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24 Cards in this Set
- Front
- Back
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What can differential diagnosis of abdominal pain be based on (name categories)?
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location
association with meals associated bleeding associated fever associated jaundice associated weight loss |
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What organs are indicated with epigastric pain?
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FOREGUT
esophagus stomach duodenum liver gallbladder pancreas |
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What organs are indicated with umbilical pain?
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MIDGUT
jejunum ileum ascending colon transverse colon |
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What organs are indicated with hypogastric pain?
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HINDGUT
descending colon rectosigmoid |
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DDX of Epigastric Pain
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GERD
PUD – gastric ulcer, duodenal ulcer Nonulcer dyspepsia Gastroparesis Pancreatitis Pancreas Cancer |
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DDX RUQ Pain
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Biliary colic (if severe pain)
Acute cholecystitis Ascending cholangitis Hepatic abscess Hepatitis |
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DDX RLQ Pain
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Appendicitis
Crohns disease |
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DDX LUQ Pain
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Splenic rupture
Splenic abscess Pancreatitis Pancreas Cancer |
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DDX LLQ Pain
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Diverticulosis
Diverticulitis Colon Cancer Ulcerative Colitis Infectious Colitis Ischemic Colitis |
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DDX Periumbilical Pain
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Small Bowel Obstruction
Small Bowel Infarction |
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DDX Rectal Pain
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Ulcerative Colitis
Stercoral Ulcer Anal fissure Thrombosed hemorrhoid |
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DDX for Poorly Localized Abdominal Pain
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Irritable Bowel Syndrome
Infectious gastroenteritis |
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DDX of Abdominal Pain Exacerbated by eating
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GERD
Gastric ulcer – benign or malignant Nonulcer dyspepsia Partial small bowel obstruction Biliary colic Pancreatitis Mesenteric ischemia |
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DDX of Abdominal Pain Relieved with eating
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Duodenal Ulcer
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DDX of Abdominal Pain Associated with Blood Loss
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GERD
PUD Cancer – esophageal, gastric, or colon Inflammatory bowel disease Enteroinvasive infection Ischemic gut syndrome - Ischemic colitis - Acute mesenteric ischemia |
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DDX of Abdominal Pain Associated with Fever
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Gastroenteritis
Inflammatory bowel disease Acute cholecystitis Ascending cholangitis Hepatic abscess Pancreatitis Appendicitis Diverticulitis |
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DDX of Abdominal Pain Associated with Jaundice
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Ascending cholangitis
Hepatic abscess - Amebic - Pyogenic Acute hepatitis Cholangiocarcinoma Pancreas cancer |
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DDX of Abdominal Pain Associated with Weight Loss
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Cancer
- Stomach - Pancreas - Gallbladder, bile ducts - Liver Chronic Intestinal Angina |
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Abdominal Pain with Etiology Outside the Abdomen
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myocardial infarction
pericarditis pleuritis pneumonia pulmonary infarction rectus sheath hematoma shingles kidney stones, urinary tract infection pelvic inflammatory disease, ectopic pregnancy |
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Physical Exam of Abdominal Pain
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vital signs
abdominal distention scars bowel sounds tenderness to palpation - localization - peritoneal signs masses, hernias |
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Lab Evaluation of Abdominal Pain
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CBC
LFTs amylase, lipase UA pregnancy test Troponin I, ECG |
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What is an acute abdominal series?
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Plain films of the abdomen
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When is an ULTRASOUND used in abdominal pain?
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more sensitive than CT for gallbladder stones
portable, cheap, no radiation, no IV contrast use if gallstones or acute cholecystitis is suspected use in pregnant patients |
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CT and abdominal pain
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the best comprehensive imaging of the abdomen
order CT of abdomen AND pelvis order oral contrast and IV contrast |
