Podcast
Questions and Answers
Obstruction of the appendix lumen, often by a fecalith, is the primary etiology of which condition?
Obstruction of the appendix lumen, often by a fecalith, is the primary etiology of which condition?
- Cholecystitis
- Appendicitis (correct)
- Acute Pancreatitis
- Diverticulitis
What is the immediate treatment of choice for a ruptured aortic aneurysm?
What is the immediate treatment of choice for a ruptured aortic aneurysm?
- Immediate vascular surgery (correct)
- Intravenous fluids and analgesia
- Nasogastric decompression
- Administration of broad-spectrum antibiotics
Adhesions from previous surgeries are a common cause of which abdominal emergency?
Adhesions from previous surgeries are a common cause of which abdominal emergency?
- Ectopic Pregnancy Rupture
- Perforated Peptic Ulcer
- Strangulated Hernia
- Intestinal Obstruction (correct)
The eradication of Helicobacter pylori is a preventative measure against which condition?
The eradication of Helicobacter pylori is a preventative measure against which condition?
Which of the following is a shared risk factor for both acute pancreatitis and cholecystitis?
Which of the following is a shared risk factor for both acute pancreatitis and cholecystitis?
A patient presents with severe abdominal pain, fever, and rebound tenderness in the right lower quadrant. Which condition is MOST likely, considering these symptoms?
A patient presents with severe abdominal pain, fever, and rebound tenderness in the right lower quadrant. Which condition is MOST likely, considering these symptoms?
Which of the following pairs of conditions are both primarily managed, in their acute phase, with surgical intervention aimed at restoring normal anatomical structure or function?
Which of the following pairs of conditions are both primarily managed, in their acute phase, with surgical intervention aimed at restoring normal anatomical structure or function?
Consider a scenario where a patient presents with acute abdominal pain. Differentiating solely based on initial presentation, which of the following pairs of conditions would be the MOST challenging to distinguish and might require further specific diagnostic investigations to differentiate?
Consider a scenario where a patient presents with acute abdominal pain. Differentiating solely based on initial presentation, which of the following pairs of conditions would be the MOST challenging to distinguish and might require further specific diagnostic investigations to differentiate?
What is the MOST common type of thyroid cancer?
What is the MOST common type of thyroid cancer?
Which intervention is NOT part of the 'Sepsis Six' protocol?
Which intervention is NOT part of the 'Sepsis Six' protocol?
A patient presents with sudden onset confusion. Which of the following is the MOST critical initial step in management?
A patient presents with sudden onset confusion. Which of the following is the MOST critical initial step in management?
Which of the following is a known risk associated with chronic use of NSAIDs?
Which of the following is a known risk associated with chronic use of NSAIDs?
A patient is diagnosed with a goitre due to iodine deficiency. Which of the following is the MOST appropriate initial treatment?
A patient is diagnosed with a goitre due to iodine deficiency. Which of the following is the MOST appropriate initial treatment?
After a thyroidectomy, a surgeon places a drain. What is the PRIMARY purpose of this drain?
After a thyroidectomy, a surgeon places a drain. What is the PRIMARY purpose of this drain?
A patient presents with suspected sepsis. After initiating the 'Sepsis Six', which of the following lactate levels would MOST strongly suggest a poorer prognosis?
A patient presents with suspected sepsis. After initiating the 'Sepsis Six', which of the following lactate levels would MOST strongly suggest a poorer prognosis?
A patient with a history of peptic ulcer disease is prescribed a high dose of NSAIDs for chronic pain. To MOST effectively mitigate the risk of ulcer recurrence, which medication should be added?
A patient with a history of peptic ulcer disease is prescribed a high dose of NSAIDs for chronic pain. To MOST effectively mitigate the risk of ulcer recurrence, which medication should be added?
Which of the following conditions is characterized by inflammation of pouches in the colon?
Which of the following conditions is characterized by inflammation of pouches in the colon?
What is a common etiology for intestinal obstruction?
What is a common etiology for intestinal obstruction?
Which of the following is the MOST appropriate initial treatment for acute pancreatitis?
Which of the following is the MOST appropriate initial treatment for acute pancreatitis?
A patient presents with severe abdominal pain and is diagnosed with a perforated peptic ulcer. Which of the following is the MOST crucial next step in their management?
A patient presents with severe abdominal pain and is diagnosed with a perforated peptic ulcer. Which of the following is the MOST crucial next step in their management?
Which preventative measure is MOST likely to reduce the risk of cholecystitis?
Which preventative measure is MOST likely to reduce the risk of cholecystitis?
What is the likely consequence of a strangulated hernia or volvulus if left untreated?
