Approach to patient w abdominal pain

Question 1

Due to stretching of fibers innervating the walls of hollow or solid organs

Answer 1

visceral pain

Question 2

midline pain due to bilateral innervation (visceral innervation)

Answer 2

visceral pain

Question 3

why is visceral pain poorly localized

Answer 3

bilateral innervation

Question 4

late and localized pain

Answer 4

parietal pain due to somatic sensory inneration

Question 5

vague pain that is epigastric; suggest which organs may be affected

Answer 5

1.stomach 2.duodenum 3.biliary tract 4. pancreas

Question 6

vague pain that is periumbilical; suggest which organs may be affected

Answer 6

small bowel, appendix, cecum

Question 7

vague pain that is suprapubic; suggest which organs may be affected

Answer 7

colon,sigmoid, GU tract

Question 8

acute appendicitis gives a localized pain at____________which is aggravated by _________

Answer 8

Mcburnerys point, movement or coughing

Question 9

which type of pain can be localized to a specific dermatome

Answer 9

parietal pain

Question 10

causes tenderness and guarding which progresses to ridicity and rebound tenderness

Answer 10

parietal pain

Question 11

produces symptoms not signs, i.e may have pain in the neck or shoulder but normal movement and normal findings

Answer 11

referred pain

Question 12

referred pain: testicular pain indicates

Answer 12

uretral obstruction//UTI

Question 13

referred pain: ipsilateral shoulder or supraclavicular pain indicates

Answer 13

sub diaphragmatic irritation

Question 14

referred pain: right infrascapular pain indicates

Answer 14

biliary disease

Question 15

referred pain: back or proximal lower extremity indicates

Answer 15

gynecologic pathology

Question 16

referred pain: epigastric,neck,jaw or upper extremity pain indicates

Answer 16

MI

Question 17

MI is often confused withhhhh

Answer 17

gastritis

Question 18

the most common caue of emergency ADMISSION via ER

Answer 18

abdominal oain

Question 19

75 year old w/ right iliac fossa pain

Answer 19

think colitis or cancer

Question 20

a female in her reproductive years with right iliac fossa pain

Answer 20

ovarian torsion, ectopic pregnancy

Question 21

past surgery that suggests adhesions or reccurence of same pathology

Answer 21

laparotomy, tumor, hernias

Question 22

what do u ask in occupation/toxic exposure

Answer 22

CO, lead

Question 23

out of proportion pain; tachycardia, excuciating pain, soft tender abdomen, but everything else is normal

Answer 23

suspect bowel ischemia (emboli in the sup. Mesentric artery)

Question 24

bowel ischemia is treated by

Answer 24

operation/heparin

Question 25

which sign is this: Tap on the left side of the abdomenèif it causes pain on the right side –> suspect appendicitis

Answer 25

iliopsoas

Question 26

whichsign is this: Put Hand on the right subcostal margin and ask the patient to take a deep breath, if it
was interrupted due to pain –> Cholecystitis

Answer 26

murphys

Question 27

A lab test with elevted lactic acid is imp in

Answer 27

bowel ischemia

Question 28

a lab test with elevated LFT/amylase/lipase

Answer 28

pancreatitis

Question 29

which is more specific amylase or lipase in urine

Answer 29

lipase in urine, bec everything awesome is repulsive

Question 30

free air in the abdomine

Answer 30

perforated duodenal ulcer

Question 31

has inflammation w fever, leukocytosis, right iliac fossa pain

Answer 31

acute cholecystitis

Question 32

fever, leukocytosis, right iliac fossa pain

Answer 32

biliary colic

Question 33

stte the two most common causes of acute abdominal pain

Answer 33

appendicitis then cholecystitis

Question 34

t or f, giving a pt with appendicitis analegesia will prior to diagnosis will mask the pathology

Answer 34

false, pt will still have rebound tenderness

Question 35

units of blood needed for a pt

Answer 35

6 units

Question 36

The goal of the clinical evaluation of the patient with acute abdominal pain is

Answer 36

to reach to an early, efficient, and accurate diagnosis.