Part gallstone and part signs of acute abdomen and differential

Question 1

How common are gallstones?

Answer 1

Common; present in 15% of adult population

Question 2

Gallstone occurence male vs female

Answer 2

Females are over 50 times more likely to form stones than men

Question 3

Family history and gallstones

Answer 3

Positive family history makes it five times elevated risk

Question 4

Age and occurence of gallstones

Answer 4

frequency increases with age. Marked increase >40.

Question 5

Risk factors for gallstones

Answer 5

• 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.

Question 6

What is a sign used to check if the gallbladder is inflamed and how is it performed?

Answer 6

• 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

Question 7

What is cholecystitis?

Answer 7

Inflammation of the gallbladder

Question 8

What is an acute abdomen?

Answer 8

Refers to the signs and symptoms of
abdominal pain and tenderness

Question 9

Surgical acute abdomen conditions

Answer 9

Question 10

Non surgical causes of the acute abdomen

Answer 10

Question 11

Location and causes of referred pain

Answer 11

Question 12

Laboratory test for abdominal pain

Answer 12

Question 13

Abdominal examinations signs and their division based on stage of examination

Answer 13

History

Question 14

What is shoulder pain on inspiration, associated with?

Answer 14

Associated with hemoperitoneum

Question 15

What are Varicose veins at umbilicus associated with?

Answer 15

Portal hypertension

Question 16

What is periumbilical bruising associated with?

Answer 16

hemoperitoneum

Question 17

What is local area of discoloration near umbilicus and flank associated with?

Answer 17

Acute pancreatitis

Question 18

What is a Yellow discoloration of umbilical region associated with ?

Answer 18

ruptured common bile duct

Question 19

What is pain or pressure in epigastric or anterior chest with persistent firm pressure applied at McBurney point associated with?

Answer 19

acute appendicitis

Question 20

What is Sharp pain created by compressing appendix between abdominal wall and iliacus associated with?

Answer 20

chronic appendicitis

Question 21

What is Transient abdominal wall rebound tenderness, associated with?

Answer 21

peritoneal inflammation

Question 22

What is Loss of abdominal tenderness when abdominal wall muscles contracted, associated with?

Answer 22

intrabdominal source of abdominal pain

Question 23

What is Extreme pelvic pain with movement of the cervix, associated with?

Answer 23

Pelvic inflammatory disease

Question 24

What is Palpable gallbladder when jaundice is present associated with?

Answer 24

, periampullary mass

Question 25

What is Abdominal wall mass that does not cross midline and is palpable when rectus is contracted, associated with?

Answer 25

Rectus muscle hematoma

Question 26

What is Elevation of extended leg against resistance is painful, associated with?

Answer 26

retocecal acute appendicitis

Question 27

Which of the appendicitis signs is associated with more than one condition?

Answer 27

Flexion and external rotation of right thigh creates hypogastric pain, Pelvic abscess or inflammatory mass
(appendicitis)

Question 28

ERCP uses

Answer 28

• 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

Question 29

ERCP indications

Answer 29

Question 30

Differential diagnosis of acute abdomen in elderly patients

Answer 30

Question 31

Differential diagnosis of acute abdomen in oncology patients

Answer 31

Question 32

Differential diagnosis of acute abdomen by quadrant (4)

Answer 32