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ITM Week 3: the middle aged patient > Acute abdominal pain > Flashcards

Acute abdominal pain Flashcards

1
Q

What are the two mot important decisions regarding acute abdominal pain

A

Does patient need referral

Does patient need surgery

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2
Q

What is visceral abdominal pain like

A

rampy, achy, diffuse

Poorly localised

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3
Q

What is somatic abdominal pain like

A

Sharp, cutting, stabbing

Well localised

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4
Q

What is referred abdominal pain like

A

Distant from site of generation

Symptoms, but no signs

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5
Q

What are common causes of acute abdominal pain

A

Luminal obstruction

Inflammation

Peritonitis- perforation of bowel and inflammation of peritonium

Ischaemia and infarction

Non-specific abdominal pain

Munchausen’s syndrom (spurious abdominal pain)

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6
Q

What area of the abdomen is the foregut

A

Epigastric region

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7
Q

What area of the abdomen is the midgut

A

Periumbilical region

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8
Q

What area of the abdomen is the hindgut

A

Pelvic region

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9
Q

causes of abdominal pain in abdominal wall

A 
Hernia
Haematoma
Abscess
Neuropathy
Herpes Zoster
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10
Q

Causes of abdominal pain post-operative

A

Intra-abdominal bleeding or collection

Abastomotic leak

Abdominal compartment syndrome

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11
Q

Extra abdominal causes of abdominal pain (lungs(

A

Lobar pneumonia
Pleurisy
Pulmonary embolism

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12
Q

Extraabdominal causes of abdominal pain (heart)

A

Acute MI
Congestive cardiac failure
Myocarditis

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13
Q

Extra abdominal causes of abdominal pain (metabolic/endocrine)

A 
Porphyrias
Diabetic ketoacidosis 
Lead poisoning 
Hypercalcaemia 
Adrenal insufficiency
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14
Q

Extra abdominal causes of abdominal pain (vasculitis0

A

Henoch-Schonlein purpura
Systemic lupus
Polyarteriris nodosa
Familial Mediterranean fever

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15
Q

Exceptions of abdominal pain

A

Pregnancy
The Older Adult
Immunocompromised Patients
Altered Anatomy (malrotation, situs inversus)

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16
Q

How do you assess patients

A 
History 
Look at charts:
-Respiratory: respiratory rate, o2 sat, FiO2
-Circulation: rate, rhythm, BP
-Urine output, fluid balance 
-Drugs

Read the notes: premorbid conditions, operation notes, special instructions

17
Q

How do you examine the patient

A

Avoid unnecessary movement

Hippocratic facies (big eyes, sunken cheeks. Seen as premortem condition)

Confusion

Signs of dehydration/hypovolaemia

Abdomen:
-previousscars, drains, fistulae, bruising, abdominal may be oft in elderly and immunocompromised

18
Q

How do you anticipate the need for HDU, ICU care

A 
Elderly patients
Diagnosis 
Severity of illness: 
-scoring systems
Comorbidity 
Communication
19
Q

What does a low white cell count signify

A

neutropenia

sepsis

ITM Week 3: the middle aged patient (4 decks)

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