Term
| What are the three types of abdominal pain? |
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Definition
-Visceral (distention or stretching of hollow organs. Pain- steady, vague, excruciating, colicky)
-Parietal (somatic): ischemia, inflammation, stretching. Pain- sharp, knifelike, constant, cough and mvmt make it worse
-Referred: pain distant from organ involved |
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Term
| Any female that presents with abd pain should have what two exams? How about for males? |
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Definition
pelvic and rectal
testicular and rectal |
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Term
| Need to rule out GI bleed when there is abd pain- what does coffee ground emesis indicate? |
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Definition
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Term
| What always needs to be ruled out if there is referred pain? |
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Definition
| cardiac issues, do this with an EKG |
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Term
| What is the gold standard imaging study for gallbladder issues? |
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Definition
US
also use it for hydronephrosis and suspected pregnancy |
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Term
| when should contrast never be ordered? |
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Definition
| if there is suspicion of a bleed |
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Term
| How long should all abd pain remain NPO in the ED? |
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Definition
| until you are comfortably sure it is not a surgical abdomen |
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Term
| DDx for abd pain in the elderly? |
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Definition
AAA
mesenteric ischemia (pain out of proportion to PE)
MI |
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Term
| DDX for abd pain in pediatrics? |
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Definition
ruptured appendix
intussusception
volvulus
pyloric stenosis |
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Term
| DDX for abd pain in immunocompromised |
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Definition
enterocolitis
large bowel perf
obstruction
pancreatitis |
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Term
| Whats a good med to give to stop nagging cramping pain in the ED (but it won't stop diarrhea)? |
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Definition
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Term
| Hematememsis- differentiate between blood from esophagus and that from stomach |
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Definition
-esophagus: bright red
-stomach: coffee ground emesis from sitting in the stomach acid |
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Term
| Differentiate blood in the stool |
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Definition
-Melena: dark or black tarry stools
-Hematochezia: passing of maroon or dark red stools
-BRBPR is generally from the descending colon, rectosigmoid, or rectum |
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Term
| What is Cullen's Sign? Grey Turner's? |
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Definition
Cullens- bluish discoloration around the umbilicus sometimes associated with inter peritoneal hemorrhage, especially after rupture of the uterine tube in ectopic pregnancy
Grey Turners= similar discoloration occurs in the flank area in acute hemorrhagic pancreatitis |
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