EM

Question 1

in women, pain in one of the lower quadrants

Answer 1

• could be ruptured ectopic

Question 2

mid-epigastric radiating to back

Answer 2

• pancreatitis

Question 3

RUQ with radiation to back or right shoulder

Answer 3

• gallbladder disease, PID

Question 4

RLQ radiating to right shoulder

Answer 4

• ectopic or appendicitis

Question 5

LLQ radiating to left shoulder

Answer 5

• diverticultitis

Question 6

pain that gets better when laying flat

Answer 6

• appendicitis

Question 7

pain with movement

Answer 7

• irritation of parietal peritoneum

Question 8

writhing on gurney

Answer 8

• kidney stones

Question 9

aorta over 5-6 cm

Answer 9

• check for aneurysm

Question 10

bacterial overgrowth with appendicitis

Answer 10

• Bacterioides fragilis and E. coli

Question 11

black stones

Answer 11

• form primarily in gallbladder

- hemolysis induced

Question 12

brown stones

Answer 12

• form in gallbladder and intrahepatic and extrahepatic ducts
• formed in bile infected with enteric bacteria

Question 13

leading cause of large bowel obstruction

Answer 13

• carcinoma

Question 14

signs of intussusception

Answer 14

• red current jelly stool, stool mixed with blood and mucus

- sausage shaped mass upon palpation of the abdomen

Question 15

hallmark signs of hemorrhagic pancreatitis

Answer 15

• Cullens sign: umbilical ecchymosis

- Grey Turner’s sign: flank ecchymosis

Question 16

hallmark sign of acute pancreatitis

Answer 16

• elevated amylase and lipase

Question 17

mesenteric ischemia

Answer 17

• lactic acid elevated in 91% of patients

- pain is disproportionate to abdominal findings

Question 18

distention

Answer 18

• large bowel obstruction

- sigmoid or cecal volvulus

Question 19

high pitched rushes

Answer 19

• small bowel obstructions

Question 20

pulsatile aorta

Answer 20

• AAA

Question 21

occult blood

Answer 21

• carcinoma

- GI bleed

Question 22

unequal femoral pulses

Answer 22

• aortic dissection

Question 23

diagnostic test for appendicitis

Answer 23

• CT

Question 24

cholecystitis symptoms

Answer 24

• pain that radiates to the back or below the right scapula
• clay colored stools
• fever
• N/V
• jaundice

Question 25

tests for cholecystitis

Answer 25

- CT and US

Question 26

symptoms of bowel obstruction

Answer 26

- severe pain that comes and goes - distention - vomiting - constipation if complete blockage - diarrhea if partially blocked

Question 27

Ogilvie syndrome

Answer 27

- colonic pseudo-obstruction | - massive gaseous distention of colon

Question 28

diagnostic test for diverticulitis

Answer 28

- CT | - avoid BE and colonoscopy as they can perforate the bowel

Question 29

perforated ulcer

Answer 29

- acute onset of severe epigastric pain | - chemical and bacterial peritonitis

Question 30

aortic dissection

Answer 30

- chest and upper back pain before migrating into the abdomen as the dissection moves distally

Question 31

acute intermittent porphyria

Answer 31

- suddenly experience symptom triad: weakness, psychosis, ab pain - may have seizures