Rr-Symptoms- Abdominal Pain

Front 1

Ways to diagnosis abdominal pain

Back 1

- location
- quality
- severity
- timing/duration
- context
- modifying factors
- associated signs and symptoms

Front 2

Pain vs. Tenderness

Back 2

Pain is a symptom
Tenderness is a sign

where you have the pain and where you have the tenderness can be different

Front 3

Cholecystitis

Back 3

Epigastric pain
Can occur with aching, burn, or hynger
can be severe
can increase with smoking
can occur with nausea

Front 4

Peptic Ulcer Disease

Back 4

Epigastric pain
can occur with aching, burn, or hunger
can be mildly severe
can occur for an extended period of time
can be constant, or decrease at night
modifying factor - milk, alkylating agent
associated with nausea

Front 5

Bowel Obstruction

Back 5

Can be painful
Can be associated with nausea

Front 6

Pancreatitis

Back 6

Epigastric Pain that radiates to the back
Associated with nausea

Front 7

GERD

Back 7

Can be associated with epigastric pain, an aching, burning, or hunger pain, can be relatively severe.

Can be constant and decrease at hight
can increase with smoking
can be decreased with milk
can be associated with nausea

Front 8

IBD

Back 8

Includes Ulcerative Colitis and Crohn's Disease

Front 9

History point most specific to IBD

Back 9

Family member with MS

Front 10

Abdominal Exam Pearls

Back 10

- Epithelium = Epithelium (skin can reflect mucosa)
- Imaging/labs are very important
- Rectal & Pelvic = only direct access

Front 11

Blue Rubber Bled Nevus Syndrome

Back 11

Congenital
Most common place on feet

Front 12

Management of ruptured aneurysm

Back 12

-- diagnose with CT angiography of abdomen

STAT vascular surgery consult
Type and cross for blood
Maintain bp and urine output

Front 13

Flow of which blood vessel would be affected by a graft that is used to fix an infrarenal aneurysm

Back 13

Inferior mesenteric artery

Front 14

What is supplied by the inferior mesenteric artery?

Back 14

Descending colon

Front 15

Catastrophic causes of abdominal pain

Back 15

Sudden onset
Ill appearing
Unstable
-- ruptured abdominal aortic aneurysm
-- mesenteric ischemia
-- perforation of GI tract
--- Ulcer, small bowel, appendix
-- ruptured ectopic pregnancy

Front 16

Abdominal Aortic Aneurysm

Back 16

- Dilatation of the abdominal aorta > 3cm in diameter
- Common cause of sudden death
- Most are asymptomatic until they rupture
- High mortality rate
-- most die before getting to the hospital
- Size remains the best indicator of risk of rupture

Front 17

Survival - Abdominal Aortic Aneurysm

Back 17

No survival advantage with surgery if < 5.5 cm in diameter
- surveillance by ultrasonography is safe

Front 18

Treatment for Aortic Aneurysm

Back 18

- Open surgical repair
- Endovascular repair
--- lower morbidity and a faster rehabilitation

Front 19

Risk factors for Abdominal Aortic Aneurysm

Back 19

- Age
- Male
- Smoking
- Hypertension
- Aneurysm Diameter
- Atherosclerosis
- Genetic Factors

Front 20

Marfan Syndrome: Genetics

Back 20

- Hereditary
- Autosomal Dominant
- Defective FBN1 gene: Marfan syndrome type 1
- Defects in TGFBR2 gene = Marfan syndrome type 2

Front 21

Marfan Syndrome: CV

Back 21

CV complications are a major cause of mortality
Valvular heart disease is common
Multiple CV processes in same patient
Many pts experience a second or third aortic event

CV abn:
-- aortic root and ascending aorta dilation
-- aortic aneurysms (thoracic and abdominal)
-- aortic dissection