What is the likely consequence of a strangulated hernia or volvulus if left untreated?
A patient presents with sudden, excruciating abdominal pain, dizziness, and signs of shock. Imaging reveals free fluid and gas in the abdominal cavity. Considering the acute nature and severity, which of the following conditions is the MOST likely cause?
A patient presents with sudden, excruciating abdominal pain, dizziness, and signs of shock. Imaging reveals free fluid and gas in the abdominal cavity. Considering the acute nature and severity, which of the following conditions is the MOST likely cause?
In a resource-limited setting where immediate surgical intervention for a ruptured ectopic pregnancy is not available, which of the following interventions, while not curative, might be considered as a temporizing measure to potentially stabilize the patient until definitive care can be accessed?
In a resource-limited setting where immediate surgical intervention for a ruptured ectopic pregnancy is not available, which of the following interventions, while not curative, might be considered as a temporizing measure to potentially stabilize the patient until definitive care can be accessed?
Which of the following is the PRIMARY preventative measure against goitre formation in populations with dietary iodine deficiency?
Which of the following is the PRIMARY preventative measure against goitre formation in populations with dietary iodine deficiency?
Which of the following underlying condition that is MOST directly addressed when managing acute delirium?
Which of the following underlying condition that is MOST directly addressed when managing acute delirium?
Which intervention, when delayed in the management of sepsis, has the MOST significant negative impact on patient survival?
Which intervention, when delayed in the management of sepsis, has the MOST significant negative impact on patient survival?
A patient who has undergone a thyroidectomy suddenly develops stridor and difficulty breathing. What is the MOST likely immediate cause?
A patient who has undergone a thyroidectomy suddenly develops stridor and difficulty breathing. What is the MOST likely immediate cause?
A patient with a history of heavy NSAID use presents with signs of acute peritonitis. Which imaging modality is MOST crucial for identifying a potential bowel perforation?
A patient with a history of heavy NSAID use presents with signs of acute peritonitis. Which imaging modality is MOST crucial for identifying a potential bowel perforation?
A patient is admitted with suspected sepsis. After initial fluid resuscitation and antibiotics, their blood pressure remains low. Which of the following is the MOST appropriate next step in management?
A patient is admitted with suspected sepsis. After initial fluid resuscitation and antibiotics, their blood pressure remains low. Which of the following is the MOST appropriate next step in management?
A patient with known peptic ulcer disease requires long-term NSAID therapy for chronic arthritis. Despite co-prescription of a PPI, they develop recurrent gastrointestinal bleeding. What is the MOST appropriate next step in managing this patient's ulcer prevention?
A patient with known peptic ulcer disease requires long-term NSAID therapy for chronic arthritis. Despite co-prescription of a PPI, they develop recurrent gastrointestinal bleeding. What is the MOST appropriate next step in managing this patient's ulcer prevention?
In the context of acute abdominal conditions, which of the following is the MOST likely initial management strategy for a patient presenting with a suspected perforated peptic ulcer?
In the context of acute abdominal conditions, which of the following is the MOST likely initial management strategy for a patient presenting with a suspected perforated peptic ulcer?
Which of the following conditions is LEAST likely to be directly caused by a mechanical obstruction?
Which of the following conditions is LEAST likely to be directly caused by a mechanical obstruction?
A patient presents with right upper quadrant pain, fever, and jaundice. Which of the following conditions is MOST likely?
A patient presents with right upper quadrant pain, fever, and jaundice. Which of the following conditions is MOST likely?
Which of the following is the MOST critical preventative measure to reduce the risk of a ruptured aortic aneurysm?
Which of the following is the MOST critical preventative measure to reduce the risk of a ruptured aortic aneurysm?
A patient with a history of Crohn's disease undergoes an elective bowel resection. Years later, they present with signs of intestinal obstruction. Which of the following is the MOST likely cause of this obstruction, considering their history?
A patient with a history of Crohn's disease undergoes an elective bowel resection. Years later, they present with signs of intestinal obstruction. Which of the following is the MOST likely cause of this obstruction, considering their history?
A patient with a history of well-managed Graves' disease presents with a noticeably enlarged thyroid gland but denies any new symptoms. Palpation reveals a smooth, diffuse goitre. Which of the following is the MOST appropriate initial step in management?
A patient with a history of well-managed Graves' disease presents with a noticeably enlarged thyroid gland but denies any new symptoms. Palpation reveals a smooth, diffuse goitre. Which of the following is the MOST appropriate initial step in management?
Which aetiology of delirium warrants immediate blood glucose measurement?
Which aetiology of delirium warrants immediate blood glucose measurement?
Following a complete thyroidectomy, a patient's serum calcium is found to be low despite administration of calcium gluconate. Which medication should be administered immediately?
