This document provides an overview of acute abdomen including definitions, common causes, history taking, and physical examination. Key points include: acute abdomen is defined as severe abdominal pain requiring urgent surgery; common surgical causes include appendicitis, cholecystitis, and perforated ulcers; a thorough history focuses on pain characteristics and associated symptoms; physical exam involves inspection, auscultation, percussion, and localized palpation to identify areas of tenderness. Specific examination findings can suggest etiologies like appendicitis, pelvic inflammation, or hemorrhage.
writes I have a good salary, am married, and have two children. My whole life I've been drawn to prescription and have always enjoyed it. However, I have a unattached in English literature, so I've always put it as unattainable to become a doctor. Now, once again, I'm bearing in mind doing one of the post bac premed programs out there and going for it.
In this PPT presentation I try to teach many causes of Abdominal pain in various quadrants of the abdomen. Since it is individual case based teaching i concentrate only in the essential minimum an undergraduate medical student should know and you will have immersive learning experience.
writes I have a good salary, am married, and have two children. My whole life I've been drawn to prescription and have always enjoyed it. However, I have a unattached in English literature, so I've always put it as unattainable to become a doctor. Now, once again, I'm bearing in mind doing one of the post bac premed programs out there and going for it.
In this PPT presentation I try to teach many causes of Abdominal pain in various quadrants of the abdomen. Since it is individual case based teaching i concentrate only in the essential minimum an undergraduate medical student should know and you will have immersive learning experience.
Dr. Guy Nicastri, Associate Professor of Surgery and Family Medicine at the Warren Alpert School of Medicine at Brown University takes us through some of the pearls of the Acute Abdomen Examination in the Adult
Physical exam of an acute surgical abdomen. Using detailed descriptions of pain along with onset and physical exam tests including peritoneal signs and more advanced physical exam maneuvers in order to formulate a diagnosis and severity of illness.
acute abdomen conditions in radiology and their evaluation
acute pancreatitis, cholicystitis, pelvic pathology, mri evaluation , intra abdominal abcess, plain radiography evaluation of acute abdomen, vascular causes of acute abdomen, causes of acute abdomen.
Dr. Guy Nicastri, Associate Professor of Surgery and Family Medicine at the Warren Alpert School of Medicine at Brown University takes us through some of the pearls of the Acute Abdomen Examination in the Adult
Physical exam of an acute surgical abdomen. Using detailed descriptions of pain along with onset and physical exam tests including peritoneal signs and more advanced physical exam maneuvers in order to formulate a diagnosis and severity of illness.
acute abdomen conditions in radiology and their evaluation
acute pancreatitis, cholicystitis, pelvic pathology, mri evaluation , intra abdominal abcess, plain radiography evaluation of acute abdomen, vascular causes of acute abdomen, causes of acute abdomen.
An overview of acute abdomen,a medical emergency,based on information provided in Sabiston textbook of medicine 20th edition and ACS surgery 7th edition,2 of the best textbooks in surgery.
acute abdomen is a must know for every medical student and medical care practitioners,especially surgeons.
Describes the concept of a surgical abdomen, acute abdominal pain, emergency intervention and approach to management, including the controversial use of analgesic and antibiotics in emergency room.
Similar to History and examination of acute abdomen by dr fahad akhtar (20)
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
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neurochemical systems and has rewarding and addictive properties. It
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5th edition of the Diagnostic and Statistical Manual of Mental Disorders
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
3. What Is Acute Abdomen?
Synonym: Acute abdominal pain
Defination: A condition of severe abdominal pain
caused by an acute disease or injury to internal
organ(s) usually requiring emergency surgery.
OR
Previously undiagnosed pain that arises suddenly
less than 7 days (usually less than 48 hours),
needs urgent surgical intervention .
OR
Abdominal pain of a non traumatic origin with
maximum duration of 5 days.
4. Common Causes:
SURGICAL:
1) Inflammation/Infection ( Acute appendicitis,
acute cholecystitis, acute pancreatitis, meckels
diverticulitis, acute diverticulitis, acute
cholangitis, urinary tract infection)
2) Obstruction ( Intestinal obstruction, biliary colic,
ureteric colic, acute retention of urine)
3) Ischemia ( Mesenteric ischemia, torsion of a
viscus)
4) Perforation ( Perforated peptic ulcer, perforated
appendix, toxic mega colon with perforaton, gall
bladder perforation, ruptured abdominal aortic
aneurysm)
7. HISTORY:
1) PARTICULARS : Age, gender, marital status,
occupation, address .
2) PRESENTING COMPLAINTS: Symptoms
which made patient to come to doctor, for
example: abdominal pain.
3) HISTORY OF PRESENTING ILLNESS:
Describe the presenting complaints in detail one
by one.
8. PAIN CHARACTERISTICS:
Site – Where is the pain? Or the maximal site of
the pain.
Onset – When did the pain start, and was it
sudden or gradual? Include also whether it is
progressive or regressive.
Character – What is the pain like? An ache?
Stabbing?
Radiation – Does the pain radiate anywhere?
Associations – Any other signs
or symptoms associated with the pain?
Time course – Does the pain follow any pattern?
Exacerbating/relieving factors – Does anything
change the pain?
