peritonitis

Question 1

primary

Answer 1

spontaneous bacterial peritonitis (SBP)
transmigration of bacteria thru bowel wall
enteric gram neg bacilli most common
klebsiella, pneumococcus, enterococcus

Question 2

secondary

Answer 2

peritonitis from sx amenable source
polymicrobial
penetrating trauma
perforation dt appy, colitis, peptic ulcer, diverticulitis, pancreatitis, cholecystitis

Question 3

SBP S&S

Answer 3

fever and abd pain with change in ams dt hepatic encephalopathy

Question 4

secondary S&S

Answer 4

acute abd pain, high fever, n/v, constipation, ascites, dyspnea, tachypnea, dehydration, abd exam: distention, rebound tender, general rigidity, decreased bs, hyperresonance

Question 5

diat test

Answer 5

paracentesis: evaluate ascitic fluid
bld cultures (+) 25%
wbc elevated in secondary
bun: increase
abd xray: free air/bowel dilation
cxray: elevated diaphragm

Question 6

sbp tx

Answer 6

abx: 3rd generation cephalosporin for 10 days

Question 7

secondary tx

Answer 7

sx to eliminate source
empiric abx
monitor cultures
iv fluid
monitor vs, urinary output