Following a complete thyroidectomy, a patient's serum calcium is found to be low despite administration of calcium gluconate. Which medication should be administered immediately?
Which of the following findings on an erect abdominal X-ray would MOST strongly suggest a bowel perforation?
Which of the following findings on an erect abdominal X-ray would MOST strongly suggest a bowel perforation?
A patient with no prior history of thyroid disease presents with a rapidly enlarging, painful goitre, accompanied by fever and elevated inflammatory markers. Palpation reveals a tender, firm thyroid gland. Fine needle aspiration is inconclusive. Which of the following conditions is the MOST likely cause?
A patient with no prior history of thyroid disease presents with a rapidly enlarging, painful goitre, accompanied by fever and elevated inflammatory markers. Palpation reveals a tender, firm thyroid gland. Fine needle aspiration is inconclusive. Which of the following conditions is the MOST likely cause?
Flashcards
Appendicitis
Appendicitis
Inflammation of the appendix, often caused by blockage leading to infection.
Cholecystitis
Cholecystitis
Inflammation of the gallbladder, commonly due to gallstones blocking the cystic duct.
Strangulated Hernia/Volvulus
Strangulated Hernia/Volvulus
Intestinal ischemia caused by a twisted (volvulus) or entrapped (hernia) bowel.
Intestinal Obstruction
Intestinal Obstruction
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Perforated Peptic Ulcer
Perforated Peptic Ulcer
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Diverticulitis
Diverticulitis
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Ruptured Aortic Aneurysm
Ruptured Aortic Aneurysm
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Ruptured Ectopic Pregnancy
Ruptured Ectopic Pregnancy
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Goitre (Thyroid Enlargement)
Goitre (Thyroid Enlargement)
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Acute Confusional State (Delirium)
Acute Confusional State (Delirium)
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Sepsis/Septicaemic Shock
Sepsis/Septicaemic Shock
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Analgesics (NSAIDs)
Analgesics (NSAIDs)
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Antibiotics
Antibiotics
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Acid Suppressants (PPIs)
Acid Suppressants (PPIs)
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IV Fluids
IV Fluids
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"Sepsis Six"
"Sepsis Six"
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Acute Pancreatitis
Acute Pancreatitis
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Thyroid Enlargement (Goitre)
Thyroid Enlargement (Goitre)
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Thyroid Cancer
Thyroid Cancer
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Steroids
Steroids
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Surgery (laparotomy/laparoscopy)
Surgery (laparotomy/laparoscopy)
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Blood Tests (FBC, LFTs, Amylase, U&E)
Blood Tests (FBC, LFTs, Amylase, U&E)
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Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG)
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Imaging (CXR, Erect Abdominal X-Ray, Ultrasound, CT)
Imaging (CXR, Erect Abdominal X-Ray, Ultrasound, CT)
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Goitre Causes
Goitre Causes
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Delirium Causes
Delirium Causes
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Thyroid Cancer Type
Thyroid Cancer Type
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Sepsis Definition
Sepsis Definition
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Laparoscopy Benefit
Laparoscopy Benefit
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Study Notes
- Acute abdomen refers to severe abdominal symptoms that require urgent diagnosis and treatment.
Appendicitis
- Inflammation of the appendix, and a common acute surgical emergency.
- Obstruction of the appendix lumen commonly causes infection and inflammation by a fecalith.
- Treatment includes antibiotics and appendicectomy.
- Not specifically preventable, but prompt treatment reduces complications such as perforation or abscess.
Cholecystitis
- Gallbladder inflammation, often due to gallstones blocking the cystic duct.
- Gallstones (cholesterol/pigment) are the primary cause, with infection being a less common factor.
- Treatment involves analgesia, antibiotics, and potentially cholecystectomy.
- Maintaining a healthy weight and diet lowers the risk of gallstone formation.
Strangulated Hernia/Volvulus
- Intestinal ischaemia results from a twisted (volvulus) or entrapped bowel (hernia).
- A loop of bowel becoming trapped or a twisted segment causes it.
- Treatment is a surgical emergency to restore blood flow.
- Early repair of hernias and prompt care for unexplained abdominal pain is recommended for prevention.
Intestinal Obstruction
- Blockage of the small or large bowel caused by adhesions, tumors, or other factors.
- Causes include post-surgery adhesions, hernias, neoplasms, or impacted stool.
- Treatment includes nasogastric decompression, IV fluids, and possibly surgery.
- Not always preventable, but avoiding unnecessary abdominal surgeries can reduce adhesions.
Perforated Peptic Ulcer
- A full-thickness ulcer leads to GI contents leaking into the peritoneum.
