perforated viscus

Practice targeted AMC-style multiple-choice questions on perforated viscus.

A 68-year-old man with a history of poorly controlled type 2 diabetes, hypertension, and chronic kidney disease (stage 3) presents to the emergency department with severe abdominal pain and vomiting. On examination, he has a distended abdomen with diffuse tenderness and guarding. His vital signs show a blood pressure of 90/60 mmHg, heart rate of 110 bpm, and a temperature of 38.5°C. Laboratory tests reveal leukocytosis, elevated serum lactate, and worsening renal function. A CT scan of the abdomen shows pneumoperitoneum and free fluid, suggesting perforated viscus. What is the most appropriate next step in the management of this patient?

A. Immediate exploratory laparotomy

B. Administer intravenous fluids and reassess in 2 hours

C. Initiate broad-spectrum antibiotics and observe

D. Consult nephrology for dialysis before surgery

E. Perform a diagnostic laparoscopy

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

Upright X-ray demonstrating small bowel obstruction

Image by James Heilman, MD — CC BY-SA 3.0 · Source

A 68-year-old male presents with a 3-day history of abdominal pain, distension, and obstipation, with a background of multiple abdominal surgeries. Vitals show HR 110, BP 110/70, T 37.8°C. Physical exam reveals a distended abdomen with high-pitched bowel sounds. An upright abdominal X-ray is shown. Considering the clinical findings and the radiographic appearance, which of the following potential complications is the MOST critical to evaluate for urgently?

A. Acute kidney injury

B. Severe electrolyte imbalance

C. Bowel ischaemia or strangulation

D. Deep vein thrombosis

E. Aspiration pneumonia

Mark this as a high-quality question

Mark this as a poor-quality or problematic question

perforated viscus

Related Topics