4 a) You are called to assess a 69-year-old obese male patient who is day 2 post-

laparotomy for a perforated duodenal ulcer. He is now hypotensive, tachycardic and anuric
i) Define the following terms
 Intra-abdominal Hypertension (IAH). (1)
 Abdominal Compartment Syndrome (ACS). (2)
 Abdominal Perfusion Pressure (APP). (1)

ii) Describe how to measure intra-abdominal pressure in the emergency department.

(3)
catherterize-urine voided…25 saline given…manapoetr or transducer…at mid axillar level at
asis.
iii) List the adverse cardiorespiratory effects of an increase in intra-abdominal pressure in a
mechanically ventilated patient. (7)
b) Discuss the approach to renal colic in the emergency department using the following
headings
i) Differential diagnoses.
ii) Special Investigations.
ii) Patient disposal from the emergency department. (8)
c) List strategies you would implement to reduce inappropriate laboratory testing in your
emergency department. (3)
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