Define and describe the changes associated with light and deep palpation to assess any degree of tenderness, i.e. rebound tenderness, guarding which would indicate a peritoneal irritation or distended viscous.
Recognize and perform the special techniques in examining the abdomen for specific findings: (1) rebound tenderness, (2) shifting dullness in ascites, (3) Fluid wave in ascites, (4) hooking technique for palpating the liver, (5) Murphy's sign for acute cholecystitis, (6) ballottement, and (7) the techniques of assessing possible appendicitis
Differential Dx. of Acute Abdominal Pain (Understand the anatomic correlation of abdominal pain and types of abdominal pain): causes of abdominal pain by quadrants, parietal pain, visceral pain and referred pain.
It has an acute onset, it can have many potential etiologies and may required immediate medical or surgical intervention, also is mostly accompany by signs of peritoneal irritation (with some exceptions) like: rigidity, tenderness (with or without rebound), involuntary guarding, also may or may not have signs of hypotension and shock.
exam abdomen (gently) looking for signs of acute abdomen.(IAPP) Identify and describe the common localized abdominal masses including umbilical hernia, incisional hernia, epigastric hernia, diastases recti, and lipoma.
Pelvic(gynecological) exam for females and rectal exam for both male and female (gross blood, asses sphincter tone, and any other evidence of trauma).
Check for blood in stools: UC, diverticular ds, diverticulitis, hemorroids
A 40 y/o female with known gallstones presents with colicky RUQ pain and vomiting. She has a h/o similar episodes that usually resolve after 3-4 hrs. VS: BP 110/60, P 78, R 16, T 98.4*F. PE: mildly tender RUQ without signs of peritonitis. Which of the following would be LEAST appropriate in her ED management?
A 28 y/o man has complaints of intermittent, colicky, periumbilical, and lower-quadrant pain for 24 hours. The patient admits to nausea and decreased appetite. He is afebrile. Which of the following is the most likely diagnosis?
A 7 y/o boy presents with c/o flank pain, fever, frequency, dysuria, and hematuria for 1 day. The UA shows >10 WBC’s per high-powered field, RBC’s, and WBC casts. Of the following, the most likely diagnosis is: