EAC Abdominal Conditions and Assessment Flashcards
describe the importance of history when assessing a patient
helps to provide insight into the potential cause of the problem
technique for history taking of patients with acute abdominal pain
Site Onset Character Radiates Associated signs and symptoms Time Exacerbating/Alleviating Score
main causes of:
Acute abdominal pain
Appendicitis Cholecystitis Intestinal Obstruction Ureteric Colic (stones) Gastritis Perforated Peptic Ulcer Gastroenteritis Pancreatitis Diverticular Disease Leaking or ruptured AAA Gynaecological Disorders
main causes of:
Chronic abdominal pain
IBS
Inflammatory bowel syndromes: Ulcerative Colitis, Crohns Disease)
Gastric and Duodenal Ulcers
Intra-Abdominal Malignancy
signs and symptoms of: Renal Colic (Kidney Stones)/Ureteric Colic
Cramp like pain that varies in intensity
Stone moves down ureters and stretches the wall
Pain is usually in side, radiating to the groin
Often with nausea and vomiting
signs and symptoms of:
Acute Cholecystitis
is swelling (inflammation) of the gallbladder
Sharp right upper quadrant pain Right shoulder tip pain Pain worse on deep breaths and palpitation Pyrexia >38c Nausea and vomiting History of fat intolerance
signs and symptoms of:
Appendicitis
is a painful swelling of the appendix
Constant pain increasing in intensity Peri umbilical to right lower quadrant Pain worse on movement Nausea, vomiting, anorexia Pyrexia >37.5 Atypical signs in the elderly and young
signs and symptoms of:
UTI
Infection of Kidneys, Ureters, Bladder, Urethra
Cramping pain in lower abdomen or back Dysuria - burning sensation Increased frequency Haematuria - cloudy or frank blood ?kidney infection: temp >38C, rigors, vomiting
signs and symptoms of:
Abdominal Aortic Aneurysm
is a swelling (aneurysm) of the aorta
Consider AAA in patients >50 years
Sudden onset of severe constant pain that peaks soon after onset, often will radiate to sides, lower back and buttocks
Renal colic type pain
Pulsatile mass
Hypotension and severe shock
Collapse
Hypotension with bilateral lower limb ischemia or mottling (a late sign)
History of smoking, Hypertension and Hypercholesterolemia
causes of abdominal pain and/or PV bleeding in Pregnancy
early pregnancy 24weeks
- Placental Abruption
- Uterine Rupture
- Severe pre-eclampsia
signs and symptoms of:
Ectopic Pregnancy
is when the foetus develops outside the uterine cavity, most commonly in the fallopian tubes.
Pain in lower abdo, pelvic area or back
Nausea
GI symptoms especially: DandV
if pregnancy ruptures: severe pain, shoulder tip pain, feeling faint/collapse
History: Missed last menstrual period (can occur before this) History of pelvic inflammatory disease Previous ectopic pregnancy Intrauterine device fitted Tubal surgery Sterilisation or reversal or procedure Endometriosis
!!suspect ectopic pregnancy in any women of child bearing age with the above signs!!
serious conditions that cause abdominal pain
from IHCD manual
Internal Bleeding - vomiting blood, BPV
Peptic Ulcer - common cause of internal bleeding
Diverticulitis - Faecal matter seeps through thin walled diverticula causing inflammation and abscesses
Abdominal Aortic Aneurysm - area of weakening and dilation in the wall of an artery
Kidney Stone - symptoms usually occur when stone starts moving down the ureter and stretches the wall
Ectopic Pregnancy - foetus develops outside uterine cavity
Pelvic Inflammatory Disease - hx of PID predisposes to ectopic pregnancy
Appendicitis - painful swelling of the appendix
Immunosuppressed Patients - e.g. HIV and alcoholic pt’s
define:
Addison’s Disease
Rare disorder of the adrenal glands. It affects the production of two essential hormones called cortisol and aldosterone.
The adrenal gland is damaged and so cannot respond to crisis situations where an increase in adrenaline or cortisol is required.
signs and symptoms of:
Addison’s Disease
early signs: Fatigue Muscle weakness Low mood Loss of appetite and unintentional weight loss Increased thirst
Progressive signs: Low BP when standing which can cause dizziness or fainting Nausea Vomiting Diarrhoea Abdominal, joint or back pain Muscle cramps Chronic exhaustion Reduced libido Brownish discolouration of the skin, lips and gums particularly in the creases of the palms, scars, knuckles, keens
management of:
Addison’s Disease
Hydrocortisone IM
