peritonitis Flashcards

1
Q

primary

A

spontaneous bacterial peritonitis (SBP)
transmigration of bacteria thru bowel wall
enteric gram neg bacilli most common
klebsiella, pneumococcus, enterococcus

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2
Q

secondary

A

peritonitis from sx amenable source
polymicrobial
penetrating trauma
perforation dt appy, colitis, peptic ulcer, diverticulitis, pancreatitis, cholecystitis

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3
Q

SBP S&S

A

fever and abd pain with change in ams dt hepatic encephalopathy

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4
Q

secondary S&S

A

acute abd pain, high fever, n/v, constipation, ascites, dyspnea, tachypnea, dehydration, abd exam: distention, rebound tender, general rigidity, decreased bs, hyperresonance

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5
Q

diat test

A
paracentesis: evaluate ascitic fluid
bld cultures (+) 25%
wbc elevated in secondary
bun: increase
abd xray: free air/bowel dilation
cxray: elevated diaphragm
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6
Q

sbp tx

A

abx: 3rd generation cephalosporin for 10 days

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7
Q

secondary tx

A
sx to eliminate source
empiric abx
monitor cultures
iv fluid
monitor vs, urinary output
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