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43 Cards in this Set
- Front
- Back
Right shoulder pain could be |
Perf Duodenal ulcer |
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Left shoulder pain could be |
Ruptured spleen |
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Right back pain could be |
Biliary colic |
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Right posterior abdominal pain could be |
Pancreatitis or renal colic |
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Low back pain could be |
Uterine or rectal pain |
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Severe sudden persistent abd or back pain, may spread to groin/butt/legs, syncopal, clammy, N/V, tachycardia, shock |
AAA rupture |
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Nausea, pain in jaw/neck/back/arm/shoulder, SOB, lightheaded, tired |
Myocardial infarction |
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Pelvic/shoulder pain, vaginally bleeding, lightheaded |
Ectopic pregnancy |
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Severe craving abdominal pain, vomiting, abdominal distention, gassy, constipation |
Intestinal obstruction |
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Sudden severe abd pain starts mid/upper abd pain then generalizes, tenesmus, fever, N/V |
Mesenteric ischemia |
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Dull navel pain progressing to sharp RLQ pain, lower back pain, fever, vomiting, diarrhea or constipation, loss of appetite |
Appendicitis |
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Severe upper abdominal pain spreads to back or shoulder wakes up at night or when stomach empty, dyspepsia, bloated, fullness, N/V, bloody or bla k stool, CP, fatigue, weight loss, heartburn |
Perforated peptic ulcer |
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LUQ pain, left shoulder pain, confusion, dizzy, shock, nausea |
Ruptured spleen |
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List abdominal symptom red flags |
Sudden severe onset, radiation, awakens, change in location, syncope, vomiting, hematemesis, distention, decreased UOP, fever, pain worse with movement |
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Symptoms of hepatic rupture |
Pain may have been going on for weeks before rupture, hepatomegaly, RUQ tenderness, abd distention, peritoneal signs, shock |
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Type of pain? Poorly localized and characterized |
Visceral |
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Type of pain occurs with irritation of parietal peritoneum, intense, localized, constant |
Somatic |
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Type of pain: felt remotely due to peripheral affluent nerve fibers that enter spinal cord that also carry fibers from other locations |
Referred |
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DDX RUQ PAIN (name 9) |
Biliary colic, acute cholecystitis, cholangitis, acute hepatitis, liver abscess, hepatic congestion due to CHF, perforated Duodenal ulcer, RLL PNA, PE |
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T/F You should normally be able to see the small bowel on a plain film. When you see the abnormal of it on the plain film, it can mean.... |
False, should not be able to see. If you do see, it could mean obstruction. |
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CT AP for abdominal or pelvic pain, with or without contrast? Oral or IV? |
With contrast. Oral for bowel, GI tract, appendix; perforation? Leakage? Large appendix? IV contrast shows blood flow or ischemia. |
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Ruptured spleen, lacerated liver best test? |
CTAP |
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This is a Good test for pregnancy, cyst, stone, hydronephrosis, aorta, hepatic and biliary disease. |
Ultrasound |
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A HIDA or DISIDA helps to visualize |
Emptying and filling of gall, bladder and extra hepatic billiary tree. |
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XR abdomen is good to see |
Obstruction, stones, pneumoperitoneum, foreign body, need fir further testing. |
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CT AP helps to see |
Vasculature, infection or abscess formation, inflammation, bleeding, mass, ischemia, perforation, dilation. |
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ERCP is an MRI with endoscopy and is a good test for |
Pancreatic or bile duct problems, can also have stent placed, sphincterotomy, or stone removal |
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What is the difference between an MRCP and an ERCP? |
MRCP Shows the same things, but a procedure cannot be done during it.And sedation is not used. |
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What is a HIDA scan used for? |
It uses a radioactive tracer to see the bile duct, gallbladder, liver, and small intestine. it might be used as a test to detect a problem, an ERCP can treat. Or might be used after an MRCP to confirm a problem. |
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An MRI for abdominal pain cN be used for |
a follow up test. AAA, choley, pancreatitis, hepatic d/o, appendicitis, masses/ tumor |
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With a pregnant woman with abdominal pain, keep these in your differential because they are higher risk for |
Thrombus, MI, aortic dissection |
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Most common cause of acute abdominal pain in infants? |
Appendicitis |
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Which are sx of acute or probable surgical causes of abd pain in infants? Fever, _____ vomit, _____ diarrhea, _____ bowel sounds, voluntary ______, rigidity, _______ tenderness. |
Fever, bilious vomit, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, rebound tenderness. |
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Baby boys with abdominal pain, must check for this list random cause |
Hair tourniquet of testes |
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Common causes of abdominal pain in school age children |
Resp infections, gastroenteritis, colitis, UTI, PID, pregnancy, ovarian cyst or torsion, or abuse |
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What is carnetts sign |
Pain when tensing abdominal muscles. While palpating, have pt either raise head or both legs with straight knees. If pain is worse, it's likely abdominal wall in origin. (Skin or musculoskeletal). |
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You find a small bowel obstruction. What could cause it? |
Adhesions, hernias, inflammatory bowel disease. |
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You find a large bowel obstruction. What could cause it? |
Carcinoma, volvulus, diverticulitis, inflammatory bowel disease. |
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Sx of obstruction |
Vomiting, hiccups, obstination and failure to pass gas, Abdominal distention, increased bowel sounds. |
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Your patient has a bowel obstruction and is having vomiting with bile and mucus period where do you think the location of the obstruction is? |
High in the intestines |
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Your patient has a bowel obstruction and is having feculent vomiting. where do you think the location of the obstruction is? |
Low in the intestines |
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Tests for obstruction |
CBC (infection or abscess), LFT (ro gallbladder), BMP, lipase for pancreatitis. XR with air fluid level, ladder appearance. CT AP with oral and IV contrast. |
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Tx for obstruction |
NF if vomiting, IV crystalloid, correct electrolytes, ATB, surgical consult |