Week 8: Appendicitis, Alcohol Withdrawal Flashcards
What are the 2 main causes of appendicitis?
occlusion of the appendiceal lumen by a fecalith (accumulated feces) or intramural thickening caused by hypergrowth of lymphoid tissue
What are the clinical manifestations of appendicitis?
How is it diagnosed?
-Periumbilical pain (RLQ/ McBurney point), anorexia, N&V
Localized tenderness, rebound tenderness and muscle guarding
Low grade fever
-CT scan or ultrasound
What is the Rovsing sign?
Palpation of the LLQ causing pain to be felt in the RLQ
What is the blumberg sign?
Pain upon removal of pressure rather than application of pressure to the abdomen (rebound tenderness)
What are possible complications of appendicitis?
Perforation, perionitis, abscess
What is the treatment of appendicitis?
Appendectomy
-if the appendix has ruptured, and there is evidence of peritonitis or an abscess, antibiotics and parenteral fluids may be used to prevent sepsis and dehydration for 6-8 hours before an appendectomy
When do S&S of alcohol withdrawal appear and for how long do they last?
S&S of withdrawal generally begin 6-12 hours after the last drink, and may last for 3-5 days
What are S&S of alcohol withdrawal?
tremors, N&V, anxiety, sweating, hyper reflexia, agitation, insomnia, increased HR and BP
What are possible complications of alcohol withdrawal?
Alcohol-withdrawal delirium
Death may be caused by hyperthermia, peripheral vascular collapse or cardiac failure
What is Wernick’s Encephalopathy?
inflammatory, hemorrhagic, degenerative condition of the brain caused by a thiamine deficiency resulting from poor diet and alcohol-induced suppression of thiamine absorption.
If untreated, can lead to irreversible amnesia
What benzodiazepine antagonist can be used in the case of overdose?
What other interventions can be initiated?
-Flumazenil
-gastric lavage, activated charcoal
What are the S&S of benzodiazepine overdose?
Agitation, confusion, lethargy, stupor, slurred speech, nystagmus, slow or rapid shallow respirations, hypotension
What are the S&S of opioid withdrawal?
craving, abdominal cramps, diarrhea, N&V, flu-like symptoms
peaks 2 to 3 days after last use, resolves by days 5 to 7
What are the S&S of opioid overdose?
pinpoint pupils, clammy skin, depressed respirations, and decreased LOC that may lead to coma and death
What drugs can be used in management of opioid withdrawal?
Methadone or Buprenorphine