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Block 32- GI/surgery > Acute abdominal pain PT1 > Flashcards

Acute abdominal pain PT1 Flashcards

1
Q

4 common presentations of hernias

A

palpable mass
pain
cough impulse
abdominal discomfort

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2
Q

position for examination of a hernia

A

examine whilst standing

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3
Q

what is a inguinal hernia

A

peritoneal contents protruding through abdo wall where its weakened by the inguinal canal

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4
Q

who is more at risk of inguinal hernias

A

men

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5
Q

why are males more prone to inguinal hernias

A

superficial inguinal ring to transport contents of the spermatic cord to testes

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6
Q

what does an inability to reduce a hernia suggest

A

it has been incarcerated /intestinal obstruction

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7
Q

what does severe pain in a hernia suggest

A

strangulation

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8
Q

risk factors for inguinal hernias

A 
chronic cough 
constipation 
urinary obstruction 
heavy lifting 
ascites 
surgery
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9
Q

2 types of inguinal hernia

A

direct

indirect

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10
Q

most common type of inguinal hernia

A

indirect (80%)

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11
Q

what is an indirect inguinal hernia

A

hernia protrudes through the internal inguinal ring

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12
Q

what are indirect inguinal hernias usually due to

A

failure of embryonic closure of the processus vaginalis (mainly congenital)

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13
Q

direct inguinal hernia=

A

protrusion through a weakened area of abdominal fascia into the inguinal canal

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14
Q

femoral hernia=

A

peritoneal contents protruding through femoral canal

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15
Q

femoral hernia more common in _____ and why

A

female- wider bone structure of pelvis

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16
Q

what is high risk about femoral hernias

A

strangulation due to femoral vessels

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17
Q

where is the lump in a femoral hernia

A

below the line of the inguinal ligament -medially in groin and lateral to pubic tubercle

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18
Q

cough impulse in femoral hernia ?

A

no

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19
Q

incisional hernia =

A

incompletely healed surgical wound

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20
Q

umbilical hernia=

A

abdominal wall posterior to the navel s damaged causing weakness along linea alba causing peritoneal contents to protrude through

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21
Q

what is rare in umbilical hernias

A

strangulation and incarceration

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22
Q

3 causes of umbilical hernias

A

congenital
acquired
paraumbilical

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23
Q

epigastric hernia=

A

protrusion of intestine in middle of abdomen along linea alba above umbilicus below breast bone

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24
Q

spigelian hernia=

A

herniation of intestinal contents through spigelian fascia in lower abdomen

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25
Q

what is the spigelian fascia

A

aponeurotic layer between rectus abdominus muscle and semilunar line

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26
Q

other word for spigelian hernia

A

lateral ventral hernia

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27
Q

2 complications of hernias

A

strangulation

incarceration

28
Q

why does strangulation of a hernia occur

A

hernias become tightly constricted by posterior wall forming a narrow neck which can occlude blood supply

29
Q

signs of hernia strangulation (4)

A
  • sudden growth and discolouration
  • pain
  • irreducible
  • nausea and vomiting
30
Q

incarceration of a hernia =

A

hernia becomes occluded part of bowel so solids cannot pass -bowel obstruction

31
Q

what is the only solution for hernia incarceration

A

surgery

32
Q

signs of an incarcerated hernia (4)

A

palpable mass
pain
nausea and vomiting
constipation

33
Q

10 causes of pain in right iliac fossa

A 
acute appendicitis 
diverticulitis 
mesenteric adenitis 
perforated duodenal ulcer 
pelvic inflammatory disease 
inflammed meckel's diverticulum 
ectopic pregnancy 
crohns 
biliary disease 
renal colic
34
Q

most common cause of acute appendicitis

A

obstruction of the lumen of the appendix

35
Q

what can obstruct the lumen of the appendix

A

faecolith
normal stool
infective agent
lymphoid hyperplasia

36
Q

what is the dangerous consequence of acute appendicitis is not treated

A

perforate and release purulent fecal contents

37
Q

symptoms of acute appendicitis (6)

A
  • general central abdo pain progressing to right iliac fossa
  • pain worse on movement
  • anorexia
  • nausea and vomiting
  • dysuria
  • constipation
38
Q

diverticulitis=

A

small pouches of mucosa in the large intestine becoming inflammed

39
Q

why do diverticular form

A

increased intraluminal pressure from fecal accumulation due to lack of fiber in diet

40
Q

presentation of diverticulitis (5)

A
  • acute left lower quadrant abdo pain
  • fever
  • nausea
  • diarrhoea
  • blood in stool
41
Q

mesenteric adenitis=

A

inflammation of the mesenteric lymph nodes causing abdominal pain

42
Q

who gets mesenteric adenitis

A

children under 16

43
Q

what usually triggers inflammation of the lymph nodes

A

viral infection

44
Q

presentation of mesenteric adenitis (4)

A
  • cold prior to abdo pain
  • abdo pain in umbilicus and right iliac fossa
  • fever and generally unwell
  • nausea and diarrhoea
45
Q

management of mesenteric adenitis

A

usually self-limiting -analgesia and fluids

46
Q

high association between duodenal ulcers and (3)

A

H.pylori
smoking
NSAIDs

47
Q

symptoms of a perforated duodenal ulcer (4)

A
  • meal dyspepsia
  • sudden acute abdo pain
  • syncope
  • generalised peritontis
48
Q

pelvic inflammatory disease=

A

infection of the upper female reproductive system

49
Q

upper female reproductive system =

A

uterus
fallopian tubes
ovaries

50
Q

what causes pelvic inflammatory disease

A

bacteria spreading from the vagina upwards

51
Q

common infective agents for pelvic inflammatory disease (2)

A

Neisseria gonorrhoeae

chlamydia

52
Q

long term complications of pelvic inflammatory disease

A

infertility
ectopic pregnancy
cancer

53
Q

symptoms of pelvic inflammatory disease (6)

A
  • fever
  • cervical motion tenderness
  • vaginal discharge
  • painful intercourse
  • uterine tenderness
  • irregular mestruation
54
Q

meckels diverticulum=

A

remnant of the attachment of small bowel to the embryological yolk sac

55
Q

inflamed meckels diverituculum mainly occurs in

A

children

56
Q

where is meckels diverticulum located

A

terminal ileum proximal to appendix

57
Q

what can inflamed meckel’s diverticulum mimic (symptoms wise)

A

appendicitis

58
Q

symptoms of meckel’s diverticulum (4)

A
  • painless rectal bleeding
  • central abdo pain
  • melena
  • intestinal obstruction
59
Q

ectopic pregnancy=

A

embryo attached outside uterus

60
Q

where can an ectopic pregnancy be (3)

A

fallopian tubes,
ovarian
cervical

61
Q

risk factors for ectopic pregnancy (7)

A
  • pelvic inflammatory disease
  • infertility
  • IUD
  • tubal surgery
  • smoking
  • endometriosis
  • STIs
62
Q

symptoms of ectopic pregnancy (5)

A
  • vaginal bleeding
  • lower abdominal pain
  • pelvic pain
  • tender cervix
  • pain can radiate into shoulder
63
Q

is crohns or UC more prevalent

A

UC

64
Q

disease of biliart tree –>

A

obstructive jaundice

65
Q

bilirubin accumulation presents with (5)

A 
dark urine 
jaundice 
pale stools 
pruritus 
nausea and vomiting
66
Q

murphy’s sign=

A

tenderness causing muscle guarding worse on inspiration

Block 32- GI/surgery (9 decks)

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