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24 Cards in this Set
- Front
- Back
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**MCC of LLQ acute abd?
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sigmoid colon
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**MCC of suprapubic acute abd?
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distended bladder
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LUQ
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**stomach
**spleen (infarction) GIT (diverticula) pancreas (pancreatitis) LLL of lung (PNA) |
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epigastrium
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**stomach (PUD, gastritis, carcinoma)
**pancreas (pancreatitis) heart (MI) gallbladder esophagus (hernia, GERD) |
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RUQ
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**gallbladder (cholic/cholycystitis/ dyskinesia)
**liver (abscess, hepatitis) appendix (unusualy position) kidney (acute pyelonephritis) RLL of lung (PNA) |
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LLQ
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sigmoid colon (stricture)
colon (diverticula) testicles/ovaries |
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central
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small bowel (ischemia, IBD)
appendix (early appendicitis) **abd aorta (AAA) |
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suprapubic
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**bladder
appendix **sigmoid colon (diverticula) |
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RLQ
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appendix (appendicitis)
**colon (IBD) mesentary (adenitis) kidneys (renal colic/infxn) testicles/ovaries (torision,cysts) herniations |
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what are types of emergencies encountered w/ an acute abd?
when are they treated? |
- AAAs, perforations, ischemic bowel, hemorrhage
- tx'd first |
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what are some types of labs/work ups ordered by the ER?
what do they help distinguish? |
**lactic acid levels: r/o ischemic bowels (ischemia inc lactic acid)
**plain films: r/o pneumoperitoneum (free air in belly) - CT: r/o//dx: PUD, bowel perforations, AAA, gallbladder obstructions, appendicitis |
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what should women always be screened for?
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pregnancy
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AAA
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- >3cm dilatation of aorta
- infrarenal (easy to tx), asymptomatic, occur in older men |
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what are the criteria that call for surgical resections or minor surgical procedures w/ AAAs?***
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- increase in size >5cm
+ - onset of pain, hypotension, anemia, pulsatile abd mass |
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pneumoperitoneum
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- air in peritoneum
- caused by: --perforated peptic ulcer, colon, SI, appendix (less common) |
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how is pneumoperitoneum tx'd?
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- laparotomy plus closure of appropriate organ
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abd hemorrhage
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- caused by bleed from mesentery, some solid organ (liver/spleen), portal HTN, ruptured ovarian cysts/ectopic pregs
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tx of abd hemorrhage
what if caused by ectopic prego |
closure
- salpingectomy (sx removal of Fallopian tube) |
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mesenteric ischemia caused by:
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- dec blood supply
- hematological causes like: --venous occlusion --thrombosis --hypotension |
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what are symptoms of mesenteric ischemia?
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**disproportionally intense abd p
- inc wbc count - acidosis - dec blood pressure |
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what is mesenteric ischemia a/w?
what population does this occur in? |
- arrhythmias (a-fib)
- vascular ds - older pts w/ vasc/heart ds and DM |
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what type of imaging may be helpful w/ mesenteric ischemia?
- tx? |
- CT
- laparotomy plus tx of underlying cause |
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**pelvic inflammatory ds w/ significant infarction results in?
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- Fitz-Hugh-Curtis syndrome
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**definition of pelvic inflamm ds
- acute cases involve? |
- pelvic infxn w/ involvement of RUQ
- peritoneum |