Approach to the acute abdomen Flashcards

1
Q

my role in determining the level of care needed in acute abdomen

A

observation, admission, imaging, lab test

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2
Q

location of radiation tells you what about an acute abdomen

A

certain quadrants are attributed to different problems and helps narrow the differential

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3
Q

Description of acute abdomen pain

A

location, temporal elements (gradual vs sudden, quality, severity, aggravating factors, and associated sypmtoms

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4
Q

what are the types of abdominal pain

A

visceral, parietal (somatic), and Referred

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5
Q

visceral pain

A

walls of organs and capsules of solid organs, dull, poorly localized (midline), manifest in location correspoding to diseased organs embryonic origin

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6
Q

Parietal (somatic) pain

A

distinct (sharper) and localized, ie. ischemia, inflammation, stretching of parietal peritoneum

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7
Q

referred pain

A

felt at site far from diseased organ dt shared cerntral pathways in the nervous system. i.e. gallbladder dz felt in r suprascapular area,

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8
Q

acute abd hx

A

pmh, etoh/drug, fmh, travel, sick contacts, meds

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9
Q

acute abd physical exam

A

bs, abd exam (inspection, auscultation, percussion, palpation), rectal, pelvic,

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10
Q

acute abd what test should I order

A

abd xray, us, ct: abd/pelvis, with/without contrast, oral contrast/iv contrast, MRI

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11
Q

acute abd what labs should i order

A

cbc, chem, lft, lipase/amylase, coag studies, ua w/ culture, GC/Chlamydia swab, lactate

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12
Q

what constitutes emergent evaluation of surgical abd?

A

unstable vs
signs of peritonitis on exam,
concern that and pain is life-threatening condition

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13
Q

S&S of peritonitis

A

abd rigidity, rebound tenderness, pain that is worse if stretcher lightly bumped

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14
Q

er abd pain, must rule out

A

ruptured AAA, aortic dissection, perforated bowel, Volvulus (twisted loop), mesenteric ischemia, torsion of structures (ovarian/testicular)

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15
Q

common causes of acute abd in er

A

non specific 34%, appendicitis, biliary tract dz, SBO, GYN dz, pancreatitis, perforated ulcer, cancer, diverticular dz

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16
Q

acute abd diagnostic approach RUQ

A

liver and biliary tree pain

17
Q

acute abd diagnostic approach Epigastric

A

pancreatitis and gastfic etiology

cv risk factors

18
Q

acute abd diagnostic approach LUQ

A

splenic etiologies

19
Q

acute abd diagnostic approach lower quadrants

A

radiating from upper quadrants or pelvis.
assoc with distal intestinal tract
appendicitis, diverticulitis, GU problems