Misc Flashcards
breakdown of skeletal muscle tissue
Rhabdomyolysis
MCC: Crush injury, Seizures
Pathophysiology of Rhabdomyolysis
→ release of the following substances:
- ___ and serum ___ → pigment nephropathy → ATN
- ____ → cardiac arrhythmia
- ____ → metabolic acidosis
Creatine phosphokinase (CPK) myoglobin (myoglubinuria)
Potassium
Lactic acid
Rhabdomyolysis
Classic triad:
Generalized weakness
(2)
Myalgia
Darkened urine
Rhabdomyolysis cx (3)
AKI (pre-renal 2/2 hypovolemia)
compartment syndrome
cardiac arrhythmias
Management of Rhabdomyolysis
- IVF
- ___
Correct hyperkalemia
Insulin, Albuterol, Potassium binders, HD
pneumoperitonuem
(air in CT or CXR)
suggests what dx?
ulcer perforation
widened mediastinum can be seen in what dx (2)
aortic rupture
esophageal perforation
pericardial effusion (?)
Pleural effusions can be seen in patients with
Free wall rupture s/p MI
recent CABG
(2)
perforated esophagus
aortic dissection
Tachycardia
Hypotension
JVD
+/- new RBBB
dx:
Pulmonary Embolism
Common complication of AAA repair?
Mesenteric Ischemia
ischemic colitis
No peritoneal signs, but causes severely tender abdomen (2)
Mesenteric (ischemia)
Compartment Syndrome
Desmopressin is used to stop bleeding in (2)
VWB disease
Hemophilia A
Hepatic Encephalopathy
Genital urinary causes of acute abdomen → PEPTO
Pyelonephritis Ectopic Pregnancy (Ruptured) Testicular/Ovarian Torsion
GI causes of acute abdomen → DOPA
Diverticulitis
Obstructed bowel
Perforated bowel (2/2 PUD)
Appendicitis
Cardiovascular causes of acute abdomen →
MAAAAD Tummy
Mesenteric ischemia
AAA rupture
Aortic Dissection
Biliary Pancreatic causes of acute abdomen →
it’s in the name, girl
Pancreatitis (Gallstone)
Cholecystitis (Cholelethiasis)
Cholangitis (Choledocolithiasis)
GI causes of LUQ pain (2)
Gastric Ulcer
Splenic lac/abscess/infarction
GI causes of LLQ pain (2)
Diverticulitis
IBD (Ulcerative colitis & Chrons)
Causes of Periumbilical pain →
MAAAAD Appetizers
mesenteric ischemia
AAA ruptured
Aortic Dissection
Appy (early)
Causes of Epigastric pain →
9, guess as many as you can
MI AAA ruptured Aortic Dissection Esophagitis Gastritis pancreatitis GERD PUD Mesenteric Ischemia
infection of the ascitic fluid in the absence of any focal intraabdominal findings
Spontaneous bacterial peritonitis
*monomicrobial infection
Associated w/ Cirrhosis
Cirrhotic patient’s with a recent history of an UGI bleed are at increased risk for what complication?
Spontaneous bacterial peritonitis
Diffuse abdominal pain/tenderness
Fever and chills
Worsening ascites
New-onset or worsening encephalopathy
Diagnosis
SBP
Diagnostics for Spontaneous bacterial peritonitis
Paracentesis
*neutrophil count of ≥ 250/mm3 confirms SBP
**serum-ascites albumin gradient (SAAG) > 1.1 confirms portal HTN as cause of SBP
RUQ pain in mother can also be ____ because guts pushed up in belly
appendicitis
3 Common example of referred pain →
Right shoulder pain:
Cholecystitis Liver hematoma (diaphragmatic irritation)
Pancreatitis
(L shoulder) Spleen Lac
Common example of referred pain →
Left shoulder pain (Kehr sign):
hemoperitoneum
splenic rupture
Common example of referred pain →
Left-sided chest, arm, jaw pain:
myocardial infarction
Common example of referred pain →
Periumbilical pain:
early stages of appendicitis
then localizes to RLQ (McBurney’s point)
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:
urgent laparotomy
