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Diagnostic reasonig for Abdominal Pain > Diagnostic Reasoning for Abdominal Pain GU > Flashcards

Diagnostic Reasoning for Abdominal Pain GU Flashcards

1
Q

GU related abdominal pains can manifest as

A

Hematuria
Pain
Protien Urea
Changing voiding patterns

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2
Q

Ask in the pts. History with Abominal suspected GU

A

FH: Heridetary component , nephritis, DM
PMH: Concurrent morbidity, Urinary pattern
SH: sexual HX. diapram use, # of new partners, STDs
Medication Hx: Sedatives, hynotics, diuretics, anticholenergic drugs,

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3
Q

Ask in the pts. History with Abominal suspected GU , Hx, of present illnes:

A

Onset of the pain
pain level and discrib the pain
Timing of the pain

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4
Q

Ask in the pts. History with Abominal suspected GU , with Hematuria.

A

check for urethritis, stricture

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5
Q

Acute abdominal pain frequently requires

A

urgent investigation and mangement

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6
Q

associated symtoms with a Surgical Abdomen

A 
fever
chills
wt. loss
diarrhea/constipation
melena
jaundice
change in urine or stool or change in diameter of stool.
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7
Q

a Surgical Abdomen what to inquire about PMH:

A

past abdominal surgeries, abdominal disease, CVD risk

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8
Q

Surgical Abdomen what to inquire about what type of intake

A

ETOH, and tylenol, ASA, NSAIDS

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9
Q

Acute abdominal pain is

A

pain for less than a few days and is progressivly worse until the time pt. is seen.

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10
Q

Pain in the abdomen that has not changed for months is

A

chronic abdominal pain

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11
Q

Abdominal pain that is not acute or chronic is

A

Subacute.

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12
Q

Two conditions that require urgent referral

A

Obstruction

Peritonitis

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13
Q

Obstruction s/symtoms

A 
S/S= pain,anorexia, bloating,n/v, 
P.I observation: distention
Auscutation= High pitched bowel sounds
Percussion: tympany
Palpitation= feel a possible mass tenderness
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14
Q

Peritonitis s/s

A

s/s= look sick, lie still to minimize the pain and discomfort
P.I poor relief from analgesics,
Auscultation=decrease boewl sounds
percussion=ridgity
palpation= tenderness and pain even when the strcher is touched.

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15
Q

Labs for a surgical abdomen

A 
CBC, Electrolytes
BUn, Creatine
glucose
Lipase
U/A/ urine cultures
pregnancy test
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16
Q

VS iwth a surgical abdome might see

A

fever

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17
Q

Other diagnostic test to perform

A

Abdominal xray, check for free air or obstruction

18
Q

When the abdominal xray is inconclusive which test is more sensative .

A

CT scan

19
Q

What test is best to find the etiology of peritonitis

A

ultra sound

20
Q

What is visable with an abdominal ultrasound?

A

The appenditis, abdominal absess, other intra pelvic pathologies.

21
Q

Painful pulsatile mass with or with out a bruit should suspect

A

ruptured aortic mass

22
Q

Suspected ruputred arotic mass is a

A

immediate surgical referral.

23
Q

A 30-year-old alcoholic man with no past medical or surgical history is brought in by ambulance to the ED with severe (7/10) epigastric abdominal pain. The pain started 5 hours after the ingestion of a large meal. It radiates to the back and is associated with nausea and nonbloody, nonbilious emesis. He denies any problems or pain with urinating. On physical examination, he is afebrile, tachycardic, and tender without rebound in the epigastrium and left upper quadrant.
What is the most likely diagnosis?

A

Pancreatitis

24
Q

A 48-year-old healthy obese woman comes to your clinic with a 1-day history of nonradiating epigastric burning pain that started 2 hours after eating lunch, which she rates as a 4 on 10-point pain scale. She describes similar pains in the past few months but never as severe. The pain is worse when lying flat in bed at night and has been relieved in the past by antacids. She denies fevers, weight loss, changes in her bowel movements, or radiation to her back. Physical examination demonstrates normal vital signs and is only notable for mild epigastric tenderness.
Which of the following disorders do you suspect?

A

Peptic ulcer disease

25
Q

A 41-year-old healthy woman sees you with a 10-month history of abdominal pain, accompanied by an increase in stool frequency and a more watery consistency of her stool. She reports that her pain improves with defecation. She denies fever, bleeding, or weight loss.
What is the most likely diagnosis?

A

Irritable bowel syndrome (IBS)

26
Q

A 22-year-old woman comes to clinic complaining of a 4-day history of bloody diarrhea. The patient recently returned from a spring break vacation in Mexico with her college roommates. She reports diffuse abdominal discomfort but no nausea or vomiting. Three of her traveling companions were also complaining of bloody diarrhea.
What is the most likely cause of her bloody stools?

A

infectious colitis

27
Q

Liver or biliary tree pain can radiate to the

A

back

epigastruim

28
Q

Most pain in the right upper quadrent is related to

A

the biliary tree

29
Q

right upper quadrent pain with feverand jaundice is related to

A

the biliary tree

30
Q

Acute choleycystitis can present as a person that is

A

systematically unwell with a low grade fever

31
Q

Right upper quadrent pain lab test should be

A 
CBC with diff
glucose , lipase
electroytes, BUN Creatine,
Aminotranshease
alkatine phoshate
bilirubin
32
Q

High aminotransferases, and a increase in bilirubin with right upper quadrent pain is most likely

A

choledocholithiasis

33
Q

other diagnostic test for right upper quadrent pain

A

endoscopic ultrasound
MRCP
ERCP most invasive

34
Q

Epigastric pain all of the sudden is suggestive of

A

pancreatitis

35
Q

Pancreatitis pain s/s

A

sudden epigastric pain
N/V
anorexia
pain radiating to the back

36
Q

signs of dyspepsia

A

bloating
abdominal fullness
heart burn
nausea

37
Q

epigastric pain that needs immediate attention

A 
>50
wt. Loss
persistant vomiting
dysphagia
anemia
hematemesis
palpable mass
38
Q

Anemia
elevated WBC
elevated Platelet
low ferritain suspect

A

celeiac

IBS

39
Q

the initial consideration in abdominal pain should be weather the symtoms are

A

acute or chonic

40
Q

patients with a acute abdominal should be assessed for

A

surgical abdomen

41
Q

Chronic abdominal pain have begin functional disorders oof

A

IBS

functional dyspepsia

Diagnostic reasonig for Abdominal Pain (1 decks)

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