Part gallstone and part signs of acute abdomen and differential Flashcards
How common are gallstones?
Common; present in 15% of adult population
Gallstone occurence male vs female
Females are over 50 times more likely to form stones than men
Family history and gallstones
Positive family history makes it five times elevated risk
Age and occurence of gallstones
frequency increases with age. Marked increase >40.
Risk factors for gallstones
- Ethnicity
- Female Sex
- Family history and genetics
- Age
- Obesity— 25% of morbidly obese have evidence of gallstones.
- DM— a correlation with lipid abnormalities.
- Diet— with high- cholesterol, high- carbohydrate diet.
- Drugs— OCP, octreotide, thiazide diuretics.
- Chronic diseases— cirrhosis, Crohn’s disease, cystic fibrosis (CF),
sickle cell.
What is a sign used to check if the gallbladder is inflamed and how is it performed?
- Performed by palpating/putting pressure the right upper quadranat
- Inspiration causes the gallbladder to descend onto the fingers, producing
pain if the gallbladder is inflamed
What is cholecystitis?
Inflammation of the gallbladder
What is an acute abdomen?
Refers to the signs and symptoms of
abdominal pain and tenderness
Surgical acute abdomen conditions
Non surgical causes of the acute abdomen
Location and causes of referred pain
Laboratory test for abdominal pain
Abdominal examinations signs and their division based on stage of examination
History
What is shoulder pain on inspiration, associated with?
Associated with hemoperitoneum
What are Varicose veins at umbilicus associated with?
Portal hypertension
What is periumbilical bruising associated with?
hemoperitoneum
What is local area of discoloration near umbilicus and flank associated with?
Acute pancreatitis
What is a Yellow discoloration of umbilical region associated with ?
ruptured common bile duct
What is pain or pressure in epigastric or anterior chest with persistent firm pressure applied at McBurney point associated with?
acute appendicitis
What is Sharp pain created by compressing appendix between abdominal wall and iliacus associated with?
chronic appendicitis
What is Transient abdominal wall rebound tenderness, associated with?
peritoneal inflammation
What is Loss of abdominal tenderness when abdominal wall muscles contracted, associated with?
intrabdominal source of abdominal pain
What is Extreme pelvic pain with movement of the cervix, associated with?
Pelvic inflammatory disease
What is Palpable gallbladder when jaundice is present associated with?
, periampullary mass
What is Abdominal wall mass that does not cross midline and is palpable when rectus is contracted, associated with?
Rectus muscle hematoma
What is Elevation of extended leg against resistance is painful, associated with?
retocecal acute appendicitis
Which of the appendicitis signs is associated with more than one condition?
Flexion and external rotation of right thigh creates hypogastric pain, Pelvic abscess or inflammatory mass
(appendicitis)
ERCP uses
- During ERCP, diagnostic procedures can be done, namely cholangiopancreatoscopy, biopsy, or brush cytology.
- An intraductal ultrasound may also be done.
- Therapeutic uses include sphincterotomy, stent placement, and stone removal
ERCP indications
Differential diagnosis of acute abdomen in elderly patients
Differential diagnosis of acute abdomen in oncology patients
Differential diagnosis of acute abdomen by quadrant (4)