12. Other Symptoms Associated With
Abdominal Pain
Constipation: Suggests mechanical bowel
obstruction
Diarrhea: Suggests pelvic abscess, blood stained
suggests ischemic colitis, IBD
Fever: Marker of inflammation
Hematochezia or malena: Lower GI bleed or
colonic ischemia
Hematuria: Cystitis, ureteric colic
13. Past Medical History
Ask about: Diabetes mellitus, hypertension, IHD,
tuberculosis, hepatitis, blood transfusion
Past Surgical History
Ask about: Previous abdominal surgery, mode of
operation (laparoscopic or open), operative notes
and pathology reports should be obtained and
reviewed
14. Medication History
Ask about: NSAIDS, anticoagulants, antiplatelets,
OCPs, corticosteroids, chemotherapeutics or
immunosuppresents
Family History: Often provides the best
information about medical causes of acute
abdomen
Gynecological History:
Ask about: Menstruation history is crutial to
diagnosis of ectopic pregnancy, mittelschmerz,
endometriosis, History of vaginal discharge or
dysmenorrhea to rule out pelvic inflammatory
15. Personal And Social History
Ask about: Any habit or addiction, dietary details,
sleep disturbance, patient economic status, home
surroundings
Occupational History
Ask about: Exact nature of job, details of job in
past, exposure to chemicals or radiations
Travel History
May raise the posibility of amebic liver abscess,
hydatid cyst, tuberculosis, dysentery
16. EXAMINATION
Three types of abdominal pain (visceral, parietal,
referred)
1) Visceral pain: Due to stretching of fibers
innervating the walls of hollow or solid organs,
occurs early and poorly localized, can be due to
early ischemia or inflammation
2) Parietal pain: Caused by irritation of parietal
peritoneum fibers, occurs late and better
localized, can be localized to a dermatome
superficial to site of painful stimulus
3) Referred pain: Pain is felt at site away from
pathological organ, pain is usually ipsilateral to
17. Abdominal Exam
Although we will focus on abdominal exam, but a
thorough physical exam (head to toes) is very
important in arriving at comprehensive differential
diagnosis list.
Examples:
Presence of jaundice may indicate biliary or
hepatic etiology
Irregularly irregular heart rate atrial fibrillation:
mesenteric ischemia
Skin lesions (pyoderma gangrenosum): IBD
18. ABDOMINAL EXAM
The exam should be performed in this specific
order:
1) General appearance
2) Vital signs
3) Inspection
4) Auscultation
5) Percussion
6) Palpation
It should include: examination of inguinal area (
including external genitalia in males), Rectal
exam, Pelvic exam in females.
19. GENERAL APPEARANCE
Pallor – Malabsorption, acute or chronic blood
loss
Icterus – Heaptobiliary disease
Cyanosis – Cirrhosis with portal HTN
Clubbing – Ulcerative colitis, crohn’s diease
Lymphadenopathy – Localized or generalized
20. Continued
Inflammation, peritonitis ( lies perfectly still or in
bed with thighs and knees flexed)
Obstruction/Colic ( restless, writhing, abdominal
distension)
Shock ( pallor, cyanosis, diaphoresis, decreased
mental status)
21. VITAL SIGNS
Tachycardia (early shock)
Rapid shallow breathing (peritonitis)
Hypotension (may be a late finding, infectious
etiology or perforation)
22. INSPECTION
Abdominal contour : Distended vs scaphoid,
irregular (mass, volvulus, obstruction, hernias)
Skin : Ecchymossis around umblicus, flanks (
pancreatitis, trauma)
Scars
Prominent veins on the abdominal wall (portal
hypertension)
23. AUSCULTATION
Bowel sounds
Auscultate all regions
Listen in each region
Listen before feeling
Absent bowl sounds (ileus, peritonitis, shock)
Hyperactive (enteritis, obstruction)
Bruits ( AAA, reno-vascular disease)
24. PERCUSSION
Hyperresonance : Bowel distension with air
(obstruction)
loss of liver dullness in RUQ (liver dullness) - free
air
• Fluid thrill and shifting dullness: Ascites
25. PALPATION
Palpate each region
Warm hands
Communicate with patient (let the patient know
what you are about to do)
Place patient supine
Note tenderness (localize vs diffuse)
Rebound tenderness (press on abdomen and
release, positive if pain is worse upon release
Involuntary and voluntary guarding (distract the
patient)
Rigidity
Feel for masses
26. Findings that suggest specific
etiology
Courvoisier sign (palpable gall bladder in
presence of painless jaundice – periampullary
tumor)
Caput medusa (varicose veins at umblicus –
cirrhosis with portal HTN)
Murphy’s sign (pain during inspiration while
palpating RUQ – acute cholecystitis)
Ransohoff sign (periumblical yellow discoloration
– ruptured CBD)
27. Hemoperitoneum
Hemorrhagic pancreatitis (cullen sign –
periumblical bruising, grey turner sign –
disoloration around flanks )
Danforth sign (shoulder pain on inspiration)
Kehr’s sign (left shoulder pain when supine or
pressure applied to LUQ – splenic rupture
28. Appendicitis
Rovsing sign (palpation on LLQ produces pain at RIF)
Ten horn test (pain caused by gentle traction of right
testicle)
Aaorn sign (persistent pressure applied at
McBurney’s point causes pressure in epigastrium and
upper chest wall)
PELVIC INFLAMMATION/ABSCESS
Illiopsoas sign (allow patient to lie on opposite side of
pain, extend the thigh on affected side, this cause
pain if there is irritation of iliopsoas muscle)
Obturator sign (flexion and internal rotation of right
thigh produces hypogastric pain)
Chandelier sign (extreme lower abd/pelvic pain with
29. Inguinal examination
Palpate inguinal area with and without valsalva
maneuver
Pay attention to femoral area to rule out femoral
hernia
In males testis should be examined to rule out
testicular torsion
NEVER MISS DRE (digital rectal examination )
AND PELVIC EXAMINATION.