GI- BUTTARO QUESTIONS AND
CORRECT ANSWERS
GI 4rRED 4rFLAGS 4r- 4rANS--AAA
Obstruction
Ruptured 4rspleen
Ruptured 4rectopic 4rpregnancy
Visceral 4rperforation 4r& 4rperitonitis
Ischemic 4rbowel
Testicular/ovarian 4rtorsion
Visceral 4rpain 4r- 4rANS--is 4rpoorly 4rlocalized 4r- 4rinvolves 4rhollow 4rorgans 4r(eg. 4rearly
4rappendicitis)
Parietal 4rpain 4r- 4rANS--is 4rwell 4rlocalized 4r- 4rinvolves 4rabd 4rwall 4r(eg. 4rlate
4rappendicitis/peritonitis)
Less 4rimpressive 4rsx 4rin 4relderly 4r- 4rdon't 4rbe 4rfooled
Abdominal 4rPEARLS 4r- 4rANS--Should 4rdo 4rrectal 4r& 4rpelvic 4rfor 4rfull 4rassessment
Female 4rof 4rreproductive 4rage 4r- 4rR/O 4rectopic
Note 4rprevious 4rabd 4rsurgeries 4r- 4rmay 4rsuggest 4rbowel 4robstruction
Don't 4rforget 4rthe 4rcardiac, 4rpulmonary, 4rrenal, 4rrectal, 4r& 4rpelvic 4rareas
Constipation 4rpreceding 4rabd 4rpain 4r= 4rcolon/rectal 4rproblem
Diarrhea 4ris 4rassociated 4rw 4rinfectious 4rGE, 4rIBD, 4rdiverticulitis 4r& 4rearly 4rintestinal
4robstruction
Vomiting 4rw 4ronset 4rof 4rpain 4rsuggests 4rperitoneal 4rirritation 4ror 4rperforation 4rof
4rviscus
Pain 4rrelieved 4rby 4rvomiting 4rsuggests 4rinfectious 4rGE, 4rbiliary 4rcolic, 4ror 4rpancreatic
4rdisease
High 4rfever, 4r> 4r102 4rw 4raccompanying 4rlethargy 4r& 4rchills 4rmay 4rsignal 4rimpending
4rseptic 4rshock 4ror 4radvanced 4rperitonitis
McBurney's 4rpoint 4r- 4rANS--
Appendicitis 4rpresentation 4r- 4rANS--Common 4rcause 4rof 4racute 4rabd 4rpain
Most 4rcases 4rbefore 4rage 4r30
Presentation
, * 4rPain 4rincreasing 4rin 4rintensity 4rover 4r24-48 4rhour 4rperiod; 4rlocalizing 4r- 4rinitially
4rvague, 4rperiumbilical; 4rlater 4r- 4rspecific 4rRLQ 4r- 4rMcBurney's 4rpoint; 4rrebound
* 4rA/N/V, 4rconstipation
* 4rLow-grade 4rfever, 4rleukocytosis
Pearls
Pain 4rfirst; 4rthen 4rvomiting
Sx 4r> 4r72 4rhr 4rusually 4rnot 4rappendicitis
No 4ranorexia; 4rT 4r> 4r102 4ror 4r< 4r99.5 4rless 4rlikely 4rto 4rbe 4rappendicitis
Abd 4rpain 4rw/o 4rother 4rsx 4ris 4rrarely 4ra 4rserious 4rproblem
appendicitis 4rDX 4r- 4rANS--CBC; 4rCT 4rw 4rcontrast 4r(93-98% 4raccuracy)
UA, 4rhcg, 4r
Surgical 4rreferral
common 4rcauses 4rof 4rvomiting 4r- 4rANS--GI
CNS
Drug 4rSE
Metabolic/endocrine
Cardiac
Other
Diarrhea 4r- 4rdefinitions 4r- 4rANS--> 4r3 4rstools/day
> 4r200 4rgm/day
Acute: 4r<14 4rdays 4r
Persistent: 4r15-30 4rdays
Chronic: 4r> 4r30 4rdays
Osmotic 4rdiarrhea 4r- 4rANS--Non-absorbable 4rsolute 4rdraws 4rwater 4rinto 4rintestine
Up 4rto 4r1 4rliter/day
Secretory 4rdiarrhea 4r- 4rANS--Most 4rcommon
Disruption 4rof 4repithelial 4rcells 4rcauses 4rleakage 4r- 4rnutrient 4r& 4relectrolyte-rich 4rfluid
Large 4rvolume
Diarrhea 4rred 4rflags 4r- 4rANS--Fever
Abdominal 4rpain
Dehydration
Bloody 4rstools
Gastroenteritis 4r- 4rANS--Sudden 4ronset 4rof 4rvomiting 4r& 4rdiarrhea
Causes
50-70% 4rviral
Norovirus, 4rrotovirus, 4radneovirus...
