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26 Cards in this Set
- Front
- Back
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What are the symptoms that are common to the acute abdomen?
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Nausea
Vomiting Diarrhea Anorexia Fever |
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How will patients describe visceral pain?
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Midline
Poorly localized |
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What types of fibers transmit visceral pain?
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Sympathetic fibers
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What's the organization of the visceral pain?
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Foregut, midgut, hindgut
Celiac axis, SMA, IMA |
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What's transmitted by the visceral fibers?
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Distension
Ischemia Traction |
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How will someone describe somatic pain?
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Well-localized, easily described
It will often OBSCURE the visceral component |
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What are the major causes of acute abdominal pain?
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Inflammation:
-Appendicitis -Cholecystitis -Pancreatitis -Diverticulitis Perforation Obstruction -Bowel -Ureter Vascular causes -Acute ischemia -Ruptured aneurysm |
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What is the history of someone with appendicitis?
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Periumbilical pain
Anorexia RLQ pain |
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What tests should you order for appendicitis?
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CBC
Urinalysis Pregnancy test Helpful: Amylase LFTs Imaging |
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What are good imaging tests for appendicitis?
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Ultrasound
Xray (fecalith) Cat scan |
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What are secondary problems from a perforated abscess?
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Wound infection
Intraperitoneal abscess Fecal fistula Intestinal obstruction |
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What is associated with risks of death from appendicitis?
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71-90 years
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What are other findings that you can have at a negative appendectomy?
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Mesnteric lymphadenitis
Crohn's Meckel's diverticulitis Cecal diverticulitis Cecal carcinoma Ectopic pregnancy PID Ovarian cysts |
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What are causes of air in the abdomen?
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Perforation, always:
Stomach Large bowel |
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What's the history of a perforated ulcer?
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Sudden, severe, intially epigastric
DIffuse abdominal pain Somatic pain Peritonitis |
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What are risk factors from a perforated ulcer?
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Shock
Long-standing perforation Old age |
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What are the bacterial found normally in the gut?
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Lactobacilli
Aerobic streptococci |
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What do you find in the abdomen in the case of a perforation?
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Coliforms
Clostridia Candida |
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What do you want to achieve with operation in a perforation?
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Safety
Clean the peritoneum Close the perforation Alteration of the ulcer diathesis |
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What are stereotypical physical exam findings in someone with a bowel obstruction?
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Distended abdomen
Fever Hyperactive bowel sounds DIffuse tenderness |
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What are the labs in someone with a bowel obstruction?
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Elevated white count
Tachycardic Increased specific gravity on UA |
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What's the main cause of small intestinal obstruction?
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POST-OPERATIVE ADHESIONS!
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What operations cause obstructions?
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Hysterectomy
Appendectomy Colectomy |
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What are electrolyte abnormalities in a proximal obstruction?
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Hypochloremic alkalosis
Compensatory hypokalemia Azotemia |
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What are electrolyte abnormalities in a distal obstruction?
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Normal electrolytes
Azotemia Hemoconcentration |
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What are symptoms and signs of a bowel infarction?
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Continuous abdominal pain
Fever Peritoneal signs Mass Tachycardia Leukocytosis Acidosis |
