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28 Cards in this Set
- Front
- Back
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Testicular torsion |
Testicular torsion is a urological emergency in which the goal is to save the affected testis. |
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Testicular torsion presentation |
severe, acute onset of hemi scrotal pain, N/V |
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Physical exam for testicular torsion |
enlarged tender testis scrotal edema absence of cremasteric muscle reflex |
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Prompt intervention of testicular torsion includes? |
emergents urology consult diagnosis made by clinical suspicion prompt surgical exploration and detorsion |
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Acute presentation of acute appendicitis? |
atypical in 1/3 of cases |
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Diagnosis of appendicitis in children? |
history physical |
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PID diagnosis? |
cervical motion tenderness abdo pain
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Lab tests in PID |
culture for bacteria molecular diagnostic tests (NAAT) on urine or cervical discharge for chlamydia and N ghonorrhea |
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Complications of PID? |
infertility sepsis tubo ovarian abscess other intra abdo abscesses |
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To do a rectal exam if child might have appendicitis? |
Yes If there is an abdominal complaint (atypical diarrhea, constipation, pain, bleeding, etc.)As part of an in-depth neurological examination. |
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Ddx of abdo pain and vomiting |
Mesenteric adenitis Ovarian torsion Pneumonia |
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Appendicitis |
Always consider in a child or adolescent with acute abdominal pain.Classic pattern (60% of the time) is periumbilical pain followed by generalized RLQabdominal pain.Vomiting is very common; |
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Cholecystitis |
Pain, most often in the RUQ, is steady, and may radiate to the shoulder.Pain is usually constant and worse after eating, especially fatty foods. |
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Ectopic pregnancy |
Ectopic pregnancy classically presents with lower abdominal pain, vaginal bleeding, andabnormal menstrual history.Fever and diffuse abdominal pain are uncommonA history of vomiting without diarrhea suggests extra-intestinal pathology. |
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Who to suspect ectopic in? |
Strongly consider in any sexually active female patient with abdominal pain (it is an emergency). |
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Hepatitis |
Usually presents with fever, malaise, diffuse or RUQ abdominal pain, nausea, and vomitingwithout diarrhea.Patients will often comment on jaundice and a change in the color of their urine.Onset of symptoms depends on the etiology of the hepatitis |
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Pancreatitis |
May present with diffuse abdominal pain, but other patterns (such as epigastric or RUQ) aremore common; band-like pain radiating to the back is highly suggestive.Pain is constant and usually severe.Nausea and vomiting are almost always present |
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Hepatitis |
h abdominal pain in almost all cases, more typically in the lowerabdomen; RUQ pain can occur with perihepatitis-Fitz-Hugh-Curtis syndrome-an occasionalcomplication (5% of cases) of PID caused by N. gonorrhoeae or C. trachomatis (this pain isof sudden onset and may refer to the right shoulder).Vomiting is seen in some but not all cases of PID. |
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UTI |
dysuria, frequency, and urgency.Poorly localized abdominal pain occasionally occurs with a UTI; fever or back painsuggests pyelonephritis. |
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Acute gastro |
vomiting diarrhea sick contacts |
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PE findings appendicitis |
Tenderness over McBurney's point is commonly seen in adults, but less frequently found inchildren. |
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Cholecystitis PE |
RUQ tenderness is usually seen with cholecystitis.Murphy's sign ( |
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Ectopic preg PE |
Physical examination may be completely normal in an early, unruptured ectopic pregnancyMore rarely, diffuse abdominal tenderness, adnexal or cervical motion tenderness may alsobe seen.Mild enlargement of the uterus may be present
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Hepatitis PE |
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Pancreatitis |
low grade fevers diffuse abdo tenderness or pain |
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PID |
fever diffuse abdo pain pain localized to RUQ cervical motion tenderness purulent discharge |
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UTI |
CVA tenderness |
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When to hospitalize patient with PID? |
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