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FinalMB Part I - Surgery > General Sugery > Flashcards

Flashcards in General Sugery Deck (15)
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1

Outline the potential differential diagnoses for generalised abdominal pain? (4)

- Peritonitis
- Ruptured AAA
- Intestinal obstruction
- Ischaemic colitis

2

Outline the potential differential diagnoses for RUQ pain? (3)

- Biliary colic
- Acute cholangitis
- Actue cholecystitis

3

Outline the potential differential diagnoses for epigastric pain? (4)

- Acute gastritis
- PUD
- Pancreatitis
- Ruptured AAA

4

Outline the potential differential diagnoses for central abdominal pain? (4)

- Ruptured AAA
- Intestinal obstruction
- Ischaemic colitis
- Early stage appendicitis

5

Outline the potential differential diagnoses for RIF pain? (5)

- Acute appendicitis
- Ectopic pregnancy
- Ruptured ovarian cyst
- Ovarian torsion
- Meckel's diverticulitis

6

Outline the potential differential diagnoses for LIF pain? (4)

- Diverticulitis
- Ectopic pregnancy
- Ruptured ovarian cyst
- Ovarian torsion

7

Outline the potential differential diagnoses for suprapubic pain? (4)

- Lower UTI
- Acute urinary retention
- Pelvic inflammatory disease
- Prostatitis

8

Outline the potential differential diagnoses for loin-to-groin pain? (3)

- Renal colic (kidney stones)
- Ruptured AAA
- Pyelonephritis

9

Outline the potential differential diagnoses for testicular pain? (2)

- Testicular torsion
- Epididymo-orchitis

10

What are the signs of peritonitis? (5)

- Guarding; tensing of abdominal muscles when palpated
- Rigidity; involuntary persistent tightness/tensing
- Rebound tenderness; pain worse upon rapid release of palpation pressure
- Coughing test; coughing elicits abdominal pain
- Percussion tenderness; pain and tenderness upon percussion

11

What are the three main types of peritonitis? (3)

- Localised peritonitis; caused by underlying organ inflammation (appendicitis, cholecystitis)
- Generalised peritonitis; caused by perforation of abdominal viscus
- Spontaneous bacterial peritonitis (SBP); associated with ascites and liver disease

12

What should be done as part of the initial assessment in an unwell patient presenting with an acute abdomen?

Airway; patent and secure
Breathing; RR and SpO2
Circulation; HR, BP CRT, IV Access
Disability; AVPU/GCS and Glucose
Exposure; full examination

13

Outline which blood tests should be carried out with a patient presenting with an acute abdomen and why? (10)

- FBC; bleeding (Hb) and infection (WCC)
- U&Es; kidney function, contrast CT
- LFTs; hepatobiliary cause
- CRP; inflammation and infection
- Amylase; pancreatitis
- INR; synthetic function of liver
- Serum Calcium; scoring acute pancreatitis
- ABG; lactate (sepsis) and PaO2 for scoring acute pancreatitis
- G&S +/- RXM; may require transfusion
- Blood Cultures; if infection suspected

14

Outline which imaging tests should be carried out with a patient presenting with an acute abdomen and why? (4)

- AXR; bowel obstruction
- Erect CXR; pneumoperitonism indicates perforation
- Abdominal USS; gallstones, biliary duct dilatation and gynaecological pathology
- CT Scan; AAA or other diagnosis

15

Outline the initial management of a patient presenting with an acute abdomen? (10)

- ABCDE
- Alert Seniors
- Nil by mouth
- NG tube
- IV Fluids
- IV Abx
- Analgesia
- Investigations
- VTE
- Prescribe regular medication