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Flashcards in Anorectal Disease Deck (121)
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91

Most Common Cause of Peritonitis

Perforated GI tract

92

Common Conditions of an Acute Abdomen

Appendicitis
Biliary disease
Pancreatitis
Diverticular disease
PUD
Incarcerated hernia
IBD
IBS

93

Appendicitis

Anorexia
Vague periumbilical discomfort that radiates to RLQ
N/V
Urinary symptoms
Diarrhea

94

What is the most common extrauterine cause for abdominal pain in pregnant women?

Appendicitis

95

Biliary Disease

Acute cholecystitis
RUQ or epigastric pain
Radiate to right shoulder or back
N/V
Anorexia
Murphy's sign
Progress to septic shock
Jaundice

96

Pancreatitis

Pain in LUQ
Band-like radiation to back
Maximum pain intensity within 10-20 minutes
N/V common

97

Diverticular Disease

LLQ pain
N/V
+/- change in bowel habits

98

PUD

Epigastric pain
Indigestion
Reflux symptoms

99

Complications of PUD

Bleeding
Perforation

100

Incarcerated Hernia

Inguinal most common
Severe pain
Require immediate surgical consultation

101

Acute Complications of IBD

Pain
Bleeding
Perforation
Bowel obstruction
Fistula
Abscess formation
Toxic megacolon

102

IBS

Persistent symptoms for >3 months in 1 year
Pain associated with change in stool frequency of consistency
Pain received by BM

103

Evaluation of an Acute Abdomen

H&P will exclude all but a few causes
Labs & imaging give final diagnosis
Rule out life-threatening causes

104

Features of High Risk Abdominal Pain

>65 years old
Immunocompromised
Alcoholism
CV disease
Major comorbidities
Prior surgery or recent GI instrumentation
Early pregnancy
Sudden onset pain
Pain maximal at onset
Pain + vomiting
Constant pain

105

Important History

Age
Sex
PMHx
SHx
Meds
Location of pain
HPI
Pregnancy test

106

Causes of RUQ Abdominal Pain

Hepatitis
Cholecystitis
Cholangitis
Biliary colic
Pancreatitis
Budd-Chiari syndrome
Pneumonia/empyema pleurisy
Sub-diaphragmatic abscess

107

Causes of RLQ Abdominal Pain

Appendicitis
Salpingitis
Ectopic pregnancy
Inguinal hernia
Nephrolithiasis
IBD
Mesenteric adenitis

108

Causes of Epigastric Abdominal Pain

PUD
GERD
Gastritis
Pancreatitis
MI
Pericarditis
Ruptured aortic aneurysm

109

Causes of Peri-umbilical Abdominal Pain

Early appendicitis
Gastroenteritis
Bowel obstruction
Rupture aortic aneurysm

110

Causes of LUQ Abdominal Pain

Splenic abscess
Splenic infarct
Gastritis
Gastric ulcer
Pancreatitis

111

Causes of LLQ Abdominal Pain

Diverticulitis
Salpingitis
Ectopic pregnancy
Inguinal hernia
Nephrolithiasis
IBS
IBD

112

Causes of Diffuse Abdominal Pain

Gastroenteritis
Mesenteric ischemia
Metabolic
Malaria
Familial Mediterranean fever
Bowel obstruction
Peritonitis
IBS

113

PE of an Acute Abdomen

General appearance important
Inspection, auscultation, palpation, & percussion of abdomen
Rectal/pelvic exam
Surgical scars should be palpated

114

Red Flags of an Acute Abdomen

Severe pain
Signs of shock
Signs of peritonitis
Abdominal distention

115

Acute Abdomen Diagnostics

Urine pregnancy test
Serum lipase
Serum amylase
Plain x-rays
Ultrasound
CT

116

Diagnostic Test of Choice in RUQ Pain

Ultrasound

117

Diagnostic Test of Choice in RLQ Pain

Ultrasound with IV contrast

118

Diagnostic Test of Choice in LLQ Pain

CT with oral & IV contrast

119

Diagnostic Test of Choice in LUQ Pain

Endoscopy
Ultrasound
CT

120

Diagnostic Test of Choice in Suprapubic Pain

Ultrasound