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SAPE October 2015 > GI - GASTRO > Flashcards

GI - GASTRO Flashcards

1
Q

Sxs:

  • RUQ pain, fever, jaundice
  • Right subscapular pain
  • Radiates to or through back
  • Pain comes and goes, worse after eating fatty meal
  • N/V
  • Indigestion or bloating sensation
A

Cholelithiasis

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2
Q

Sxs:

  • Epigastric pain
  • No guarding/rebound tenderness
  • Bowel sounds variable
  • N +/- V
  • Hiccups
  • Anorexia
A

Gastritis

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3
Q

Sxs:

  • Epigastric pain (gnawing or burning)
  • RUQ pain
  • Pain worse with eating
  • Nausea/anorexia
A

PUD - Gastric Ulcers

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4
Q

Sxs:

  • Heartburn
  • Regurgitation of digested food
  • Chest pain
  • Persistent/non-productive cough
  • Bronchospasm
  • Aspiration
A

GERD

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5
Q

Sxs:

  • LLQ pain that increases with bowel movement
  • Left sided pain worse after eating
  • Diarrhea or constipation
  • Fever/chills, anorexia
  • N/V possible
  • Rebound tenderness, guarding
A

Diverticulitis

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6
Q

Sxs:

  • Crampy abdominal pain relieved by gas/stool
  • Change in bowel habits
  • N/V/heartburn
A

IBS

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7
Q

Sxs:

  • Fever, elevated WBC
  • Tachycardic
  • RUQ pain
  • Right subscap pain
  • Positive Murphy’s sign
A

Cholecystitis

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8
Q

Sxs:

  • Epigastric pain (gnawing or burning)
  • RUQ pain
  • Pain decreased with meals then increases 2-3 hours post-prandial
A

PUD - Duodenal Ulcers

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9
Q

Sxs:

  • Periumbilical pain migrates to RLQ
  • Anorexia/N/V
  • Fever, tachycardia
  • Rebound tendernes, guarding
  • Psoas sign
  • Obturator sign
  • Rovsing’s sign
A

Appendicitis

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10
Q

Sxs:

  • Vomit
  • Obstipation
  • Distention
  • Crampy
  • Abdominal pain
A

Bowel obstruction

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11
Q

Sxs:

  • Bloody diarrhea
  • LLQ pain
A

Ulcerative colitis

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12
Q

Sxs:

  • RLQ pain
  • Fistulas common
  • Gall/renal stones common
  • Cobble stone appearance
  • Skip leasions
A

Crohn’s dz

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13
Q

Most common type of gallstones

A

Cholesterol

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14
Q

Risk Factors for Cholelithiasis

A

fair, fat, female, forty, flatulence, fertile

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15
Q

Charcot’s Triad

A
  • RUQ pain
  • Fever
  • Jaundice
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16
Q

Murphy’s Sign

A

pushing into the RUQ under the rib cage to check for pain/tenderness in gallbladder area

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17
Q

Gold standard test for cholelithiasis

A

ultrasound

18
Q

Diagnostic Tests and Findings for Cholecystitis

A
  • leukocytosis and elevated CRP

- radiographic signs: thickening of GB wall, sonographic Murphy’s sign, pericholecystic fluid

19
Q

Causes of Gastritis

A
  • H. pylori
  • NSAIDs
  • stress-related mucosal changes
  • atrophy
20
Q

Risk Factors for GERD

A
  • obesity/pregnancy

- alcohol, smoking, caffeine

21
Q

What is first line “test” for GERD? What other tests might be done?

A
  • trial treatment

- then barium swallow or perhaps endoscopy

22
Q

Risk Factors for PUD

A
  • H pylori
  • NSAID use
  • smoking
  • FHx
  • meds: bisphosphonates, corticosteroids, chemo drugs
23
Q

Common Causes of PUD

A
  • H pylori
  • NSAIDs
  • stress
  • Zollinger Ellison syndrome
24
Q

Risk Factors for NSAID Induced Ulcers

A
  • age 60+
  • Hx PUD/GI bleed
  • toxic NSAID use
  • corticosteroid, bisphosphonate, SSRI, anticoagulant, antiplatelet use
  • immunocompromised
25
Q

Tests for PUD

A
  • CBC
  • FOBT
  • H pylori testing
  • endoscopy for pts 55+, with alarm sxs or those w/ ulcers that don’t respond to tx
26
Q

H pylori Testing

A
  • endoscopy is gold standard, but invasive
  • urea breath test
  • IgG serology
  • stool antigen
  • may get a false negative if using abx/bismuth/PPI
27
Q

Diverticulitis Sx Triad

A
  • LLQ pain/tenderness
  • fever
  • leukocytosis
28
Q

Tests and Results for Diverticulitis

A
  • CBC: low Hgb, leukocytosis
  • positive UA and blood culture
  • elevated ESR
  • CT or flex sig is diagnostic
  • colonoscopy after recovery from acute sxs
29
Q

Risk Factors for IBS

A
  • genetics
  • young
  • women - menstruation
  • stress with exacerbations
  • previous gastroenteritis
30
Q

Rome 3 Criteria

A

-abdominal pain 3 d/mo x3 months with 2 or more of:
relieved by stool evacuation
change in stool form
change in stool frequency

31
Q

Labs and Imaging for IBS

A
  • CBC, FOBT usually normal

- abdominal US

32
Q

Most common cause of acute surgical abdomen

A

appy

33
Q

Tests for Appy

A
  • elevated WBC
  • US for pg women and children
  • CT with oral contrast is test of choice
34
Q

Define acute diarrhea.

A

less than 14 days duration

35
Q

Define chronic diarrhea and list common causes.

A
  • decrease in fecal consistency >4 weeks

- IBS, IBD, malabsorptive syndromes, chronic infxs, idiopathic

36
Q

Psoas Sign

A

RLQ pain with flexing of the right thigh up toward chest

37
Q

Obturator Sign

A

pt on side; flexion at hip and internal rotation of thigh; if RLQ painful, positive test

38
Q

Rovsing Sign

A

deep palpation of LLQ elicits referred pain in RLQ

39
Q

McBurney’s Point

A

point over the appendix that is 1/3 of the way from the ASIS to the belly button

40
Q

Causes of Constipation

A
  • low fiber and water intake

- meds: opioids, anticholinergics

41
Q

What presents with a tinkling sound when the abdomen is auscultated?

A

bowel obstruction

42
Q

Tests and Results for Bowel Obstruction

A
  • abd XR: air/fluid levels, distended bowel loops

- CBC: elevated WBC, moderate increase in Hct

SAPE October 2015 (12 decks)

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