Approach To A Patient With Surgical Complaint Flashcards
Pain
Pertinent information to elicit
Provocation and Palliation Quality Region and radiation Severity Timing
Chest pain
Probably etiology
Muscular, cardiac, pneumothorax Aortic pathology Cholecystitis Pancreatiti Peptic ulcer GERD
Epigastric pain
Differentials
Gastric: esophagitis, gastritis, peptic ulcer
Pancreatic: Pancreatitis, Mass
Others: Cardiac, aotic dissection, mesenteric ischemia, biliary, bowel obstruction, gynecologic
Right upper quadrant differentials
Biliary: cholecystitis, cholelithiasis, cholangitis
Hepatic: abscess, hepatitis,mass
Renal: nephrolithiasis, pyelonephritis
Others: cardiac, pulmonary, gastric
RLQ pain
Differentials
Colonic: appendicitis, colitis, diverticuliti, inflammatory
Gynecologic: ectopic pregnancy, ovarian torsion,pelvic inflammatory disease
Renal: nephrolithiasis, pyelonephritis, genitourinary tract infection
LLQ pain differentials
Colonic : colitus, diverticulitis, inflammatory
Gynecologic:ectopic pregnancy, ovarian torsion, pelvic inflammatory disease
Renal: Nephrolithiasis, Pyelonephritis
LUQ pain differentials
Pancreatic : Pancreatitis, Mass
Renal: Nephrolithiasis, Pyelonephritis
Others: cardiac, gastric
Flank pain
Differentials
Nephrolithiasis, pyelonephritis, mass
Back pain differentials
Muscular Spondylosis Fracture Referred pain Aortic pathology
Pertinent information to elicit with mass or swelling
Size or location Size and shape Onset and duration Edges or borders Tenderness Temperature Consistency Mobility Pulsation Reducibility
Probable etiology mass or swelling
Congenital
Inflammatory or infections
Neoplastic, whether benign or malignant
Others: Hernia, lymphnode
Pertinent information to elicit in acute abdomen
Associated symptoms or signs of shap pain, fever, distention
Tenderness
Peritoneal irritation - caused by bacterial or chemical contamination of the cavity
Probable etiology of acute abdomen
Intestinal obstruction ( complete or incomplete)
Peritonitis from appendicitis, perforated PUD, anastomotic leak after surgery, strangulated bowel, cholecystitis, pancreatitis, bowel perforation
Intra-abdominal abscess or other infections
Trauma
Upper Gastrointestinal complaints
Pertinent information
PQRST
Dysphagia, odynophagia , reflux, bleeding, nausea, vomiting
Dysphagia
Differentials
Esophagitis Strictures Diverticulum Achalasia Esophageal cancer
