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CLASP > acute abdo > Flashcards

acute abdo Flashcards

1
Q

what imaging is used for bowel obstruction

A

supine AXR

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2
Q

what is used for assessing hollow viscus perforation

A

erect CXR

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3
Q

cons for CT

A

radiation exposure
contrast induced nephropathy
contrast allergy

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4
Q

RIF differential diagnosis

A

appendicitis
renal colic
tubo-ovarian pathology

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5
Q

imaging in appendicitis

A

ideally USS first
then CT if US is inconclusive

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6
Q

US findings in acute appendicitis

A

aperistaltic, non-compressible, dilated appendix (>6mm)
appears round when compression is applied
periappendiceal fluid collection
target appearance

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7
Q

CT findings for acute appendicitis

A

appendiceal dilation (>6mm)
wall thickening and enhancement
thickening of the caecal apex
periappendiceal inflammation
- fat stranding, thickening of fascia, fluid, phlegmon, abscess

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8
Q

what is fat stranding

A

when the fat becomes inflammed it becomes more white (normally black)
used as a marker for inflammation

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9
Q

first line imaging for ureteric stones

A

non-contrast CT (CT KUB)

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10
Q

differential diagnoses for LIF pain

A

diverticulitis
colitis
colorectal cancer
tubo-ovarian pathology
renal colic

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11
Q

presentation of acute diverticulitis

A

left iliac fossa pain
unremitting pain with associated tenderness
possible, an ill-defined mass
as the disease progresses, symptoms become more generalised

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12
Q

first line imaging for acute diverticulitis

A

CT with IV contrast
could consider CXR to look for perforation

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13
Q

epipoloic appendagitis

A

epiploic twists and becomes inflamed

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14
Q

epigastric and RUQ pain differentials

A

biliary colic
cholecystitis
pancreatitis
perforation

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15
Q

acute cholecystitis diagnosis

A

almost always secondary to gallstones
diagnosis based on:
- RUQ pain, fever, WCC, CRP
confirmatory imaging

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16
Q

imaging in acute cholecystitis

A

US first line to assess gall bladder and biliary tree
CT can be false for calculi, but good for complications
MRI if biliary tree dilatation

17
Q

US findings in acute cholecystitis

A

gallbladder wall thickening
pericholecystic fluid

18
Q

treatment of acute cholecystitis

A

medical/conservative
interventional radiology- percutaneous
ERCP if obstructed biliary tree
surgery

19
Q

presentation of pancreatitis

A

acute onset of severe central epigastric pain
poorly localised tenderness and pain
exacerbated by supine position
radiates to the back
elevated serum amylase

20
Q

role of imaging in pancreatitis

A

to clarify diagnosis when clinical picture is confusing
detect complications
determine possible cause

21
Q

when do you use US in pancreatitis

A

to identify gallstones as a possible cause

22
Q

pancreatitis on CT

A

focal or diffuse parenchymal enlargement
indistinct pancreatic margins owing to inflammation
surrounding retroperitoneal fat stranding
looking for vascular complications

23
Q

causes of perforation

A

common:
perforated ulcer
diverticular

less common:
secondary to cancer
secondary to ischaemia

24
Q

first line imaging in perforation

A

CT- shows free fluid, will show clues to site of origin
- localised inflammatory change
- distribution gas
- defect in wall

25
Q

causes abdominal pain and distension

A

bowel obstruction (small or large)
masses
ascites

26
Q

symptoms of small bowel obstruction

A

vomiting
pain
distention
increased bowel sounds
tenderness
palpable loops

27
Q

common causes of small bowel obstruction

A

adhesions, cancer, herniae, gallstones

28
Q

imaging in small bowel obstruction

A

XR- good place to start
CT- dilated small bowel loops, normal calibre or collapsed loops distally

29
Q

gallstone ileus CT

A

gas in biliary tree

30
Q

causes of large bowel obstruction

A

colorectal cancer
volvulus
diverticulitis

31
Q

imaging in large bowel obstruction

A

Xray first line
CT for more detail

32
Q

causes of sudden abdominal pain and shock

A

bowel ischaemia
perforation
pancreatitis
leaking AAA
ruptured ectopic pregnancy

33
Q

causes of bowel ischaemia

A

arterial occlusion
venous occlusion
non-occlusive hypoperfusion

34
Q

imaging in bowel ischaemia

A

CT

CLASP (4 decks)

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