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Study Notes - Gastroenterology > *The Acute Abdomen > Flashcards

*The Acute Abdomen Flashcards

1
Q

What causes RUQ acute abdo problems? (6)

A 
Biliary colic
cholecystitis
cholangitis
Pneumonia
Musculoskeletal
liver abscess/ hepatitis
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2
Q

What is the acute abdomen?

A

a condition of severe abdominal pain, usually requiring emergency surgery, caused by acute disease of or injury to the internal organs.

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3
Q

What will most patients with RUQ pain have?

A

Gallstones

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4
Q

what symptoms/ signs can gallstones cause?

A

RUQ/ epigastric pain
Temperature
Jaundice
(depends on what type of problem the gallstones are causing)

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5
Q

Intermittent RUQ pain (which may radiate to the shoulder blade) with no temperature or jaundice?

A

Biliary colic

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6
Q

Constant RUQ pain (which may radiate to the shoulder blade) with a temperature but no jaundice?

A

Cholecystitis

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7
Q

Constant RUQ pain (usually), jaundice but no temperature?

A

Choledocholithiasis (presence of at least one gallstone in the common bile duct)

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8
Q

Constant RUQ pain with a temperature and jaundice?

A

Cholangitis

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9
Q

Constant epigastric pain which can radiate to the back and may or may not cause a temperature or jaundice?

A

Pancreatitis

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10
Q

What causes epigastric acute abdo problems? (5)

A 
pancreatitis
Perf DU
AAA
Gastritis/ reflux
Oesophagitis
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11
Q

What in the history is usually found in a patient with pancreatitis?

A

Alcohol or gallstones sometimes

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12
Q

How is pancreatitis diagnosed?

A

Amylase more than 300

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13
Q

What tests are done on a patient with probable pancreatitis/

A

Amylase (more than 300 for diagnosis)
Scoring
USS (to look for gallstones)
CT (if you’re unsure if a patient has pancreatitis)

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14
Q

What in the history can indicate a perforated DU?

A

Alcohol intake

NSAID use

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15
Q

Why do you need to take an erect x-ray for a patient with a suspected DU?

A

To look for air under the diaphragm

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16
Q

What presentation should make you suspect an AAA?

A

Severe epigastric pain radiating to the back with collapse

17
Q

How is gastritis/ GORD/ oesophagitis diagnosed?

A

Upper GI endoscopy

18
Q

What causes an acute abdomen in the LUQ? (3)

A

Splenic injury/ rupture/ infarct
Pneumonia
Musculoskeletal

19
Q

What test should be done on a trauma patient to rule out abdominal injury?

A

CT

20
Q

What history is usually present with spleen problems?

A

Splenomegaly or injury

21
Q

What causes an acute abdomen in the flank areas?

A

Pyelonephritis
renal colic
musculoskeletal

22
Q

Where does renal pain often radiate?

A

To the back

23
Q

What can renal colic pain mimic?

A

A ruptured AAA

24
Q

What wil urinalysis show in a patient with renal colic?

A

Blood in the urine

Leucocytes (if they have an infection)

25
Q

What causes an acute abdomen in umbilicus?

A

Obstruction
Early appendicitis
AAA
Meckels

26
Q

Elderly male, severe pain radiating to back, collapse, CV history?

A

AAA until proven otherwise - need an urgent CT

27
Q

Presentation of obstruction?

A

Generalised abdo pain
Distended abdomen
vomiting
constipation

28
Q

Causes of obstruction?

A

Hernia
Tumour
Previous surgery

29
Q

What causes a suprapubic acute abdomen? (4)

A

UTI
Ovarian
Appendicitis
Diverticulitis

30
Q

LIF acute abdomen causes? (5)

A 
Diverticulitis
Ectopic pregnancy
Torsion of ovarian cyst
Hernia (femoral/ inguinal)
Gastroenteritis
31
Q

What is complicated diverticulitis?

A

Complicated diverticulitis refers to the clinical presentation of acute diverticulitis with inflammatory manifestations and complications, such as feculent peritonitis, obstruction, perforation, phlegmon, and/or abscess formation (the most severe complication is perforation - usually need a Hartmans procedure)

32
Q

What things should make you suspicious of an ectopic pregnancy?
What should you do?

A 
Child bearing age
Sudden onset
LIF/ RIF pain
Sepsis + shock
BHCG
do a pregnancy test
33
Q

Sudden onset suprapubic pain that is severe and mid-cycle?

A

Ovarian torsion

34
Q

What should you always examine the groin for in all acute abdomen problems?

A

Hernias

35
Q

What causes RIF acute abdomen problems?

A 
Appendicitis
Ectopic pregnancy
Torsion of ovarian cyst
Hernia: femoral/ inguinal
Diverticulitis
Chrons
Meckels
Perf caecal cancer

Study Notes - Gastroenterology (42 decks)

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