Chapter 19- Gastrointestinal and Urologic Emergencies

A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:

acute cholecystitis.

Functions of the liver include:

secretion of bile and filtration of toxic substances.

Which of the following conditions is more common in women than in men?

Cystitis

A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:

Mallory-Weiss tear.

A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:

administer oxygen and prepare for immediate transport.

Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:

age-related deterioration of their sensory systems.

A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:

aortic aneurysm.

Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:

appendicitis.

A 47-year-old male presents with severe abdominal pain of 3 hours' duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:

be alert for signs and symptoms of shock.

You are transporting a 49-year-old male with "tearing" abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient's condition has deteriorated significantly. You should:

consider requesting a rendezvous with an ALS unit.

Esophageal varices MOST commonly occur in patients who:

consume a lot of alcohol

Chronic renal failure is a condition that:

is often caused by hypertension or diabetes.

Injury to a hollow abdominal organ would MOST likely result in:

leakage of contents into the abdominal cavity.

You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:

leave him in a sitting position, keep him warm, and prepare for immediate transport.

Most patients with abdominal pain prefer to:

lie on their side with their knees drawn into the abdomen.

When assessing a patient with abdominal pain, you should:

palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.

The MOST common and significant complication associated with an acute abdomen is:

peritonitis

A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:

protect her airway from aspiration.

An important aspect in the treatment of a patient with severe abdominal pain is to:

provide emotional support en route to the hospital.

Patients with acute abdominal pain should not be given anything to eat or drink because:

substances in the stomach increase the risk of aspiration.