Abdominal Pain and Visceral Sensation

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Which clinical findings suggest major intra-abdominal hemorrhage?

Bradycardia and bradypnea

Hypertension and hyperthermia

Hyperthermia and tachypnea

Hypotension and tachycardia (correct)

What is a common manifestation of acute salpingitis in a young woman?

High fever with upper abdominal tenderness

Extreme lethargy combined with moderate fever

Severe chills and rigors without fever

Low-grade fever with lower abdominal tenderness (correct)

Which condition is indicated by disorientation or extreme lethargy combined with very high fever (> 39°C)?

Impending septic shock (correct)

Pyelonephritis

Appendicitis

Acute cholecystitis

What is often the cause of fever with chills and rigors in elderly or immunosuppressed patients despite an acute abdomen?

Advanced peritonitis Signup and view all the answers

What should be inspected before palpation when examining the acute abdomen?

Presence of old surgical scars and stigmata of liver disease Signup and view all the answers

What type of pain is primarily mediated by afferent C fibers located in the walls of hollow viscera and in the capsules of solid organs?

Visceral pain Signup and view all the answers

What stimuli can elicit visceral pain?

Distention, inflammation, or ischemia Signup and view all the answers

How is visceral pain generally perceived?

Dull, poorly localized, and protracted Signup and view all the answers

What type of muscle contraction can produce diffuse, deep-seated visceral pain?

Smoothe muscle contraction (colic) Signup and view all the answers

Why is visceral pain most often felt in the midline?

Because different visceral structures are associated with different sensory levels on the spine Signup and view all the answers

What could cause visceral pain to be felt in the periumbilical area?

Appendicitis Signup and view all the answers

What can lead to the perception of visceral pain in the flank areas?

Colon inflammation Signup and view all the answers

What characteristic sets visceral sensation apart from cutaneous sensation?

Slow onset and poorly localized perception Signup and view all the answers

What is the main reason for early operative intervention in the case of ruptured appendicitis during pregnancy?

To minimize the risk of fetal loss Signup and view all the answers

In which trimester of pregnancy is the risk of spontaneous abortion highest during appendicitis operation?

First trimester Signup and view all the answers

Why is nonoperative management of acute appendicitis associated with a higher rate of recurrence?

It allows the appendix to remain inflamed Signup and view all the answers

What unique challenge do immunocompromised patients present in the diagnosis of appendicitis?

They are more likely to have a normal leukocyte count Signup and view all the answers

Why should an examiner be wary of a 'benign exam' in immunosuppressed patients with appendicitis?

Because they might not show signs of inflammation Signup and view all the answers

Which group of patients falls under the category of immunocompromised?

Patients with diabetes and transplant patients Signup and view all the answers

What is the main reason for treating non-ruptured appendicitis with IV antibiotics in certain scenarios?

To avoid the need for surgery Signup and view all the answers

Why may guarding and rebound tenderness not manifest in the third trimester of pregnancy?

Due to increased abdominal wall muscle laxity Signup and view all the answers

What should be weighed against the benefits of operative intervention in pregnant patients with appendicitis?

Risk of fetal loss and maternal complications Signup and view all the answers