Brachito (apendicitis) Flashcards

1
Q

etiologia de apendicitis

A
  1. hipertofia de foliculos linfoides
  2. fecalitos
  3. secundario a estudio rx con bario
  4. Fitobezoar
  5. parasitos y gusanos
  6. Secundario a tumor carcinoide
  7. metastasis de CA mama y pulmon
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2
Q

Dx diferencial apendicitis

A
la gran simuladora
1, adenitis
2. gastroenteritis
3. diverticulitis
4. diverticulitis
5. enteritis 
6. peritonitis primaria
7. enf. px masculinos
8. ulcera peptica perforada
9. inflamacion apendices epiploicos
10. IVU
11. purpura trombocitopenica
12. purpura de hecoch schloein
13. yersinosis
14. megacolon congenito
15. trastornos ginecologicos.
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3
Q

Sintomas de la apendicitis

A

1, dolor abdominal

  1. anorexia
  2. nauseas
  3. vomitos
  4. fiebre
  5. dispepsia leve
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4
Q

Signos de apendicitis

A
  1. bloomberg
  2. rovsing
  3. psoas
  4. obturador
  5. San Martin
  6. Kerring/ hiperestesia cutanea
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5
Q

Triada migratoria de Kocher

A
  1. epigastrio
  2. periumbilical
  3. cuadrante inferior derecho
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6
Q

3 maneras de buscar el posas en apendicitis

A
  1. flexion de pierno sobre muslo, muslo sobre cadera
  2. percutir planta pie derecho
  3. ponerse de puntillas y caer sobre el calcaneo
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7
Q

Apendicitis atipica

A
  1. lactantes’
  2. embarazadas.
  3. ancianos
  4. SIDA
  5. Hernia de Amyand
    6 Hernia de Garengeot
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8
Q

Etapas de la apendicitis

A
  1. focal
  2. supurativa
  3. gangrenosa
  4. perforada
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9
Q

Apendicitis focal (1)

A
  1. bloqueo proximal
  2. > presion intraluminal
  3. dolor difuso en epigastrio (visceral)
  4. colicos, nausea, vomitos, anorexia
  5. GB normales
  6. NO fiebre
  7. oclusion de linfaticos: edema
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10
Q

Apendicitis Supurativa (2)

A
  1. dolor FID
  2. persiste obstrucción
  3. irritacion peritoneal
  4. oclusion venosa
  5. NO peristalsis
  6. irritacion de peritonea parietal y serosa
  7. proliferacion bacteriana
  8. > GB (12-14 mil/mm3)
  9. fiebre 38.5
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11
Q

Apendicitis Gangrenosa (3)

A
  • 1ra etapa complicada
    1. colapso srterial
    2. necrosis y microinfartos
    3. peritonitis local
    4. deshidratacion
    5. fiebre 40
    6. GB 18-20mil
    7. todos los sx +
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12
Q

Apendicitis Perforada (4)

A
  1. Necrosis de borde antimesenterico del 1/3 medio
  2. perforación con salida de material purulento y fecaloide
  3. abceso localizado/peritonotis generalizada
  4. septicemia generalizada (pileflebitis)
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13
Q

Posicones del apendice

A
  1. retro y preileal
  2. retrocecal
  3. Libre en peritoneo
  4. pelvis
  5. dentro de hernia
  6. alto (sub-hepatico)
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14
Q

8 signos de apendicitis en rx abdomen simple

A
  1. borramiento del psoas
  2. escoliosis hacia derecha
    3 neumperitoneo
  3. fecalito
  4. apendice engrosado
  5. plastron apendicular
  6. ileo en FID
  7. borramiento de grasa preperitoneal
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15
Q

complicaciones de apendicitis

A
  1. pileflebitis
  2. gangrena
  3. perforacion
  4. peritonitis
  5. absceso subfrenico, pelvico o apendicular’
  6. plastron apendicular
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16
Q

tx apendicitis

A
  1. hidratacion
  2. corrección hidroelectrolitica
  3. check cardiaco, pulmonar o renales
  4. ATB