Enigmatic Eponyms
Palpation of the left lower quadrant causes pain in the right lower quadrant
What is Rovsing's sign
Pigmentation of the axillary skin associated with breast or gastric cancer
What is acanthosis nigricans
Classic triad for ruptured AAA
What is pain, hypotension and pulsatile abdominal mass (Note: only ~50% have the triad)
The diagnosis on this image
What is acute appendictis
A general approach to assessing abdominal pain should include asking about the type, location, frequency and duration of the pain, it's relation to eating, nausea, vomiting, change in bowel habits, as well as this… an important associated symptom that could imply infection.
What is fever? (or chills or rigor)
This is the supraclavicular node associated with malignant gastric cancer
What is Virchow's node
Bowel sounds that result from a combination of peristalsis, gas and fluid. Usually normal and inaudible.
What is borborygmi
Classic physical exam finding for acute mesenteric ischemia
What is pain out of proportion to exam (benign exam)
This diagnosis may present in an older patient with diffuse abdominal pain and syncope
What is a ruptured AAA
This is gonoccocal or chlamydia infection that has extended to include Glisson's capsule with resulting inflammation and adhesions
What is Fitz-Hugh-Curtis syndrome
Refers to air in the bowel wall, usually suggestive of ischemic bowel, but may be present as a congenital variant or in patients on chronic steroids
What is pneumatosis intestinalis
Indicator of appendicitis when abdominal pain is caused by flexion and internal rotation of the hip
What is the obturator sign
These are the classic three symptoms of an ectopic pregnancy
What are abdominal pain, amenorrhea, and vaginal bleeding
Acute pain in the shoulder from blood in the upper peritoneal cavity. When occurring in the left shoulder, it is classic for a ruptured spleen.
What is Kehr's sign
This lab based finding can be seen in a patient with acute mesenteric ischemia. It is non-specific and if elevated is a late finding.
What is lactic acidemia (or hyperlactatemia or lactic acid elevation)
The PEx findings in ovarian torsion can be non-specific and variable. It may present as a tender, unilateral mass, however, tenderness is absent (__%) of the time.
What is 30%
This has to be on the differential in an older patient with pain out of proportion to exam
What is mesenteric ischemia
Palpable by rectal examination due to metastatic tumor cells gravitating from an abdominal cancer and growing rectovesicle or retrouterine pouch
What is Blumer's shelf
Often occurs in acute pancreatitis, severe trauma or sepsis where significant resuscitation is required. Manifests as increased abdominal pressure, low urine output and organ dysfunction.
What is abdominal compartment syndrome
The six views/windows assessed in an extended FAST (Focused assessment with sonography for Trauma) exam
What are the hepatorenal recess (Morrison's pouch), the splenorenal window, the subxiphoid pericardial window, pelvic window (pouch of Douglas in women), and two anterior thoracic views
Patients with this disease will commonly present with high WBC (above 30k), recent antibiotic use and distended large bowel on abdominal x-rays (Need full name)
What is Clostridioides difficile colitis