PID Flashcards
Pain assessment
P - position Q - quality R - radiation S - severity T - timing A - alleviating A - aggravating A - associated symptoms
Adolescent interview
H - home E - employment/education E - eating A - activity/aspiration D - drugs S - sexuality S - safety S - suicide
DDx for ab pain and vomiting
Appendicitis Cholecystitis Hepatitis Pancreatitis Ectopic Pregs - low abdominal pain and abnormal period PID - FHC from N. gonorrhea or chlamydia Ovarian Torsion - stabbing pain, N/V UTI
Testicular Torsion
urologic emergency with goal to save testis
- early adolescence with sudden onset of severe testicular pain (hemiscrotal), N/V
- enlarged, tender testis, scrotal edema, absent cremaster reflex
- doppler study to confirm and orchipexy
Acute Appendicitis
most common reason for emergency surgery in kids (older)
- up to a 1/3 of population have atypical signs
- accurate history and physical (McBurney point)
- pain starting periumbilical and moving to RLQ (can be RUQ)
- US or CT to confirm
Pelvic exam
should do in any sexually active female with abdominal pain
Rectal exam
should do with abdominal pain or if there is serious concern for neurologic damage anywhere (check for tone)
Cholecystitis
RUQ pain and (+) Murphy’s sign
Ectopic pregnancy
diffuse abdominal tenderness, cervical motion tenderness and (+) adnexal mass tenderness
Hepatitis
fever, RUQ pain, jaundice, hepatomegaly
Pancreatitis
epigastric abdominal pain radiating to back
PID PE
fever, diffuse abdominal pain, cervical motion tenderness, purulent discharge
- RUQ pain = FHC
UTI
CVA tenderness, suprapubic tenderness
Abdominal imagin
KUB (kidney, ureter, bladder)
CT
MRI
US
Pelvic Inflammatory Disease
sexually active females 15-19 most commonly (fewer protective antibodies, not fully mature SCJ, lack of protection)
- caused by N. gonorrhea, Chlamydia
DIAGNOSIS = cervical motion tenderness, purulent discharge, abdominal pain, culture, gram stain
COMPLICATIONS = sepsis, FHC, abscess, infertility
