Abdominal US ro pyloric stenosis Labs CBC ro anemia infection Management small

Abdominal us ro pyloric stenosis labs cbc ro anemia

  • chamberlain university
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Abdominal US – r/o pyloric stenosis Labs: CBC r/o anemia & infection Management: small frequent meals, frequent burping, add weight to formula (cereal) Drug of choice: H2 antagonist, GI referral PYLORIC STENOSIS Present is younger infants 3wks – 4months Characteristic features: blue eyes, blonde hair, flat feet (pes planus) Projectile vomiting, palpable pyloric mass, peristaltic waves Diagnostic test: Abdominal US “ string sign ” narrow pyloric channel 36
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Management: refer to surgery INTERUSSUSCEPTION Cause: Rotavirus vaccine Bilious vomiting, sausage shape mass in RUQ, Progressive distention tenderness (acute abdomen) ** Currant jelly stools Refer to surgery HIRSCHSPRUNGS (Aganglionic Mega Colon) More common in males Failure to pass meconium , jaundice, infrequent bowel movements, progressive abdominal distention Referral to GI NEUROBLASTOMA Arises from the adrenal glands Urine catecholamines Abdominal US or CT GASTROENTESTINAL DISORDERS APPENDICITIS: patients present with RLQ pain Blumberg’s Sign or rebound tenderness: the examiner palpates the abdominal wall. (+) if pain is elicited with the removal of pressure. Assesses peritonitis or appendicitis Markle’s Sign: found when there is abdominal pain with running. Pain in the RLQ of the abdomen is elicited by having the patient drop from standing on the toes to heels, with a jarring landing; found in acute appendicitis McBurney’s Sign: tenderness on gentle pressure at the point (McBurney’s point) on the right side of the abdomen 2/3 of the way from the navel to the boney prominence on the front of the hip. Reliable sign for appendicitis. Other sings: psoas (pain with leg elevation), Rovsing (palpation on left abdomen produces rebound pain on the right), Obturator (pain with internal rotation of the hip) The presentation of fever & malaise with RLQ rebound tenderness is consistent with acute appendicitis and should be referred to ER for further assessment d/t potential for rupture. CT scan is the diagnostic test of choice. IV fluids and antibiotics are standardly given in the inpatient setting. **Sudden absence of pain in a patient previously presenting with pain indicates surgical emergency; high 37
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risk for rupture CHOLECYSTITIS Murphy’s Sign: a maneuver during physical exam as part of the abdominal examination of the edge of the gallbladder. The patient is asked to breathe in, and with the examiner’s palpation, if the patient winces with a “catch” in the breath, the test is (+) for cholecystitits. Ultrasound is the GOLD STANDARD diagnostic exam DIVERTICULITIS Patients present with mild to moderate pain in the LLQ. Most common in older females, high incidence in those with low fiber diet Acute abdomen is an EMERGENT condition. (*air under the diaphragm on x-ray is consistent with peritonitis) Differentiates from Ulcerative colitis in that “bloody diarrhea” establishes diagnosis of UC.
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