Acute Abdomen Flashcards
What are your the 3 DDx for RUQ acute abd?
Liver Abscess
Acute cholecystitis
Acute cholangtitis
Typical findings for liver abscess (3)
- Recent biliary or systemic infection
- Fever, malaise, weight loss
- Tender hepatomegaly
Lab findings for liver abscess (3)
- Elevated Bilirubin
- Elevated AP
- Elevated Transaminases (ALT, AST)
Diagnostic step for liver abscess (1)
U/S
Typical finding of acute cholecystitis (4)
- Fever
- Right shoulder referred pain
- N/V
- Murphy’s sign
Lab findings for acute cholecystitis
- Elevated Bilirubin
- Elevated AP
- Elevated GGT
Diagnostic step for Acute cholecystits (1)
- U/S
Typical finding of acute cholangitis (3)
- Fever, chills, Jaundice (Charcot triad)
Lab findings for acute cholangitis (3)
- Elevated Bilirubin
- Elevated AP
- Elevated GGT
Diagnostic step for Acute cholangitis (1)
- U/S
What is the DDx for acute abd pain in LUQ?
Splenic rupture
Typical findings for splenic rupture (2)
- Recent hx of trauma
- Shock
Lab findings for splenic rupture (3)
- Anemia (late finding)
- Leukocytosis
- Thrombocytosis
Diagnostic step for splenic rupture (1)
U/S (FAST exam)
What is the DDx for acute abd pain in RLQ?
Appendicits
Typical findings for appendicitis (3)
- Onset: Periumbilical or epigastric
- Signs of appendicitis
- Fever
Diagnostic step for appendicitis
- CT
- U/S in children
What is the DDx for acute abd pain in LLQ?
Sigmoid Diverticulitis
Typical findings in sigmoid diverticulitis (3)
- Fever
- Possible constipation
- Elderly patients
Diagnostic step for sigmoid diverticulitis
CT
What are the DDx for acute abd pain in epigastric region (3)
- Gastric or duodenal ulcer perforation
- Acute Pancreatitis
- Acute Coronary Syndrome
Typical findings in Gastric or duodenal ulcer perforation (2)
- Hx of NSAID or glucocorticoid use
- Dyspepsia
Diagnostic step for Gastric or duodenal ulcer perforation
Abd X-ray
Typical findings in acute pancreatitis ( 3)
- Possibly Fever
- Circumferential pain
- Hx of gallstones or alcoholism
Lab findings in acute pancreatitis (2)
- Elevated Lipase
- Elevated Amylase
Diagnostic step for acute pancreatitis (2)
- U/S or CT
Typical finding in Acute Coronary Syndrome (2)
- Chest pain may be absent (especially in women), and elderly patients
- Hx of atherosclerosis
Lab tests for ACS (2)
- Troponin
- CK-MB
Diagnostic step for ACS
-ECG
What are the DDx for generalized acute abd pain (2)
- Intestinal obstruction
- Mesenteric ischemia
Typical finding in intestinal obstruction (4)
- Hx of abdominal surgery
- bloating
- No bowel activity
- progressive nausea and vomiting (late finding)
Diagnostic step for intestinal obstruction
Abd x-ray
Typical finding in mesenteric ischemia (3)
- Minimal tenderness to palpation
- Hx of A-Fib or hypercoagulability
- Elderly patients
