Acute Abdominal Pain in Emergency Medicine

Study Notes

Here is the summary of the text in detailed bullet points:

• Gynecological problems are a common cause of acute abdominal pain in women, and it's essential to consider that a woman with lower quadrant abdominal pain and tenderness may have a problem related to her ovaries, Fallopian tubes, or uterus.

• Pelvic inflammatory disease is an infection of the Fallopian tubes and surrounding tissues of the pelvis, symptoms include intense pain in the lower abdomen and a high fever.

• Ectopic pregnancies are a significant medical risk, occurring in 1-2% of all pregnancies, where the fertilized egg implants outside of the uterus, usually in the Fallopian tube, which can rupture and produce massive internal hemorrhage and acute abdominal pain.

• In the male genital tract, epididymitis and orchitis are complications of UTI, causing inflammation of the epididymis and testes, leading to pain and swelling in the scrotum.

• Priapism is a painful, tender, persistent erection that can result from diseases such as leukemia and tumors, blunt perineal trauma, a spinal cord injury, and use of certain medications.

• Benign prostatic hypertrophy is an age-related, non-malignant enlargement of the prostate gland, occurring in approximately 50% of men older than 60 years, which may be asymptomatic or lead to difficulty starting urine flow, slow weak flow, and incomplete emptying of the bladder.

• Testicular masses rarely require prehospital treatment, but may present as painful or painless, and may radiate up to the spermatic cord or be localized to a specific scrotal point.

• Testicular cancer usually presents as a painless solid lump on the testes, while testicular torsion occurs when there is a twisting of the testicle on the spermatic cord, associated with a sudden onset of scrotal pain and swelling.

• Aneurysms can occur in older people, where the wall of the aorta develops weak areas that swell and form an aneurysm, which can rupture and cause massive hemorrhage, signs of acute perianal irritation, and hemorrhagic shock.

• Hernias are protrusions of an organ or tissue through a hole or opening into a body cavity, where they don't belong, and can occur as a result of congenital defects, surgical wounds, or natural weaknesses in an area, such as the groin.

• Incarcerated hernias may become seriously compressed by the surrounding tissue, eventually compromising the blood supply, which is a serious medical emergency requiring immediate surgery.

• When assessing patients with abdominal pain, it's essential to maintain a clear and open airway, manage vomiting, and administer 100% supplemental oxygen, while also anticipating and preparing for potential complications.

• The patient history and physical examination will provide the necessary information to successfully manage the patient, and it's essential to integrate information from the primary survey and rapid secondary assessment to identify potential life threats.

• When transporting patients with acute abdominal pain, it's crucial to provide supportive care, maintain vital signs, and be prepared to assist with ventilation if needed, while also considering the possibility of ectopic pregnancy in any female of childbearing age who presents with acute abdominal pain and hypovolemic shock.

• Patients with chronic kidney disease are particularly vulnerable to life-threatening emergencies, and it's essential to support their ABCs and be alert for the possibility of hypotension or pulmonary edema.

• Renal dialysis is a life-sustaining treatment that filters and cleanses the blood of toxins, and there are two types of dialysis: peritoneal and hemodialysis.

• Patients undergoing chronic dialysis are particularly vulnerable to accidental disconnection from the machine, malfunction of the machine, or rapid shifts in fluid and electrolytes, which can lead to many complications and adverse effects.

• Sudden drops in blood pressure are not uncommon during or immediately after dialysis, and electrolyte imbalances may also develop, requiring ALS backup and aggressive management of any bleeding from the access site.

Description

This quiz assesses your knowledge of acute abdominal pain in emergency medicine, including gynecological and male genital tract problems, aneurysms, hernias, and patient care and transportation. It covers various causes and symptoms of abdominal pain, as well as life-threatening emergencies and complications. Test your understanding of acute abdominal pain and its management in emergency medical situations.