8 - abdo pain

Question 1

2 main factors modifying diagnosis of abdo pain

Answer 1

gender and age

Question 2

8 life threatening causes of abdo pain

Answer 2

1. ischemic bowel
2. AAA
3. hepatic or splenic injury
4. perf
5. acute pancreatitis
6. obstruction
7. ectopic preg
8. MI

Question 3

2 general locations of abdo pain

Answer 3

1. intra-abdo

2. extra-abdo

Question 4

3 intra-abdo causes

Answer 4

1. peritoneal inflammation
   - aseptic or bacterail
2. obstruction of hollow viscus
   - intestine or biliary tree
3. vascular disorders
   - bowel
   - AAA

Question 5

5 extra-abdo causes

Answer 5

1. abdo wall
   - usually trauma
2. pelvic
   - ectopic
   - salpingitis
   - cyst
3. intrathoracic
   - MI
   - pneumo
   - esophageal
4. metabolic
   - DKA
   - sickle cell crisis
5. neurogenic
   - pre-eruptic zoster
   - spinal disk

Question 6

locations and Dx

Answer 6

LLQ - diverticulitis
RLQ - append
RUQ - cholelitiasis, cholecycstitis
epigastric, periumbilical - pancreatitis

Question 7

Lab tests to do

Answer 7

1. CBC - look for WBCs
2. urinalysis - hematuria
3. amylase/lipase
4. bHCG
5. others

Question 8

3 uses of standard XR

Answer 8

1. air
2. foreign bodies
3. gas pattern

Question 9

uses of US

Answer 9

• AAA
• bilary tract disease
• renal
• women of childbearing age
• ascites

Question 10

uses of CT

Answer 10

• trauma
• AAA
• pancreatitis
• urolitiathis
• diverticulitis
• appendicitis

Question 11

general steps to mgmt

Answer 11

1. nothing
2. IV fluids
3. NG tube
4. analgesia
5. ABx
6. antiemetics

Question 12

mgmt of cholecystitis

Answer 12

• ALP, AST, bili, US

- ABx and anagesia

Question 13

mgmt of diverticulitis

Answer 13

• CT
• surg consult
• Abx, anal

Question 14

mgmt pancreatitis

Answer 14

• amylase, ALP, bili, AST, Ca, O2 sat
• CT
• CXR
• surg consult

Question 15

mgmt perf viscus

Answer 15

• CXR
• NG suciton
• OR

Question 16

mgmt AAA

Answer 16

• 2 large bore IV
• STAT crossmatch
  STAT surg

Question 17

3 most common causes of surgical abdo in elderly

Answer 17

1. cholecystitis
2. bowel obstuction
3. appendicitis