Misc

Question 1

breakdown of skeletal muscle tissue

Answer 1

Rhabdomyolysis

MCC: Crush injury, Seizures

Question 2

Pathophysiology of Rhabdomyolysis
→ release of the following substances:

1. ___ and serum ___ → pigment nephropathy → ATN
2. ____ → cardiac arrhythmia
3. ____ → metabolic acidosis

Answer 2

Creatine phosphokinase (CPK) 
myoglobin (myoglubinuria)

Potassium

Lactic acid

Question 3

Rhabdomyolysis
Classic triad:
Generalized weakness
(2)

Answer 3

Myalgia

Darkened urine

Question 4

Rhabdomyolysis cx (3)

Answer 4

AKI (pre-renal 2/2 hypovolemia)
compartment syndrome
cardiac arrhythmias

Question 5

Management of Rhabdomyolysis

1. IVF
2. ___

Answer 5

Correct hyperkalemia

Insulin, Albuterol, Potassium binders, HD

Question 6

pneumoperitonuem
(air in CT or CXR)
suggests what dx?

Answer 6

ulcer perforation

Question 7

widened mediastinum can be seen in what dx (2)

Answer 7

aortic rupture
esophageal perforation

pericardial effusion (?)

Question 8

Pleural effusions can be seen in patients with
Free wall rupture s/p MI
recent CABG
(2)

Answer 8

perforated esophagus

aortic dissection

Question 9

Tachycardia
Hypotension
JVD
+/- new RBBB

dx:

Answer 9

Pulmonary Embolism

Question 10

Common complication of AAA repair?

Answer 10

Mesenteric Ischemia

ischemic colitis

Question 11

No peritoneal signs, but causes severely tender abdomen (2)

Answer 11

Mesenteric (ischemia)

Compartment Syndrome

Question 12

Desmopressin is used to stop bleeding in (2)

Answer 12

VWB disease
Hemophilia A

Hepatic Encephalopathy

Question 13

Genital urinary causes of acute abdomen → PEPTO

Answer 13

Pyelonephritis
Ectopic Pregnancy (Ruptured)
Testicular/Ovarian Torsion

Question 14

GI causes of acute abdomen → DOPA

Answer 14

Diverticulitis
Obstructed bowel
Perforated bowel (2/2 PUD)
Appendicitis

Question 15

Cardiovascular causes of acute abdomen →

MAAAAD Tummy

Answer 15

Mesenteric ischemia
AAA rupture
Aortic Dissection

Question 16

Biliary Pancreatic causes of acute abdomen →

it’s in the name, girl

Answer 16

Pancreatitis (Gallstone)
Cholecystitis (Cholelethiasis)
Cholangitis (Choledocolithiasis)

Question 17

GI causes of LUQ pain (2)

Answer 17

Gastric Ulcer

Splenic lac/abscess/infarction

Question 18

GI causes of LLQ pain (2)

Answer 18

Diverticulitis

IBD (Ulcerative colitis & Chrons)

Question 19

Causes of Periumbilical pain →

MAAAAD Appetizers

Answer 19

mesenteric ischemia
AAA ruptured
Aortic Dissection
Appy (early)

Question 20

Causes of Epigastric pain →

9, guess as many as you can

Answer 20

MI
AAA ruptured
Aortic Dissection
Esophagitis
Gastritis 
pancreatitis
GERD
PUD
Mesenteric Ischemia

Question 21

infection of the ascitic fluid in the absence of any focal intraabdominal findings

Answer 21

Spontaneous bacterial peritonitis

*monomicrobial infection
Associated w/ Cirrhosis

Question 22

Cirrhotic patient’s with a recent history of an UGI bleed are at increased risk for what complication?

Answer 22

Spontaneous bacterial peritonitis

Question 23

Diffuse abdominal pain/tenderness
Fever and chills
Worsening ascites
New-onset or worsening encephalopathy

Diagnosis

Answer 23

SBP

Question 24

Diagnostics for Spontaneous bacterial peritonitis

Answer 24

Paracentesis

*neutrophil count of ≥ 250/mm3 confirms SBP

**serum-ascites albumin gradient (SAAG) > 1.1 confirms portal HTN as cause of SBP

Question 25

RUQ pain in mother can also be ____ because guts pushed up in belly

Answer 25

appendicitis

Question 26

3 Common example of referred pain → | Right shoulder pain:

Answer 26

``` Cholecystitis Liver hematoma (diaphragmatic irritation) ``` Pancreatitis (L shoulder) Spleen Lac

Question 27

Common example of referred pain → | Left shoulder pain (Kehr sign):

Answer 27

hemoperitoneum | splenic rupture

Question 28

Common example of referred pain → | Left-sided chest, arm, jaw pain:

Answer 28

myocardial infarction

Question 29

Common example of referred pain → | Periumbilical pain:

Answer 29

early stages of appendicitis then localizes to RLQ (McBurney's point)

Question 30

Altered mental status w/ peritonitis can be a sign of hemorrhagic shock due to intra-abdominal bleeding (especially in elderly post-op pts)  Next best step in management:

Answer 30

urgent laparotomy