Acute abdomen Flashcards
MCC acute abdominal pain
unknown
diarrhea
3 or more watery stool per day
determine if acute or chronic (< or > 3 weeks)
lakes or streams
giardia, metronidazole
oysters
vibrio
rice
b cereus
eggs
salmonella
meat
campylobacter e. coli yersinia staph clostridium
most specific test for diarrhea
stool cultures
1 cause of cyclic vomiting
weed
which is better amylase or lipase
lipase is more sepcific
mesenteric ischemia is MC associated with
A-fib
MC electrolyte deficiency caused from diarrhea
hypokalemia, below 2.5 admit
20 meq dose will raise K by .25, don’ texceed 40 meq per hour
hx of travel with weird foods, think
E. Coli, travelers diarrhea
cipro
also for shigella
entamoeba tx
metro + iodoquinol
common anti-motility agents
- loperamide
- bismuth subsalicylate
- diphneoxylate and atropine
MCC infectious diarrhea in hospitalized pts
C. Diff, recent admission/recent anbx use (7-10 day after)+ diarrhea think this
C. Diff treatment
metro or vanco
if severe get a CT to rule out toxic megacolon
S/S constipation
- weight loss
- rectal bleed
- unexplained anemia
- diarrhea alone can not rule out constipation
pt complains of constipation, what should you do?
rectal exam
- fluids, fiber, exercise
- dulcolax
- enema for severe
- relistor for OIC
initial test for constipation
best test
abdominal series
CT w/IV and PO contrast
MCC esopageal perforation
intraluminal procedures (post endoscopy acute, severe, unrelenting pain)
initial test for esophageal perf
best test
CXR
CT
esophagela perf tx
- stat sx consult
- fluids and broad spectrum anbx (zosyn, ceftriaxone, clinda, flagyl)
FB, plain films are good at finding
CT
radioopaque
non radioopaque
