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Illness Scripts > RUQ Pain > Flashcards

RUQ Pain Flashcards

1
Q

How are symptomatic gallstones managed?

A

Anaelgesia
Low fat diet
Laparoscopic cholecystectomy

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2
Q

Risk factors for gallstones

A

Older age
Female
Pregnancy
Obesity
Rapid weight loss
Drugs
Genetics

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3
Q

What type are most gallstones?

A

Cholesterol stones

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4
Q

Symptoms of cholecystitis

A

RUQ pain
Murphy a sign
Inflammatory picture
Possible guarding
History of biliary colic?

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5
Q

Do you get jaundice in cholecystitis?

A

No!

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6
Q

What does Murphy sign indicate?

A

Cholecystitis

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7
Q

Investigations for RUQ pain

A

FBC UE LFT CRP
Lipase
VBG
Urinalysis
CXR
ECG
USS
CT AP
MRCP

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8
Q

What proportion of cholecystitis is secondary to gallstones?

A

90%

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9
Q

What is the management of cholecystitis

A

Fluids
Antibiotics
Anaelgesia
Laparoscopic cholecystectomy

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10
Q

What is acute cholecystitis?

A

Acute inflammation of the gall bladder due to obstruction of the cystic duct (usually by dislodged gallstone)

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11
Q

Symptoms of hepatitis A

A

Fever
RUQ pain
Malaise
Jaundice
Nausea and vomiting
Itch

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12
Q

Severe symptoms of new Hep B infection

A

RUQ pain
Malaise
Jaundice
Nausea
Encephalopathy
Vomiting

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13
Q

What proportion of patients are symptomatic with hep C?

A

1/3rd get:
Fatigue
Myalgia
Jaundice

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14
Q

Which hepatitis viruses cause HCC?

A

Chronic B and C

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15
Q

How is viral hepatitis transmitted?

A

A and E - faecal oral
B, C and D - blood and fluids

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16
Q

Symptoms of renal colic

A

Sudden onset unilateral flank pain
Radiation to groin and scrotum
Vomiting
Frank haematuria
Patient pacing as can’t get comfortable

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17
Q

Investigations for renal colic

A

FBC UE LFT CRP
VBG
Urinalysis
CT-KUB

18
Q

What is the largest size of kidney stone that will likely pass naturally?

A

10mm

19
Q

How to prevent kidney stones

A

Hydrate
Reduce protein intake
Targeted salt urine chelation therapy

20
Q

Where are the most common sites for kidney stones to get stuck?

A

Pelviuteric junction
Pelvic brim
Vesicouteric junction

21
Q

What is MRCP

A

MRI scan of the upper abdomen that visualises the biliary tree and pancreatic ducts
Non invasive

22
Q

What is cholangitis

A

Infection of the biliary tree

23
Q

What is Charcots triad?

A

Fever
RUQ pain
Jaundice

24
Q

Reynauds pentad

A

Fever
RUQ pain
Jaundice
Shock (hypotension and tachycardia)
Altered mental status

25
Q

Symptoms of a perforated peptic ulcer

A

Sudden onset severe continuous epigastric pain
Guarding and peritonitis

26
Q

Investigations for perforated peptic ulcer

A

FBC UE LFT CRP
VBG
Urinalysis
ECG
CXR
CT AP

27
Q

Management of perforation

A

Emergency surgical intervention to repair defect and washout

28
Q

Symptoms of acute pancreatitis

A

Sudden onset epigastric and LUQ pain
Radiation to the back
Pain worse on movement
Nausea and vomiting

29
Q

Investigations for acute pancreatitis

A

FBC UE LFT CRP
Renal profile
Serum amylase and lipase
USS OR CT OR MRCP

30
Q

Diagnosis of acute pancreatitis

A

Serum lipase 3x greater than normal

31
Q

Risk factors for gallstones

A

Middle aged women
Younger men
Alcohol excess
Gallstones

32
Q

Causes of pancreatitis

A

Ideopathic
Gallstones
Ethanol
Trauma
S
Mumps and Malignancy
Autoimmune
Scorpion venom
Hyperlipidaemia/Hypercalcaemia
ERCP
Drugs - azathioprine, thiazides, septrin and tetracyclines

33
Q

Symptoms of DKA

A

Polyuria
Polydipsia
Weight loss
Nausea and vomiting
Abdominal pain
Malaise

34
Q

When do you get kids mail breathing?

A

In DKA

35
Q

Examination findings in DKA

A

Kussmaul breathing
Tachycardia
Hypotension
Dry
Pear drop breath
Abdo tenderness

36
Q

Scary complications of DKA

A

Hypokalaemia
Cerebral oedema
AKI
ARDS

37
Q

Management of DKA

A

Give isotonic saline
IV insulin
Correct electrolytes
Assess for trigger - ?infection

38
Q

Symptoms of gastric cancer

A

Abdo pain
Weight loss
Dysphasia sometimes
Lymphadenopathy - SMJ and Virchows node
Nausea
Melaena

39
Q

Symptoms of acute mesenteric ischaemia

A

Moderate to severe colicky or constant abdo pain
Poorly localised pain
Melaena
Diarrhoea
Peritonism

40
Q

Management of ischaemic bowel

A

Fluids
Anaelgesia
Oxygen
Antibiotics
Laparotomy to reestablish blood supply and resect non viable tissue

41
Q

Causes of ischaemic bowel

A

Thrombus
Embolus
Non-occlusive (inadequate supply, eg hypotension)

Illness Scripts (5 decks)

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