Acute Abdomen Flashcards

1
Q

Epigastric D/D

A
  • PUD/Gastritis/Cancer
  • Early Appendicitis
  • Pancreatitis
  • MI
  • Gall Bladder Disease
  • Esophageal Disease (GERD, Hernia)
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2
Q

Diffuse Abdominal pain D/D

A
GI:
- Peritonitis
- Mesenteric Ischemia
- Bowel Obstruction
- Pancreatitis
- IBS/D
- Gastroenteritis
Systemic:
- DKA
- Uremia
- SCD
- Vasculitis
- Toxin ingestion
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3
Q

RUQ Pain D/D

A
  • Gall Bladder Disease
  • Liver Disease
  • Appendicitis
  • Acute Pyelonephritis
  • RLL Pneumonia
  • CHF
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4
Q

LUQ Pain D/D

A
  • Gastric PAth
  • SPlenic infarct
  • Diverticulitis/ Colitis
  • Pancreatitis
  • LLL Pneumonia
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5
Q

Periumbilical Pain D/D

A
  • Diverticulitis
  • Early appendicitis
  • Ischemic Bowel
  • IBD
  • SBO
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6
Q

RLQ Pain D/D

A
  • Appendicitis
  • IBD
  • Mesenteric adenitis
  • Renal Colic/infarct
  • Testicular Pathology
  • OB/GYN PAth
  • Hernia
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7
Q

LLQ Pain D/D

A
  • Diverticulitis/ Colitis
  • Sigmoid stricture
  • Testicular/OB/GYN PAth
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8
Q

Right Suprapubic Pain D/D

A
  • Sigmoid diverticulitis
  • Appendicitis
  • Urinary Bladder
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9
Q

Life-threatening Acute abdomen conditions

A
  • AAA
  • Perf isch Colitis
  • Isch Bowel
  • Perf PUD
  • Hemorrhage
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10
Q

Acute Abdomen conditions “could be” life-threatening

A
  • Appendicitis
  • Cholecytectomy/lithiasis
  • Sigmoid diverticulum
  • Salpingitis
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11
Q

Acute abdomen self-limited conditions

A
  • Gastroenteritis
  • Lymphadenitis
  • Epiploic appendagitis
  • Omental infarct
  • Cecal Diverticulitis
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12
Q

Tx Pneumoperitoneum

A

Laparoscopy/Laparatomy

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13
Q

Mesenteric Ischemia

A
  • S/S: Abdominal pain; arrythmia; vascular Dx; INC WBC; Acidosis; Hypotension
  • Tx: Laparoscopy/tomy
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14
Q

Fitz-hugh-curtis syndrome

A
  • RUQ Advanced PUD via Chlamydia

- “Violin String” Adhesions

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15
Q

Most common locations Appendix

A
  • 65% Retrocecal

- 32% Pelvic

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16
Q
  • Patient in fetal position w/ RLQ pain

- Positive Psoas Sign

A

Retrocecal Appendicitis

17
Q

How does appendix move during pregnancy?

A

Superior + Lateral

18
Q

What is contraindicated in 3rd trimester

A

Laparoscopic appendectomy

19
Q

Appendicitis XRary

A
  • Appendicolith
  • Cecal ileus
  • RLQ mass effect
20
Q

Diagnostic gold standard for appendicitis

A

CT Abdomen/Pelvis

21
Q

Child Appendicitis D/D

A
  • Gastroenteritis
  • Mesenteric Lymphadenitis
  • Pyelonephritis
  • Meckel’s Diverticulitum
  • Intussusception
  • Appendicitis very uncommon <2 YO
22
Q

Female Appendicitis D/D

A
  • Obstipation
  • PID
  • Ruptured ectopic pregnancy
  • Mittelschmerz (Ovulation pain)
  • Endometriosis
  • Regional enteritis
  • UTI/stone
23
Q

Male Appendicitis D/D

A
  • Regional enteritis
  • Epidydymo-orchitis
  • UTI/Stone
24
Q

Appendicitis Complications

A
  • Phlegmon (soft tissue inflammation under skin)
  • Abcess
  • Bleeding
  • Maceration of Cecum
25
Q

indications for hemicolectomy in appendicitis patients

A
  • Cancer of appendix/cecum
  • Perforated appendix maceration at base of appendix
  • involvement of base of appendix inflammation
26
Q

Alternative treatments appendicitis

A
  • Broad spectrum Abx
  • Percutaneous abcess drainage
  • Interval appendectomy
27
Q

Appendiceal Carcinoid

A
  • Most common cancer appendix
  • Hormone-producing cells
  • Small (<1cm); asymptomatic until metastasis