Ischemia?

A

Abdominal Angina - pain after eating

- Food fear

42
Q

Acute and Chronic Mesenteric Ischemia can be diagnosed how?

A

CT angiography with IV contrast

43
Q

3 DDx for Diffuse abdominal pain?

A

Peritonitis
Toxic Megacolon
Volvulus

44
Q

How does Peritonitis arise?

A

Intraabdominal viscus

–> leakage of bacteria that then contaminates peritoneum

45
Q

How does Peritonitis arise?

A

Intraabdominal viscus

–> leakage of bacteria that then contaminates peritoneum

46
Q

With Peritonitis, describe the microbiology

A

Mixed flora

- gram (-) bacilli and anaerobes predominate

47
Q

Signs of Peritonitis?

A

Patients lie with their knees to their chest to prevent stretching of the nerve fibers

48
Q

Diagnostic test for Peritonitis?

A

CT to find source of contamination

49
Q

What 2 things can cause Toxic Megacolon?

A

IBD

C. Difficile

50
Q

Volvulus arises how?

A

Twisted bowel around its mesentary
Obstruction
Infarction

51
Q

Sigmoid Volvulus usually occurs in who?

A

Pregnant

Constipated older adults

52
Q

Cecum Volvulus usually occurs in who?

A

Younger adults

53
Q

What will be seen on X-ray with a Volvulus?

A

Bent Coffee Bean

54
Q

A Bent Coffee Bean on X-ray indicates?

A

Volvulus

55
Q

What will be seen on Barium Enema with a Volvulus?

A

Bird’s beak

GI - 2 (61 decks)

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