CORRECT ANSWERS
GI 4rRED 4rFLAGS 4r- 4rANS--AAA
Obstruction
Ruptured 4rspleen
Ruptured 4rectopic 4rpregnancy
Visceral 4rperforation 4r& 4rperitonitis
Ischemic 4rbowel
Testicular/ovarian 4rtorsion
Visceral 4rpain 4r- 4rANS--is 4rpoorly 4rlocalized 4r- 4rinvolves 4rhollow 4rorgans 4r(eg. 4rearly
4rappendicitis)
Parietal 4rpain 4r- 4rANS--is 4rwell 4rlocalized 4r- 4rinvolves 4rabd 4rwall 4r(eg. 4rlate
4rappendicitis/peritonitis)
Less 4rimpressive 4rsx 4rin 4relderly 4r- 4rdon't 4rbe 4rfooled
Abdominal 4rPEARLS 4r- 4rANS--Should 4rdo 4rrectal 4r& 4rpelvic 4rfor 4rfull 4rassessment
Female 4rof 4rreproductive 4rage 4r- 4rR/O 4rectopic
Note 4rprevious 4rabd 4rsurgeries 4r- 4rmay 4rsuggest 4rbowel 4robstruction
Don't 4rforget 4rthe 4rcardiac, 4rpulmonary, 4rrenal, 4rrectal, 4r& 4rpelvic 4rareas
Constipation 4rpreceding 4rabd 4rpain 4r= 4rcolon/rectal 4rproblem
Diarrhea 4ris 4rassociated 4rw 4rinfectious 4rGE, 4rIBD, 4rdiverticulitis 4r& 4rearly 4rintestinal
4robstruction
Vomiting 4rw 4ronset 4rof 4rpain 4rsuggests 4rperitoneal 4rirritation 4ror 4rperforation 4rof
4rviscus
Pain 4rrelieved 4rby 4rvomiting 4rsuggests 4rinfectious 4rGE, 4rbiliary 4rcolic, 4ror 4rpancreatic
4rdisease
High 4rfever, 4r> 4r102 4rw 4raccompanying 4rlethargy 4r& 4rchills 4rmay 4rsignal 4rimpending
4rseptic 4rshock 4ror 4radvanced 4rperitonitis
McBurney's 4rpoint 4r- 4rANS--
Appendicitis 4rpresentation 4r- 4rANS--Common 4rcause 4rof 4racute 4rabd 4rpain
Most 4rcases 4rbefore 4rage 4r30
Presentation
, * 4rPain 4rincreasing 4rin 4rintensity 4rover 4r24-48 4rhour 4rperiod; 4rlocalizing 4r- 4rinitially
4rvague, 4rperiumbilical; 4rlater 4r- 4rspecific 4rRLQ 4r- 4rMcBurney's 4rpoint; 4rrebound
* 4rA/N/V, 4rconstipation
* 4rLow-grade 4rfever, 4rleukocytosis
Pearls
Pain 4rfirst; 4rthen 4rvomiting
Sx 4r> 4r72 4rhr 4rusually 4rnot 4rappendicitis
No 4ranorexia; 4rT 4r> 4r102 4ror 4r< 4r99.5 4rless 4rlikely 4rto 4rbe 4rappendicitis
Abd 4rpain 4rw/o 4rother 4rsx 4ris 4rrarely 4ra 4rserious 4rproblem
appendicitis 4rDX 4r- 4rANS--CBC; 4rCT 4rw 4rcontrast 4r(93-98% 4raccuracy)
UA, 4rhcg, 4r
Surgical 4rreferral
common 4rcauses 4rof 4rvomiting 4r- 4rANS--GI
CNS
Drug 4rSE
Metabolic/endocrine
Cardiac
Other
Diarrhea 4r- 4rdefinitions 4r- 4rANS--> 4r3 4rstools/day
> 4r200 4rgm/day
Acute: 4r<14 4rdays 4r
Persistent: 4r15-30 4rdays
Chronic: 4r> 4r30 4rdays
Osmotic 4rdiarrhea 4r- 4rANS--Non-absorbable 4rsolute 4rdraws 4rwater 4rinto 4rintestine
Up 4rto 4r1 4rliter/day
Secretory 4rdiarrhea 4r- 4rANS--Most 4rcommon
Disruption 4rof 4repithelial 4rcells 4rcauses 4rleakage 4r- 4rnutrient 4r& 4relectrolyte-rich 4rfluid
Large 4rvolume
Diarrhea 4rred 4rflags 4r- 4rANS--Fever
Abdominal 4rpain
Dehydration
Bloody 4rstools
Gastroenteritis 4r- 4rANS--Sudden 4ronset 4rof 4rvomiting 4r& 4rdiarrhea
Causes
50-70% 4rviral
Norovirus, 4rrotovirus, 4radneovirus...
