Week 15 - Abdomen Flashcards
what are some causes of acute abdomen?
blood loss
obstructions
haematologic disorders
infection
perforation
toxins
blood flow blockage
endocrine and metabolic disorder
what is a mallory-weiss tear?
split in the inner layer of the oesophagus
what is cholecystitis?
inflammation of the gallbladder when a gallstone blocks bile from exiting
what are the most common causes of acute pancreatitis?
alcohol
gallstones
what is boerhaaves syndrome?
spontaneous rupture of the oesophagus that occurs during intense straining
what is buergers disease?
blood vessels in their legs, arms, feet and hands get inflamed, making it hard for blood to travel through.
what is uraemia?
buildup of toxins in the blood. Occurring when the kidneys stop filtering toxins out through urine
what is addisons disease?
adrenal glands don’t produce enough cortisol and aldosterone
what is acute intermittent porphyria?
porphyria is a deficiency in an enzyme that your body needs to make heme
what is the presentation of acute cholecystitis?
fever
guarding
positive Murphy’s sign (abrupt stopping of inspiration when the palpating hand meets the inflamed gallbladder descending with the liver from behind the subcostal margin on the right side -
but not on the left side).
Increased WBC and CRP.
what investigations are done when you suspect acute cholecystitis?
ultrasound of gallbladder and biliary ducts
what is murphys sign? when is it positive?
abrupt stopping of inspiration when the palpating hand meets the inflamed gallbladder descending with the liver from behind the subcostal margin on the right side -
but not on the left side
acute cholecystitis
what is cholangitis?
infection of the biliary tree
what is the presentation of cholangitis?
triad of:
- fevers
- right upper quadrant pain
- jaundice
what does a triad of: fevers, RUQ pain and jaundice suggest?
cholangitis
what is the presentation of a duodenal ulcer?
epigastric pain, dull or burning discomfort, typically relieved by food, nocturnal pain.
what type of ulcer has pain that is relieved by eating food?
duodenal ulcer
how is a duodenal ulcer investigated?
OGD, barium meal and pH study (Helicobacter pylori often present in mucosa or by serology).
what is the presentation of gallstone colic (with no acute inflammation or infection)?
jaundice
biliary colic
pain in epigastrium or RUQ radiating to right lower scapula.
No fever or increased WBC.
what is suggested by: jaundice, biliary colic, pain in epigastrium or RUQ radiating to right lower scapula. No fever or increased WBC?
gallstone colic (with no acute inflammation/infection)
what is the presentation of gastric carcinoma?
marked anorexia
fullness
pain
Troisier’s sign (a Virchow’s node, i.e., large lymph node in the left supraclavicular fossa).
what is troisiers sign? what is it positive in?
a Virchow’s node, i.e., large lymph node in the left supraclavicular fossa
what is suggested by these symptoms: marked anorexia, fullness, pain, Troisier’s sign (a Virchow’s node, i.e., large lymph node in the left supraclavicular fossa)?
gastric carcinoma
how do you investigate gallstone colic?
ultrasound of gallbladder and biliary ducts
what is the presentation of a gastric ulcer?
epigastric pain, dull or burning discomfort, typically exacerbated by food, nocturnal pain.
what is suggested by these symptoms: epigastric pain, dull or burning discomfort, typically exacerbated by food, nocturnal pain?
gastric ulcer
which type of ulcer is exacerbated by eating food?
gastric ulcer
what is the presentation of gastritis?
epigastric pain, dull or burning discomfort, nocturnal pain.
what investigations are done in suspected gastric ulcer?
OGD, barium meal and pH study
what is suggested by these symptoms; epigastric pain, dull or burning discomfort, nocturnal pain?
gastritis
what investigations are done in gastritis?
OGD, barium meal and pH study.
what is the presentation of a hiatus hernia?
heartburn, worsens with stooping or lying, relieved by antacids.
what is suggested by these symptoms: heartburn, worsens with stooping or lying, relieved by antacids?
hiatus hernia
what investigations are done in a hiatus hernia?
OGD, barium meal
what is the presentation of oesophagitis?
retrosternal pain, heartburn.
what is suggested by these symptoms: retrosternal pain, heartburn?
oesophagitis
how is oesophagitis investigated?
OGD
what is the presentation of pancreatitis?
pain radiating straight through to the back, better on sitting up or leaning forward.
how is pancreatitis investigated?
increased serum amylase, CT pancreas.
what are the differentials for pain in the RUQ?
cholecystitis
pyelonephritis
ureteric colic
hepatitis
pneumonia