Abdominal Pain

Desmoid

100

Two most common locations of intra-abdominal desmoid tumors

small bowel mesentery; retroperitoneum

200

What over the counter drug can be used in treatment of desmoid tumors?

NSAIDs

300

This layer in the abdominal wall is the expected location of a desmoid tumor

musculoaponeurotic layer

400

What genetic syndrome outside of FAP is associated with development of desmoid tumors

Gardner syndrome

500

In FAP-associated desmoid tumors what gene is affected and what leads to development?

APC; inactivation and accumulation of beta-catenin in cells

PP

100

What are two common presenting symptoms of pseudomyxoma peritonei?

Abdominal bloating, nonspecific abdominal pain, symptoms of obstruction

200

The peritoneal cancer index (PCI) is a score based on this?

lesion size:

0: no tumor 1: <0.5cm 2: 0.5-5cm 3: >5cm

Location within abdomen

13 locations

300

In pseudomyxoma peritonei, voluminous mucinous ascites shares a namename with this candy

jelly belly

400

A mollusk-like imaging finding of the liver seen in pseudomyxoma peritonei (PMP)

scalloping

500

This histologic subtype of appendiceal neoplasm is particularly associated with mucinous peritoneal dissemination and pseudomyxoma peritonei.

LAMN

Abd Pain 1

100

Name a surgical colloquialism for benign abdominal pain that doesn't merit continued hospital admission

tum tum ouchies

200

A patient with sudden, sever epigastric pain has free air under the diaphragm. This is the most likely diagnosis

perforated ulcer

300

This physical exam finding describes pain in the right lower quadrant when palpating the left lower quadrant.

Rosving

400

This metastatic umbilical nodule, often presenting as a firm, painless mass, is classically associated with advanced intra-abdominal or pelvic malignancy.

Sister Mary Joseph Nodule

500

Describe three types of abdominal pain

• Visceral pain is usually dull and poorly localized. It is typically the result of distention of a hollow viscus (eg, early-stage appendicitis).
• Parietal pain is usually sharp and more easily localized. It is generally the result of irritation of nerve roots innervating the peritoneum (eg, late-stage appendicitis).
• Referred pain is pain felt at a site distant from the source of painful stimuli (eg, liver pathology presenting as right shoulder pain because of diaphragmatic irritation; left shoulder pain after laparoscopic insufflation commonly known as Kerh sign). An understanding of dermatomes helps in understanding referred pain.

HIPEC

100

All tumor deposits greater than this size must be resected during cytoreduction before HIPEC

2mm

200

Describe the peritoneal cancer index (PCI)

What is 

300

Name a world-famous surgical oncologist

Dr. Dan Labow

400

Name two agents used in HIPEC

oxaliplatin

mitomycin C

doxorubicin

500

This pathology is unique in that they are still candidates for cytoreduction even if the disease is too extensive for complete cytoreduction

LAMN

Abd Pain 2

100

Most common cause of pancreatitis in the USA

gallstones

200

What is the resuscitative fluid of choice in hemodynamically significant rectus sheath hematoma?

blood

300

What is the first line treatment for type 2 rectus sheath hematoma?

supportive care

observation

400

This is the exam findings when a physical exam is relatively benign but a patient complains of severe pain. What is the associated pathology?

pain out of proportion.

acute mesenteric ischemia

500

On CT, this finding in a patient with bowel obstruction suggests a closed-loop obstruction and possible strangulation.

What is the whirl sign?

"Double-barrel"

C-sign with two transition points