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FinalMB Part I - Surgery > General Sugery > Flashcards

Flashcards in General Sugery Deck (15)
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1
Q

Outline the potential differential diagnoses for generalised abdominal pain? (4)

A
  • Peritonitis
  • Ruptured AAA
  • Intestinal obstruction
  • Ischaemic colitis
2
Q

Outline the potential differential diagnoses for RUQ pain? (3)

A
  • Biliary colic
  • Acute cholangitis
  • Actue cholecystitis
3
Q

Outline the potential differential diagnoses for epigastric pain? (4)

A
  • Acute gastritis
  • PUD
  • Pancreatitis
  • Ruptured AAA
4
Q

Outline the potential differential diagnoses for central abdominal pain? (4)

A
  • Ruptured AAA
  • Intestinal obstruction
  • Ischaemic colitis
  • Early stage appendicitis
5
Q

Outline the potential differential diagnoses for RIF pain? (5)

A
  • Acute appendicitis
  • Ectopic pregnancy
  • Ruptured ovarian cyst
  • Ovarian torsion
  • Meckel’s diverticulitis
6
Q

Outline the potential differential diagnoses for LIF pain? (4)

A
  • Diverticulitis
  • Ectopic pregnancy
  • Ruptured ovarian cyst
  • Ovarian torsion
7
Q

Outline the potential differential diagnoses for suprapubic pain? (4)

A
  • Lower UTI
  • Acute urinary retention
  • Pelvic inflammatory disease
  • Prostatitis
8
Q

Outline the potential differential diagnoses for loin-to-groin pain? (3)

A
  • Renal colic (kidney stones)
  • Ruptured AAA
  • Pyelonephritis
9
Q

Outline the potential differential diagnoses for testicular pain? (2)

A
  • Testicular torsion

- Epididymo-orchitis

10
Q

What are the signs of peritonitis? (5)

A
  • Guarding; tensing of abdominal muscles when palpated
  • Rigidity; involuntary persistent tightness/tensing
  • Rebound tenderness; pain worse upon rapid release of palpation pressure
  • Coughing test; coughing elicits abdominal pain
  • Percussion tenderness; pain and tenderness upon percussion
11
Q

What are the three main types of peritonitis? (3)

A
  • Localised peritonitis; caused by underlying organ inflammation (appendicitis, cholecystitis)
  • Generalised peritonitis; caused by perforation of abdominal viscus
  • Spontaneous bacterial peritonitis (SBP); associated with ascites and liver disease
12
Q

What should be done as part of the initial assessment in an unwell patient presenting with an acute abdomen?

A
Airway; patent and secure
Breathing; RR and SpO2
Circulation; HR, BP CRT, IV Access 
Disability; AVPU/GCS and Glucose
Exposure; full examination
13
Q

Outline which blood tests should be carried out with a patient presenting with an acute abdomen and why? (10)

A
  • FBC; bleeding (Hb) and infection (WCC)
  • U&Es; kidney function, contrast CT
  • LFTs; hepatobiliary cause
  • CRP; inflammation and infection
  • Amylase; pancreatitis
  • INR; synthetic function of liver
  • Serum Calcium; scoring acute pancreatitis
  • ABG; lactate (sepsis) and PaO2 for scoring acute pancreatitis
  • G&S +/- RXM; may require transfusion
  • Blood Cultures; if infection suspected
14
Q

Outline which imaging tests should be carried out with a patient presenting with an acute abdomen and why? (4)

A
  • AXR; bowel obstruction
  • Erect CXR; pneumoperitonism indicates perforation
  • Abdominal USS; gallstones, biliary duct dilatation and gynaecological pathology
  • CT Scan; AAA or other diagnosis
15
Q

Outline the initial management of a patient presenting with an acute abdomen? (10)

A
  • ABCDE
  • Alert Seniors
  • Nil by mouth
  • NG tube
  • IV Fluids
  • IV Abx
  • Analgesia
  • Investigations
  • VTE
  • Prescribe regular medication