Sandbox: Fatima: Difference between revisions
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! colspan="1" | Primary Peritonitis | ! colspan="1" | Primary Peritonitis | ||
| colspan="1" rowspan="1" | Spontateous Bacterial Peritonitis | | colspan="1" rowspan="1" | Spontateous Bacterial Peritonitis | ||
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! colspan="1" rowspan="7" | Secondary Peritonitis | ! colspan="1" rowspan="7" | Secondary Peritonitis | ||
| colspan="1" rowspan="1" | Perforated gastric and duodenal ulcer || | | colspan="1" rowspan="1" | Perforated gastric and duodenal ulcer || || || || | ||
* | * | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Cholangitis || || || || | ||
* | * | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Cholecystitis || || || || | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Pancreatitis || || || || | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Appendicitis || || || || | ||
* | * | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Diverticulitis || || || || | ||
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| colspan="1" rowspan="1" | Acute | | colspan="1" rowspan="1" | Acute Salphingitis || || || || | ||
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! colspan="2" | Hollow Viscous Obstruction | ! colspan="2" rowspan="4" | Hollow Viscous Obstruction | ||
| colspan="1" rowspan="1" |Small Intestine obstruction | | colspan="1" rowspan="1" |Small Intestine obstruction | ||
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|Volvulus | |||
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|Biliary Colic | |||
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|Renal Colic | |||
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! rowspan="4" |Vascular Disorders | |||
! rowspan="2" |Ischemic causes | |||
|Mesentric Ischemia | |||
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|Acute Ischemic Colitis | |||
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! rowspan="2" |Hemorrhagic causes | |||
|Ruptured Abdominal Aortic Aneurysm | |||
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|Intraabdominal or Retroperitoneal Hemorrhage | |||
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! rowspan="3" |Gynaecological Causes | |||
! rowspan="2" |Ovarian Cyst Complications | |||
|Torsion of the Cyst | |||
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|Cyst Rupture | |||
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!Pregnancy | |||
|Ruptured Ectopic Pregnancy | |||
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Revision as of 20:35, 15 February 2017
Sputum Analysis
| Sputum Analysis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acid Fast Stain | Culture on Sabourad's medium | Direct Microscopic Examination | Gentain Voilet Stain | Aerobic Culture | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Tuberculosis | Yeast and Fungi | Actinomyces and other mycelia of Fungi | Fusiform Bacteria and Spirochetes | Pyogenic organsims | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
DD
| Rhinitis | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| Positive Skin Prick or RAST | Negative Skin Prick or RAST | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Allergic Rhinitis | Non Allergic | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Infectious | Vasomotor | Gustatory | Nonallergic eosinophilic rhinitis syndrome (NARES) | ||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute Rhinosinisitis | Chronic Rhinosinusitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||
Approach
| Diagnostic Paracentesis ❑ Perform ascitic fluid cell count and differential ❑ Perform ascitic fluid culture (Inoculated at bedside) | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| PMN ≥ 250cells/mm³ | |||||||||||||||||||||||||||||||||||||||||||||||||||||
| If YES ❑ Presumptive SBP ❑ Begin empiric antibiotic therapy(eg:Cefotaxime 2g IV q8H and ❑ IV Albumin on day 1 & day 3 IF serum creatinine 1mg/dl, BUN > 30mg/dl or total albumin > 4mg/dl | IF NO ❑ Look for the signs/symptoms of Infection | ||||||||||||||||||||||||||||||||||||||||||||||||||||
| Is Culture Positive ? | Absent Symptoms ❑ Is Culture Positive? | Symptoms Present ❑ Begin Empiric Antibiotic Therapy for SBP | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Negative Culture ❑ Complete 5 day Antibiotic Course | Confirmed SBP ❑ Narrow the spectrum based on the susceptibility to complete the 5 day course | Culture Negative ❑ No Antibiotics indicated | Culture Positive ❑ Bacterascites: Repeat diagnostic paracentesis when the culture growth is discovered | ||||||||||||||||||||||||||||||||||||||||||||||||||
Diagnostic Paracentesis
| Classification of acute abdomen based on etiology | Presentation | Symptoms | Signs | |||||
|---|---|---|---|---|---|---|---|---|
| Fever | Abdominal Pain | Jaundice | Rigidity | Rebound Tenderness | Bowel sounds | |||
| Common causes of Peritonitis | Primary Peritonitis | Spontateous Bacterial Peritonitis | ||||||
| Secondary Peritonitis | Perforated gastric and duodenal ulcer |
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| Acute Cholangitis |
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| Acute Cholecystitis | ||||||||
| Acute Pancreatitis | ||||||||
| Acute Appendicitis |
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| Acute Diverticulitis | ||||||||
| Acute Salphingitis | ||||||||
| Hollow Viscous Obstruction | Small Intestine obstruction | |||||||
| Volvulus | ||||||||
| Biliary Colic | ||||||||
| Renal Colic | ||||||||
| Vascular Disorders | Ischemic causes | Mesentric Ischemia | ||||||
| Acute Ischemic Colitis | ||||||||
| Hemorrhagic causes | Ruptured Abdominal Aortic Aneurysm | |||||||
| Intraabdominal or Retroperitoneal Hemorrhage | ||||||||
| Gynaecological Causes | Ovarian Cyst Complications | Torsion of the Cyst | ||||||
| Cyst Rupture | ||||||||
| Pregnancy | Ruptured Ectopic Pregnancy | |||||||