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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
What parts of the colon and what patients are usually affect with Ogilvie Syndrome?
Right colon/cecum | ICU patients
26
Ogilvie syndrome involves massive dilation of colon without obstruction. A diameter greater than ___ is at risk for perforation
10-12 cm
27
Ogilvie syndrome should start with conservative treatment. Describe it.
- Place rectal tube - STOP drugs that slow GI motility = monitor size every 12 hours
28
Once Ogilvie syndrome involves the colon diameter > 12 cm, what should the treatment be?
Colonoscopic decompression | Surgery
29
Meckel's Diverticulum can mimc?
Appendicitis
30
How do you diagnose Meckel's Diverticulum?
Meckel's scan | = Technetium-99m scan
31
What is a Technetium - 99m scan and what does it diagnose?
Nuclear medicine up-taken in tissue | = Meckel's Diverticulum
32
1 condition that can cause LLQ pain?
Diverticulitis
33
Symptoms of Diverticulitis?
LLQ pain, N/V, constipation that progresses to loose stools due to the inflammation
34
What diagnostic tests should you NOT do for Diverticulitis and why?
Endoscopy or Barium Enema | = risk of perforation
35
4 complications of Diverticulitis?
Abscess Perforation Fistula Stricture
36
2 conditions that can cause Periumbilical pain?
Acute Mesenteric Ischemia | Chronic Mesenteric Ischemia
37
Acute Mesenteric Ischemia arises how?
Inadequate blood flow through the mesenteric A.'s | --> ischemia and gangrene of bowel wall
38
Main sign of Acute Mesenteric Ischemia?
Pain out of proportion to tenderness
39
Pain that is out of proportion to tenderness could indicate?
Acute Mesenteric Ischemia
40
Chronic Mesenteric Ischemia arises how?
Long-standing Atherosclerotic disease | --> gradual reduction in blood flow
41
Symptoms of Chronic Mesenteric Ischemia?
Abdominal Angina - pain after eating | - Food fear
42
Acute and Chronic Mesenteric Ischemia can be diagnosed how?
CT angiography with IV contrast
43
3 DDx for Diffuse abdominal pain?
Peritonitis Toxic Megacolon Volvulus
44
How does Peritonitis arise?
Intraabdominal viscus | --> leakage of bacteria that then contaminates peritoneum
45
How does Peritonitis arise?
Intraabdominal viscus | --> leakage of bacteria that then contaminates peritoneum
46
With Peritonitis, describe the microbiology
Mixed flora | - gram (-) bacilli and anaerobes predominate
47
Signs of Peritonitis?
Patients lie with their knees to their chest to prevent stretching of the nerve fibers
48
Diagnostic test for Peritonitis?
CT to find source of contamination
49
What 2 things can cause Toxic Megacolon?
IBD | C. Difficile
50
Volvulus arises how?
Twisted bowel around its mesentary Obstruction Infarction
51
Sigmoid Volvulus usually occurs in who?
Pregnant | Constipated older adults
52
Cecum Volvulus usually occurs in who?
Younger adults
53
What will be seen on X-ray with a Volvulus?
Bent Coffee Bean
54
A Bent Coffee Bean on X-ray indicates?
Volvulus
55
What will be seen on Barium Enema with a Volvulus?
Bird's beak

GI - 2 (61 decks)

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