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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

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
IVDU high risk sex behaviors jaundice transaminases
viral hepatitis fecal-oral = A and E blood/bodily fluid = B, C, D
26
sexually active women vaginal D and C cervical motion tenderness chandelier sign hx of STI (G/C)
PID
27
DDX LLQ
Ovarian dz PID Ruptured ectopic preg Diverticulitis UC
28
AST and ALT MORE THAN ALK PHOS AND BILI
Hepatocellular
29
Gradual steady pain
Itis
30
what dx test would you order if you are concerned about a perforation
CXR
31
PMH- testing
CRC screen Colonoscopy
32
Hypoactive/ absent bowel sounds
bowel obstruction (late), peritonitis, ileus
33
male smoker pulsatile abdominal mass bruit
AAA
34
pain w/ gentle percussion
peritonitis
35
what does murphys sign test for
gallbladder/ hepatic inflammation
36
what dx test would you order if you are concerned about diverticulitis
CT abdomen and pelvis
37
ALK PHOS AND BILI MORE THAN AST and ALT
Biliary
38
toxic appearing lying still guarding rigidity rebound tenderness
peritonitis
39
diarrhea travel/ food exposure
gastroenteritis
40
bruits on auscultation
abdominal aortic aneurysm
41
**acute** ripping/ tearing **chest or abdominal pain** asymetric pulses widenend mediastinum on CXR
aortic dissection
42
elderly palpitations hx of a-fib/ valvular/ athersclerotic dz abrupt onset POOP increased LDH
acute mesenteric ischemia
43
what does obturator sign test for
peritoneal irritation +/- appendicitis
44
what dx test would you order if you are concerned about appendicitis
CT abdomen and pelvis
45
free air under the diaphragm
perforation on CXR
46
Writhing in agony
Biliar/ renal colic
47
what does psoas sign test for
peritoneal irritation +/- appendicitis
48
what dx test would you order if you are concerned about hepatobiliary etiologies
abdominal US
49
DDX LUQ
Splenic injury Renal colic Diverticulitis
50
Spec drugs to ask about
NSAIDS Anticoagulant Steroids Hypo-motility agents (opioids, iron supp, K) Abx
51
air fluid levels
obstruction on X-ray

Clin Med 4 (9 decks)

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