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Clin Med 4 > Approach To Abdominal Pain > Flashcards

Approach To Abdominal Pain Flashcards

1
Q

Motionless

A

Peritonitis

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2
Q

High pitched tinkling on auscultation

A

Early bowel obstruction

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3
Q

Tympany on percussion

A

Distended bowel

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4
Q

hx of endocarditis/ a-fib

hypercoagulable state

trauma

A

splenic abscess/ infarct/ rupture

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5
Q

hyperactive bowel sounds on auscultation

A

gastroenteritis

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6
Q

how do you test for blood in the stool

A

DRE + stool guaiac/ hemoccult

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7
Q

GI alarm sxs

A

Hematemesis Melena (upper), hematochezia (lower),occult blood Iron deficiency anemia Unexplained WL Nocturnal awakening Dysphagia- solid/ liquid/ both (achalasia) Acute onset of acute pain Fever/ recurrent vomiting Personal/ FH of GI cancer

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8
Q

fever

jaundice

RUQ pain

leukocytosis

elevated AST/ALT, alk phos, bilirubin

A

acute cholangitis

most commonly secondary to choledocolithiasis

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9
Q

what dx test would you order if you are concerned about an obstruction

A

abdominal X-ray

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10
Q

what does rectal tenderness + abdominal pain suggest

A

appendicitis

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11
Q

DDX periumbilical

A

IBD, IBS, gastroenteritis Bowel obstruction/ ischemia Appendicitis AAA, DKA

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12
Q

Peritoneal signs

A

Guarding, Rigidity, Rebound tenderness

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13
Q

dilated loops of bowel

A

obstruction on abdominal X-ray

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14
Q

DDX- epigastric

A

MI PUD Pancreatitis Biliary

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15
Q

febrile

N/V

irritative voiding sxs

flank pain

CVAT

A

pyelo

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16
Q

DDX- RLQ

A

Appendicitis Ovarian dz PID Ruptured ectopic preg Crowns

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17
Q

what are some pelvic causes of abdominal pain

A

ectopic pregnancy, PID, tubo-ovarian abscess

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18
Q

What are we checking w palpation

A

Peritoneal signs, Masses, organomegaly

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19
Q

what does rovsings sign test for

A

peritoneal irritation +/- appendicitis

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20
Q

Dullness to percussion

A

Mass, Fluid

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21
Q

what dx test would you order if you are concerned about pancreatitis

A

(1) abdominal US (2) CT abdomen and pelvis

22
Q

LQ abdominal pain

+/- diarrhea

+/- hematochezia

WL

anemia

+/- FH

relapsing/ remitting

A

IBD

23
Q

toxic appearing

abdominal distention/ tenderness

hx of UC/Crohns/pseudomembranous colitis

A

toxic megacolon

24
Q

DDX- RUQ

A

Biliary dz Hepatitis Renal colic Diverticulitis

25
Q

IVDU

high risk sex behaviors

jaundice

transaminases

A

viral hepatitis

fecal-oral = A and E

blood/bodily fluid = B, C, D

26
Q

sexually active women

vaginal D and C

cervical motion tenderness

chandelier sign

hx of STI (G/C)

A

PID

27
Q

DDX LLQ

A

Ovarian dz PID Ruptured ectopic preg Diverticulitis UC

28
Q

AST and ALT MORE THAN ALK PHOS AND BILI

A

Hepatocellular

29
Q

Gradual steady pain

A

Itis

30
Q

what dx test would you order if you are concerned about a perforation

A

CXR

31
Q

PMH- testing

A

CRC screen Colonoscopy

32
Q

Hypoactive/ absent bowel sounds

A

bowel obstruction (late), peritonitis, ileus

33
Q

male

smoker

pulsatile abdominal mass

bruit

A

AAA

34
Q

pain w/ gentle percussion

A

peritonitis

35
Q

what does murphys sign test for

A

gallbladder/ hepatic inflammation

36
Q

what dx test would you order if you are concerned about diverticulitis

A

CT abdomen and pelvis

37
Q

ALK PHOS AND BILI MORE THAN AST and ALT

A

Biliary

38
Q

toxic appearing

lying still

guarding

rigidity

rebound tenderness

A

peritonitis

39
Q

diarrhea

travel/ food exposure

A

gastroenteritis

40
Q

bruits on auscultation

A

abdominal aortic aneurysm

41
Q

acute ripping/ tearing chest or abdominal pain

asymetric pulses

widenend mediastinum on CXR

A

aortic dissection

42
Q

elderly

palpitations

hx of a-fib/ valvular/ athersclerotic dz

abrupt onset

POOP

increased LDH

A

acute mesenteric ischemia

43
Q

what does obturator sign test for

A

peritoneal irritation +/- appendicitis

44
Q

what dx test would you order if you are concerned about appendicitis

A

CT abdomen and pelvis

45
Q

free air under the diaphragm

A

perforation on CXR

46
Q

Writhing in agony

A

Biliar/ renal colic

47
Q

what does psoas sign test for

A

peritoneal irritation +/- appendicitis

48
Q

what dx test would you order if you are concerned about hepatobiliary etiologies

A

abdominal US

49
Q

DDX LUQ

A

Splenic injury Renal colic Diverticulitis

50
Q

Spec drugs to ask about

A

NSAIDS Anticoagulant Steroids Hypo-motility agents (opioids, iron supp, K) Abx

51
Q

air fluid levels

A

obstruction on X-ray

Clin Med 4 (9 decks)

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