Acute Abdomen, Appendicitis, Peritonitis, Bowel Perforation, Cyclic Vomiting Syndrome

Question 1

exact cause unknown, associated w/ anxiety in some patients

pediatric patients are more prone to this disorder

may lead to migraine h/a (sometimes referred to as an abdominal migraine)

Answer 1

cyclic vomiting syndrome

Question 2

can last for months or even years

early morning nausea, fear of vomiting, abdominal distension

Answer 2

stage one: prodromal stage CVS

Question 3

lasts 24-48 hrs

paroxysms of intense and persistent n/v (incapacitating), patient will vomit profusely w/o warning up to five times per hr, diffuse mild and pain

Answer 3

stage two: hyperemetic stage CVS

Question 4

lasts for days, weeks or months

relative wellness w/ normal eating patterns, wt is regained

Answer 4

stage three: recovery phase CVS

Question 5

associated w/ long-term/excessive narcotic and marijuana use (using more than 3-5 times/day for several years or more) causing severe and frequent emesis causing incessant emesis

does not respond to anti-emetics, hot showers relieve symptoms

only cessation of usage will reduce symptoms

Answer 5

cannabis hyperemesis syndrome (CHS)

Question 6

intractable vomiting w wt loss, volume depletion, hypokalemia, ketonemia

Answer 6

hyperemesis gravidarum

Question 7

inflammation of the peritoneal membrane

diffuse abc pain, increased w/ movement or coughing, relieved by knee flexion, “guarding”, rebound tenderness, fluid shifts into the peritoneum

Answer 7

peritonitis

Question 8

mild fever, anorexia and nausea
dull, steady periumbilical pain (generally lasts 6-24 hrs) that moves to RLQ
elevated WBC w/ shift to the left

Answer 8

appendicitis

Question 9

palpation in the LLQ causes pain in the RLQ

Answer 9

rovsing’s sign

Question 10

passive extension of the r thigh when the patient is lying on the l side causes RLQ pain

Answer 10

psoas sign

Question 11

flexion and medial rotation of the hip produces pain in the RLQ

Answer 11

obturator sign