Abdominal Pain

Front 1

Right shoulder pain could be

Back 1

Perf Duodenal ulcer

Front 2

Left shoulder pain could be

Back 2

Ruptured spleen

Front 3

Right back pain could be

Back 3

Biliary colic

Front 4

Right posterior abdominal pain could be

Back 4

Pancreatitis or renal colic

Front 5

Low back pain could be

Back 5

Uterine or rectal pain

Front 6

Severe sudden persistent abd or back pain, may spread to groin/butt/legs, syncopal, clammy, N/V, tachycardia, shock

Back 6

AAA rupture

Front 7

Nausea, pain in jaw/neck/back/arm/shoulder, SOB, lightheaded, tired

Back 7

Myocardial infarction

Front 8

Pelvic/shoulder pain, vaginally bleeding, lightheaded

Back 8

Ectopic pregnancy

Front 9

Severe craving abdominal pain, vomiting, abdominal distention, gassy, constipation

Back 9

Intestinal obstruction

Front 10

Sudden severe abd pain starts mid/upper abd pain then generalizes, tenesmus, fever, N/V

Back 10

Mesenteric ischemia

Front 11

Dull navel pain progressing to sharp RLQ pain, lower back pain, fever, vomiting, diarrhea or constipation, loss of appetite

Back 11

Appendicitis

Front 12

Severe upper abdominal pain spreads to back or shoulder wakes up at night or when stomach empty, dyspepsia, bloated, fullness, N/V, bloody or bla k stool, CP, fatigue, weight loss, heartburn

Back 12

Perforated peptic ulcer

Front 13

LUQ pain, left shoulder pain, confusion, dizzy, shock, nausea

Back 13

Ruptured spleen

Front 14

List abdominal symptom red flags

Back 14

Sudden severe onset, radiation, awakens, change in location, syncope, vomiting, hematemesis, distention, decreased UOP, fever, pain worse with movement

Front 15

Symptoms of hepatic rupture

Back 15

Pain may have been going on for weeks before rupture, hepatomegaly, RUQ tenderness, abd distention, peritoneal signs, shock

Front 16

Type of pain?

Poorly localized and characterized

Back 16

Visceral

Front 17

Type of pain occurs with irritation of parietal peritoneum, intense, localized, constant

Back 17

Somatic

Front 18

Type of pain: felt remotely due to peripheral affluent nerve fibers that enter spinal cord that also carry fibers from other locations

Back 18

Referred

Front 19

DDX RUQ PAIN (name 9)

Back 19

Biliary colic, acute cholecystitis, cholangitis, acute hepatitis, liver abscess, hepatic congestion due to CHF, perforated Duodenal ulcer, RLL PNA, PE

Front 20

T/F You should normally be able to see the small bowel on a plain film. When you see the abnormal of it on the plain film, it can mean....

Back 20

False, should not be able to see. If you do see, it could mean obstruction.

Front 21

CT AP for abdominal or pelvic pain, with or without contrast? Oral or IV?

Back 21

With contrast. Oral for bowel, GI tract, appendix; perforation? Leakage? Large appendix? IV contrast shows blood flow or ischemia.

Front 22

Ruptured spleen, lacerated liver best test?

Back 22

CTAP

Front 23

This is a Good test for pregnancy, cyst, stone, hydronephrosis, aorta, hepatic and biliary disease.

Back 23

Ultrasound

Front 24

A HIDA or DISIDA helps to visualize

Back 24

Emptying and filling of gall, bladder and extra hepatic billiary tree.

Front 25

XR abdomen is good to see

Back 25

Obstruction, stones, pneumoperitoneum, foreign body, need fir further testing.

Front 26

CT AP helps to see

Back 26

Vasculature, infection or abscess formation, inflammation, bleeding, mass, ischemia, perforation, dilation.

Front 27

ERCP is an MRI with endoscopy and is a good test for

Back 27

Pancreatic or bile duct problems, can also have stent placed, sphincterotomy, or stone removal

Front 28

What is the difference between an MRCP and an ERCP?

Back 28

MRCP Shows the same things, but a procedure cannot be done during it.And sedation is not used.

Front 29

What is a HIDA scan used for?

Back 29

It uses a radioactive tracer to see the bile duct, gallbladder, liver, and small intestine. it might be used as a test to detect a problem, an ERCP can treat. Or might be used after an MRCP to confirm a problem.

Front 30

An MRI for abdominal pain cN be used for

Back 30

a follow up test. AAA, choley, pancreatitis, hepatic d/o, appendicitis, masses/ tumor

Front 31

With a pregnant woman with abdominal pain, keep these in your differential because they are higher risk for

Back 31

Thrombus, MI, aortic dissection

Front 32

Most common cause of acute abdominal pain in infants?

Back 32

Appendicitis

Front 33

Which are sx of acute or probable surgical causes of abd pain in infants?

Fever, _____ vomit, _____ diarrhea, _____ bowel sounds, voluntary ______, rigidity, _______ tenderness.

Back 33

Fever, bilious vomit, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, rebound tenderness.

Front 34

Baby boys with abdominal pain, must check for this list random cause

Back 34

Hair tourniquet of testes

Front 35

Common causes of abdominal pain in school age children

Back 35

Resp infections, gastroenteritis, colitis, UTI, PID, pregnancy, ovarian cyst or torsion, or abuse

Front 36

What is carnetts sign

Back 36

Pain when tensing abdominal muscles. While palpating, have pt either raise head or both legs with straight knees. If pain is worse, it's likely abdominal wall in origin. (Skin or musculoskeletal).

Front 37

You find a small bowel obstruction. What could cause it?

Back 37

Adhesions, hernias, inflammatory bowel disease.

Front 38

You find a large bowel obstruction. What could cause it?

Back 38

Carcinoma, volvulus, diverticulitis, inflammatory bowel disease.

Front 39

Sx of obstruction

Back 39

Vomiting, hiccups, obstination and failure to pass gas, Abdominal distention, increased bowel sounds.

Front 40

Your patient has a bowel obstruction and is having vomiting with bile and mucus period where do you think the location of the obstruction is?

Back 40

High in the intestines

Front 41

Your patient has a bowel obstruction and is having feculent vomiting. where do you think the location of the obstruction is?

Back 41

Low in the intestines

Front 42

Tests for obstruction

Back 42

CBC (infection or abscess), LFT (ro gallbladder), BMP, lipase for pancreatitis. XR with air fluid level, ladder appearance. CT AP with oral and IV contrast.

Front 43

Tx for obstruction

Back 43

NF if vomiting, IV crystalloid, correct electrolytes, ATB, surgical consult