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Gastrointestinal System > Lecture 11.1: Assessment of the Acute Abdomen > Flashcards

Lecture 11.1: Assessment of the Acute Abdomen Flashcards

1
Q

Assessing the Patient : First Steps

A
  • Get help if critically unwell
  • Look, listen, feel
  • Unconscious + unresponsive + abnormal breathing =
    CPR
  • Otherwise proceed to ABCDE assessment
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2
Q

ABCDE Assessment

A
  • Airway
  • Breathing
  • Circulation
  • Disability
  • Exposure
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3
Q

What to assess in the A of ABCDE (5)

A
  • Speaking full sentences
  • Snoring/quiet breath sounds
  • Paradoxical chest movement/accessory muscle use
  • No chest movement
  • Give oxygen
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4
Q

What to assess in the B of ABCDE (5)

A
  • Inspect
  • Palpate
  • Percussion
  • Auscultation
  • O2 sats/ABG
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5
Q

What to assess in the C of ABCDE (5)

A
  • Inspect
  • Palpate
  • Palpate
  • Take BP and attach 3 lead ECG
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6
Q

What to assess in the D of ABCDE (5)

A
  • ACVPU
  • Ensure review and treat ABCs
  • Drug chart
  • Examine pupils
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7
Q

What does ACVPU stand for?

A
  • Alert
  • Confusion
  • Voice
  • Pain
  • Unresponsive
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8
Q

What to assess in the E of ABCDE (5)

A
  • Examine patient fully
  • Include aspects of abdominal exam
  • Signs of bleeding
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9
Q

History from Critically Unwell Patients: SAMPLE

A
  • Sign/symptoms
  • Allergies
  • Medical
  • Past pertinent medical history
  • Last oral intake
  • Events leading up to present illness
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10
Q

Red Flags in GI (9)

A
  • Unintentional weight loss
  • Loss of appetite
  • Change in bowel habit >3 weeks
  • Dysphagia
  • Persistent unexplained vomiting
  • Chronic gastrointestinal bleeding
  • Epigastric mass
  • Over 55 with unexplained dyspepsia
  • Unexplained rectal bleeding
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11
Q

Differential Diagnoses: Pain in RUQ (6)

A
  • Cholecystitis
  • Hepatitis
  • Pyelonephritis
  • Ureteric Colic
  • Pneumonia
  • Pancreatitis
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12
Q

Differential Diagnoses: Pain in RLQ (9)

A
  • Appendicitis
  • Inguinal/Femoral Hernia
  • Ureteric Colic
  • IBD
  • UTI
  • PID
  • Ovarian Cyst
  • Endometriosis
  • Testicular Torsion
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13
Q

Differential Diagnoses: Pain in LUQ (5)

A
  • Pneumonia
  • Pancreatitis
  • Gastric Ulcer
  • Pyelonephritis
  • Ureteric Colic
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14
Q

Differential Diagnoses: Pain in LLQ (9)

A
  • Diverticulitis
  • Inguinal/Femoral Hernia
  • Ureteric Colic
  • IBD
  • UTI
  • PID
  • Ovarian Cyst
  • Endometriosis
  • Testicular Torsion
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15
Q

Differential Diagnoses: Pain in Epigastric Region (4)

A
  • Peptic Ulcer Disease
  • Cholecystitis
  • Pancreatitis
  • Myocardial Infarction
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16
Q

Differential Diagnoses: Pain in Umbilicus Region (4)

A
  • Small Bowl Obstruction
  • Large Bowl Obstruction
  • Appendicitis
  • Abdominal Aortic Aneurysms
17
Q

What is Guarding?

A
  • Tensing of the abdominal wall muscles to guard
    inflamed organs from the pain of pressure upon them
  • Voluntary
18
Q

What is Rigidity?

A

Involuntary tightening of the abdominal musculature that occurs in response to underlying inflammation

19
Q

What is Rebound Tenderness?

A

Pain or discomfort on removal of pressure to the abdomen rather than application

20
Q

Investigations for GI: Laboratory Tests (6)

A
  • Urinalysis
  • Pregnancy Test
  • ABG
  • FBC, U+E, LFT, CRP, amylase
  • G+S/Cross-match
  • Blood Cultures
21
Q

Investigations for GI: Imaging (3)

A
  • Erect CXR
  • USS scan
  • CT scan
22
Q

Management of GI Conditions: General Measures (8)

A
  • Oxygen
  • IV access and fluids
  • Nil by mouth
  • Analgesia +/- antiemetic
  • Organise investigations and imaging
  • VTE prophylaxis
  • Catheter
  • Antibiotics
23
Q

Urgent Surgery GI Conditions (3)

A
  • Bleeding
  • Perforations
  • Ischaemic Bowel
24
Q

What can cause bleeding in the GI System? (5)

A
  • Ruptured AAA
  • Ulcers
  • Varices
  • Ruptured Ectopic Pregnancy
  • Trauma
25
Q

What can cause perforations in the GI System? (4)

A
  • Peptic Ulcers
  • Bowel Obstruction
  • Diverticular Disease
  • IBD
26
Q

Less Urgent GI Surgery Conditions (4)

A
  • Peritonism
  • Cholecystitis
  • Bowel obstruction
  • Renal colic

Gastrointestinal System (22 decks)

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