Acute Abdomen

Question 1

What are your the 3 DDx for RUQ acute abd?

Answer 1

Liver Abscess
Acute cholecystitis
Acute cholangtitis

Question 2

Typical findings for liver abscess (3)

Answer 2

• Recent biliary or systemic infection
• Fever, malaise, weight loss
• Tender hepatomegaly

Question 3

Lab findings for liver abscess (3)

Answer 3

• Elevated Bilirubin
• Elevated AP
• Elevated Transaminases (ALT, AST)

Question 4

Diagnostic step for liver abscess (1)

Answer 4

U/S

Question 5

Typical finding of acute cholecystitis (4)

Answer 5

• Fever
• Right shoulder referred pain
• N/V
• Murphy’s sign

Question 6

Lab findings for acute cholecystitis

Answer 6

• Elevated Bilirubin
• Elevated AP
• Elevated GGT

Question 7

Diagnostic step for Acute cholecystits (1)

Answer 7

• U/S

Question 8

Typical finding of acute cholangitis (3)

Answer 8

• Fever, chills, Jaundice (Charcot triad)

Question 9

Lab findings for acute cholangitis (3)

Answer 9

• Elevated Bilirubin
• Elevated AP
• Elevated GGT

Question 10

Diagnostic step for Acute cholangitis (1)

Answer 10

• U/S

Question 11

What is the DDx for acute abd pain in LUQ?

Answer 11

Splenic rupture

Question 12

Typical findings for splenic rupture (2)

Answer 12

• Recent hx of trauma

- Shock

Question 13

Lab findings for splenic rupture (3)

Answer 13

• Anemia (late finding)
• Leukocytosis
• Thrombocytosis

Question 14

Diagnostic step for splenic rupture (1)

Answer 14

U/S (FAST exam)

Question 15

What is the DDx for acute abd pain in RLQ?

Answer 15

Appendicits

Question 16

Typical findings for appendicitis (3)

Answer 16

• Onset: Periumbilical or epigastric
• Signs of appendicitis
• Fever

Question 17

Diagnostic step for appendicitis

Answer 17

• CT

- U/S in children

Question 18

What is the DDx for acute abd pain in LLQ?

Answer 18

Sigmoid Diverticulitis

Question 19

Typical findings in sigmoid diverticulitis (3)

Answer 19

• Fever
• Possible constipation
• Elderly patients

Question 20

Diagnostic step for sigmoid diverticulitis

Answer 20

CT

Question 21

What are the DDx for acute abd pain in epigastric region (3)

Answer 21

• Gastric or duodenal ulcer perforation
• Acute Pancreatitis
• Acute Coronary Syndrome

Question 22

Typical findings in Gastric or duodenal ulcer perforation (2)

Answer 22

• Hx of NSAID or glucocorticoid use

- Dyspepsia

Question 23

Diagnostic step for Gastric or duodenal ulcer perforation

Answer 23

Abd X-ray

Question 24

Typical findings in acute pancreatitis ( 3)

Answer 24

• Possibly Fever
• Circumferential pain
• Hx of gallstones or alcoholism

Question 25

Lab findings in acute pancreatitis (2)

Answer 25

• Elevated Lipase

- Elevated Amylase

Question 26

Diagnostic step for acute pancreatitis (2)

Answer 26

• U/S or CT

Question 27

Typical finding in Acute Coronary Syndrome (2)

Answer 27

• Chest pain may be absent (especially in women), and elderly patients
• Hx of atherosclerosis

Question 28

Lab tests for ACS (2)

Answer 28

• Troponin

- CK-MB

Question 29

Diagnostic step for ACS

Answer 29

-ECG

Question 30

What are the DDx for generalized acute abd pain (2)

Answer 30

• Intestinal obstruction

- Mesenteric ischemia

Question 31

Typical finding in intestinal obstruction (4)

Answer 31

• Hx of abdominal surgery
• bloating
• No bowel activity
• progressive nausea and vomiting (late finding)

Question 32

Diagnostic step for intestinal obstruction

Answer 32

Abd x-ray

Question 33

Typical finding in mesenteric ischemia (3)

Answer 33

• Minimal tenderness to palpation
• Hx of A-Fib or hypercoagulability
• Elderly patients