Surgery

Question 1

Ddx of abdominal pain

Answer 1

Stomach: gastroenteritis, peptic ulcer
Gallbladder: biliary colic, cholecystitis
Liver: hepatitis
Pancreas: pancreatitis
Intestine: appendicitis, IBD, volvulus, SBO, LBO, diverticulitis, malignancy, ileus, mesenteric ischemia, abscess
Kidney: UTI, pyelonephritis, kidney stone
GU: Pregnancy, ectopic pregnancy, ovarian cyst, ovarian torsion, mittelschmertz, PID, ovarian/uterine tumor

Question 2

Physical exam for abdominal pain

Answer 2

Inspection: masses, distention
Auscultation: bowel sounds, hyperactive?
Palpation: deep palpation for masses, liver edge, spleen
Percussion: liver size, traube’s space

Rectal: gross or occult blood
Pelvic and speculum: pain with cervical motion, ovaries, cervical discharge

Question 3

Investigations for abdominal pain

Answer 3

Blood work: CBC, lytes, glucose, creat, urea, INR/PTT, BHCG, urinalysis, type+cross if OR is imminent
Cultures: stool, cervical swabs
Imaging: AXR, abdo US

Question 4

Management of Diverticulitis

Answer 4

1. Admit
2. NPO
3. IV fluids
4. Abx- Cipro, flagyl
5. CT abdo