Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
|
Acute Abdomen |
dau bung cap |
|
|
A 35-year-old man who presents to the emergency department with 3 days of crampy abdominal pain and diarrhea. He reports subjective fevers. On physical examination, he is tender to palpation in all quadrants but demonstrates no rebound or guarding. |
|
|
|
Does this patient have a surgical abdomen? |
|
|
|
what is an acute abdomen? |
|
|
|
Define an acute abdomen? |
acute abdomen is the sudden onset of abdominal pain |
|
|
layers of peritoneum |
the peritoneum has two layers the parietal and the visceral peritoneum |
|
|
regions of abdominal pain |
nine quadrants |
|
|
visceral abdominal pain |
1. pain is difficult to localize 2. often mediated by distension, ischemia and felt in the midline |
|
|
parietal abdominal pain |
1. nerve fibers go to one side 2. easier to localize |
|
|
differential diagnosis (acute abdomen) |
1. acute cholecystitis 2. cholangitis 3. hepatitis 4. appendicitis 5. ovarian torsion/cyst 6. pelvic inflammatory disease 7. small bowel perforation/ obstruction 8. peptic ulcer 9. pancreatitis 10. spleen 11. kidney stone 12. diverticulitis 13. colon volvulus 14. colon perforation 15. mesenteric ischemia |
|
|
approach to the patient |
1. does the patient need surgery? 2.how soon does the patient need surgery? 3. is there any additional workup necessary? |
|
|
high-yield of perforation |
free air under diaphragm |
|
|
high-yield of ischemic bowel |
thumbprinting and pnematosis |
|
|
high-yield of GI bleeding |
1. hemodynamically unstable (hypotension) 2. peritoneal signs 3. blood transfusion |
|
|
hemodynamically unstable |
huyet dong khong on dinh |
|
|
peritoneal signs |
dau mang bung |
|
|
high-yield of small bowel obstruction |
air-fluid levels |
|
|
upright abdominal X-ray |
X quang bung dung |
|
|
peritonitis |
viem phuc mac |
|
|
surgical exploration |
mo tham do |
|
|
an 18-year-old man who is otherwise healthy reports worsening abdominal pain that started around the belly button this afternoon. He is nauseated and has no appetite. |
|
|
|
appendicitis |
viem ruot thua |
|
|
physical findings |
kham lam sang |
|
|
umbilical # bellybutton. |
ron |
|
|
anorexia # the lack of appetite |
chan an |
|
|
fever & chill |
sot & on lanh |
|
|
McBurney's Point |
2/3 distance from umbilicus on a straight line to ASIS (anterior superior iliac spine) |
|
|
psoas sign |
hip flexor irritation |
|
|
flat on the bed |
nam tren giuong |
|
|
retrocecal appendix |
ruot thua sau manh trang |
|
|
gynecologic organs # appendicitis |
1. ovarian torsion/ cyst 2. ectopic pregnancy 3. pelvic inflammatory disease |
|
|
routine labs |
Xet nghiem thuong quy |
|
|
demonstrate |
chung to/ chung minh/ bieu lo |
|
|
modality |
phuong thuc |
|
|
Preop antibiotics |
1. generally to cover enteric content (Gram negative and anaerobes) 2. first generation cephalosporin or ciprofloxacin/ metronidazole |
|
|
laparoscopic appendectomy |
noi soi cat ruot thua |
|
|
passing gas |
dit |
|
|
keep in mind |
ghi nho trong dau |
