Digestive System

Question 1

Bowel Changes > Melena (black, tarry)

Answer 1

upper GI bleed (loss of > 150-200 mL of blood)

Question 2

Bowel Changes > Black, Non-sticky

Answer 2

iron, bismuth salts (pepto-bismol), black licorice

Question 3

Bowel Changes > Blood-Red

Answer 3

colon-rectal tumor, colon diverticulitis, hemorrhoids

Question 4

Bowel Changes > Pale

Answer 4

¡ fat absorption from small bowel, pancreatic disease

Question 5

Bowel Changes > Silvery

Answer 5

pancreatic cancer

Question 6

Bowel Changes > Pencil-thin, Ribbon stools

Answer 6

distal colon / anal cancer

Question 7

Bowel Pathology > Inflammatory Bowel

Crohn’s / Ulcerative Colitis

Answer 7

• joint arthralgia • skin lesions (ankles, shins) • light sensitivity • ¡ pain w/ gas/BM • anemia d/t blood loss • wt loss • clubbing of fingers • fever • rectal bleeding • (+) psoas test

Question 8

Bowel Pathology > Irritable Bowel

Answer 8

• effects females in early adulthood • stress related
• variable/intermittent s&s •abdominal cramps • nausea & vomiting • flatulence • change in bowel patterns • foul breath

Question 9

Bowel Pathology > Colon/Rectal Cancer

Answer 9

• hemorrhoids • rectal bleeding • back pain referred to LE • change in bowel patterns • nausea & vomiting •wt loss
• fatigue & dyspnea d/t iron def •red/mahogany stools

Question 10

Appendicitis > S&S

Answer 10

• (R) LQ pain, (+) McBurney’s point • pain into (R) thigh/testicles • nausea, vomiting, night sweats •guarding of rectus abdominis • (+) psoas sign • (+) obturator sign
• low grade fever • (+) rebound tenderness • position of relief: tense abdomen w/ FB / lie down w/ both knees to chest

Question 11

Appendicitis > Differential Diagnosis

Answer 11

• ¡ hemoglobin • ¡ hematocrit • change in fingernail beds

* pale skin color • fatigue • ¡ DBP

Question 12

Ulcers

Answer 12

• Hx of NSAID use / presence of H.pylori infection
• dull gnawing / burning into midline T6-T12 & radiating supra scapula
• antacids provide temporary relief
• nausea, coffee grounds vomitus
• bloody / black-tarry stools (melena)
• may have weeks of remission

Question 13

Ulcers > Gastric

Answer 13

• 30-60 min after meal
• (L) Upper Quadrant
• epigastric cramping
• localized tenderness

Question 14

Ulcers > Duodenal

Answer 14

• 2-3 hrs after a meal
• (R) of midline
• epigastric cramping
• localized tenderness

Question 15

UR Quadrant

Answer 15

• liver
• pancreas
• kidney
• lung

Question 16

UL Quadrant

Answer 16

• gall bladder
• heart
• spleen
• kidney
• stomach
• lung

Question 17

LR Quadrant

Answer 17

• appendix
• ureter
• bladder
• colon
• gonads

Question 18

LL Quadrant

Answer 18

• ureter
• bladder
• colon
• gonads