- Causes include H. pylori infection, NSAIDs, steroids, and smoking.
- Treatment includes surgical repair, antibiotics, and acid suppression.
- Prevention involves eradication of H. pylori, limiting NSAID use, and using protective agents like PPIs.
Diverticulitis
- Inflammation of diverticula in the colon can lead to perforation.
- Increased colonic pressure and a low-fiber diet causes it.
- Treatment includes antibiotics and possible surgery if perforation occurs.
- Prevention involves a high-fiber diet and adequate hydration.
Ruptured Aortic Aneurysm
- A bulge in the aorta bursts, leading to massive internal bleeding.
- Caused by weakness in the vessel wall, hypertension, and atherosclerosis.
- Treatment requires immediate vascular surgery.
- Prevention includes controlling blood pressure, smoking cessation, and screening for aneurysms.
Ectopic Pregnancy
- Implantation of an embryo outside the uterus can result in rupture.
- Damage or blockage in the fallopian tubes due to infection or surgery is the cause.
- Treatment involves surgical or medical intervention before rupture, with urgent surgery required if ruptured.
- Methotrexate may be used as a medical intervention.
- Prompt treatment of pelvic infections and early antenatal checks are key to prevention.
Acute Pancreatitis
- Inflammation of the pancreas that can be severe and cause back pain.
- Causes include gallstones, alcohol consumption, and hypertriglyceridemia.
- Treatment consists of IV fluids, analgesia, and addressing the underlying cause, such as removing gallstones.
- Prevention includes limiting alcohol intake and managing gallbladder disease.
Thyroid Enlargement (Goitre)
- Swelling of the thyroid gland that can be diffuse or nodular.
- Causes include iodine deficiency, autoimmune conditions like Graves’ disease, and nodules.
- Treatment depends on the cause, with thyroxine used for hypothyroidism and surgery for obstructive cases.
- Prevention includes adequate dietary iodine and early management of thyroid dysfunction.
Thyroid Cancer
- A malignant thyroid tumor, with papillary carcinoma being the most common type.
- Causes include genetic factors and radiation exposure.
- Treatment involves partial or total thyroidectomy, possible neck dissection, and radioactive iodine therapy.
- There is no absolute prevention, but early detection is critical.
Acute Confusional State (Delirium)
- Sudden onset of confusion.
- Causes include infection, metabolic imbalances such as hypoxia or hypoglycemia, stroke, and drug use or withdrawal.
- Treatment involves identifying and correcting the underlying cause, such as antibiotics for infection or glucose correction.
- Prevention includes good medical management of underlying conditions and avoiding polypharmacy.
Sepsis/Septicaemic Shock
- An overwhelming infection causes a systemic inflammatory response, organ dysfunction, and shock.
- Caused by bacterial, viral, or fungal infections with systemic spread.
- Treatment involves the "Sepsis Six": IV antibiotics, fluids, oxygen, measuring lactate, blood cultures, and monitoring urine output.
- Prevention includes early identification of infection, vaccination, and aseptic techniques.
List of Drugs/Treatments/Tests
- Analgesics (NSAIDs, etc.) provide pain relief, but chronic NSAID use can lead to peptic ulcers.
- Antibiotics treat infections like appendicitis, cholecystitis, and sepsis.
- Acid Suppressants (PPIs) reduce gastric acid, which aids in ulcer healing and prevention.
- Steroids can weaken mucosal defenses, increasing the risk of peptic ulcers, especially when combined with NSAIDs.
- IV Fluids correct dehydration and support blood pressure in cases of sepsis or obstruction.
- Surgery such as laparotomy/laparoscopy is used to diagnose and treat acute abdominal conditions like appendicectomy, cholecystectomy, and repair perforations.
- Drain Placement prevents fluid accumulation post-thyroidectomy or abscess drainage.
- Blood Tests (FBC, LFTs, Amylase, U&E) detect infection, organ dysfunction, and pancreatitis (amylase).
- Arterial Blood Gas (ABG) assesses oxygenation and acid-base status in sepsis and acute abdomen cases.
- Imaging (CXR, Erect Abdominal X-Ray, Ultrasound, CT) detects free air under the diaphragm (perforation), gallstones, obstruction, and aneurysms.
- Laparoscopy is a minimally invasive method for diagnosing and treating abdominal conditions.
- Sepsis Six involves administering oxygen, IV fluids, and IV antibiotics, along with taking blood cultures, measuring lactate, and monitoring urine output.
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Description
Overview of acute abdomen with focus on appendicitis, cholecystitis, and strangulated hernia/volvulus. Covers causes, treatments, and preventions for these conditions. It is designed for medical students.
