PAEA Surgery End Of Rotation (EOR) Practice Exam

What is a common physical exam finding in small bowel obstruction?

1. Hypotension and bradycardia

2. Distended tympanic abdomen and high-pitched bowel sounds

3. Decreased abdominal girth and normal bowel sounds

4. Minimal abdominal tenderness and rebound tenderness

The correct answer is: Distended tympanic abdomen and high-pitched bowel sounds

The common physical exam finding in small bowel obstruction is characterized by a distended tympanic abdomen and high-pitched bowel sounds. In cases of small bowel obstruction, gas and fluid accumulate proximal to the site of obstruction, leading to abdominal distension. This distention can create a tympanic (drum-like) sound when percussed due to the increased amount of gas in the intestines. Additionally, high-pitched bowel sounds are often heard when auscultating the abdomen. These sounds are indicative of hyperactive peristalsis as the intestines attempt to overcome the obstruction. This hyperactivity is a compensatory mechanism and can lead to the characteristic sounds of a "silent abdomen" in complete obstruction. The other choices reflect findings that do not typically align with the classic presentation of small bowel obstruction. Hypotension and bradycardia are more indicative of severe complications or other conditions rather than being common findings in uncomplicated small bowel obstructions. Decreased abdominal girth and normal bowel sounds would suggest a lack of obstruction, as small bowel obstruction generally leads to an increased abdominal size and altered bowel sounds. Lastly, minimal abdominal tenderness and rebound tenderness could point towards other abdominal pathology, such as peritonitis, rather than the mechanical obstruction of the