Pearson: Clinical Case Flashcards
McBurney's point tenderness Rovsing's sign (referred pain from left side) Obturator sign (Leg maneuvers)
Appendicitis
Cholecystitis
+ Murphy’s sign (illiciting pain while try to palpate gallbladder below the costal margin on an inspiration)
Protuberant abdomen w/ bulging flanks, positive fluid wave or shifting dullness
Ascites
Ventral hernias
Valsalva
abdominal pressure/sit-up to produce
AAA
pulsating mass
Tense protuberant abdomen tympanitic to percussion
Perforated viscera
All women who present w/ abdominal pain should receive this unless they are post-hysterectomy.
Serum quantitative bHCG (VERY sensitive, picks up almost all pregnancies)
*Urine pregnancy test may miss early ectopics
Lab ordered on most cases of abdominal pain to rule out infection
CBC w/ UA
Labs ordered to evaluate abdominal pain w/ vomiting and diarrhea
Electrolytes
BUN
creatinine
BMP (I think this is equivalent to chem 7)
Glucose, Calcium
Electrolytes
Kidney function (BUN, Cr)
CMP (chem 21?)
Glucose, Calcium
Electrolytes
Kidney function +
Protein
Liver tests
Lab to rule out DKA and hyperglycemia
Glucose and Ca
Labs for upper abdominal pain
Liver function tests
LIver enzymes
amylase
lipiase
Imaging for appendicitis
CT of abdomen and pelvis w/ contrast
Female w/ R or L LQ abdominal pain imaging
abdominal or transvaginal ultrasound of pelvis to evaluate pregnancy, complications w/ pregnancy and rule out reproductive tract pathology