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ECOS II Midterm > GIGU Case Presentations > Flashcards

GIGU Case Presentations Flashcards

1
Q

what are the different categories of UTIs?

A

asymptomatic bacteriuria, cystitis, prostatitis, pyelonephritis

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2
Q

what is asymptomatic bacteriuria?

A

presence of bacteria without symptoms

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3
Q

what is cystitis?

A

symptomatic bladder infection

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4
Q

what is prostatitis?

A

symptomatic prostate inflammation due to infection

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5
Q

what is pyelonephritis?

A

symptomatic infection of the kidneys

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6
Q

why does the classification of uncomplicated vs complicated UTI matter?

A

it determines the duration of treatment

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7
Q

what are the three categories that determine if the UTI is complicated or not?

A

systemic symptoms, history of abnormal voiding, foreign body

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8
Q

what makes pyelonephritis different from cystitis?

A

pyelonephritis includes fevers, flank pain, CVA tenderness, nausea and vomiting

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9
Q

would you order imaging on a mild case of pyelonephritis?

A

no

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10
Q

what imaging would you order for a more severe case of pyelonephritis?

A

CT scan of the abdomen/pelvis

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11
Q

what is Lloyd’s sign/punch?

A

pain to deep percussion in the area of the costovertebral angle

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12
Q

what does a positive Lloyd’s test indicate?

A

pyelonephritis or ureterolithiasis

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13
Q

where are somatic dysfunctions commonly found in patients with pyelonephritis?

A

from T10-L2

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14
Q

what is a common somatic finding in the acute and chronic renal patient?

A

iliopsoas spasm

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15
Q

where are the chapman points for the kidneys?

A

about 1 inch lateral and 1 inch superior to the umbilicus

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16
Q

where are the chapman points for the bladder?

A

the umbilicus

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17
Q

where are the chapman points for the urethra?

A

superior surface of the pubic bone

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18
Q

where are the chapman points for the ureters?

A

there are none

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19
Q

what is the duration of treatment for an uncomplicated case of pyelonephritis?

A

3-5 days

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20
Q

what is the duration of treatment for a complicated case of pyelonephritis?

A

10-14 days

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21
Q

where would you expect to find a chapman point for a SBO?

A

at the 9th ICS on the right

22
Q

what does an elevated specific gravity result indicate?

A

really concentrated urine- dehydration

23
Q

what are the three different types of mechanical bowel obstructions?

A

intrinsic, extrinsic, and intraluminal

24
Q

what could cause an intrinsic mechanical bowel obstruction?

A

congenital diseases, inflammatory bowel disease, primary intestinal malignancy, volvulus

25
Q

what could cause an extrinsic mechanical bowel obstruction?

A

adhesion (from surgery), or neoplasm

26
Q

what could cause an intraluminal mechanical bowel obstruction?

A

feces, bezoars, or foreign bodies

27
Q

what is a functional bowel obstruction?

A

intestinal dysmotility, no actual mechanical blockage

28
Q

what does a strangulated bowel obstruction indicate?

A

vascular insufficiency and high risk for intestinal ischemia

29
Q

what are the number 1 cause of bowel obstructions in the US?

A

adhesions

30
Q

what syndrome is a cause of a functional obstruction?

A

Olgilvie’s syndrome (acute dilation of the colon)

31
Q

what can an elevated lactate indicate?

A

this occurs when there is anaerobic metabolism going on in the body- tells if there is a specific ischemic event going on

32
Q

what is the gold standard for a patient with a suspected bowel obstruction?

A

CT scan of abdomen and pelvis

33
Q

where are the GI sympathetics located?

A

T9-L2

34
Q

if a patient with a suspected SBO is able to tolerate it, where should you look for paraspinal TART findings?

A

from T9-L2

35
Q

where are the chapman points for the small intestine?

A

8th-10th intercostal space bilaterally

36
Q

where are the chapman points for the colon?

A

anterior IT band

37
Q

what would you suspect if a patient presented with short duration of symptoms, n/v/d and they are young?

A

gastroenteritis

38
Q

what is acute kidney injury (AKI)?

A

impairment of renal filtration and excretory function over days to weeks that results in retention of nitrogenous and other waste products that are normally cleared by the kidney

39
Q

what are the three different types of AKI?

A

pre-renal AKI, intrinsic AKI, post-renal AKI

40
Q

what could be a cause of pre-renal AKI?

A

hypotension

41
Q

what could be a cause of intrinsic-AKI?

A

glomerulonephritis (conditions leading to inflammation of the glomerulus)

42
Q

what could be a cause of post-renal AKI?

A

bladder outlet obstruction

43
Q

what findings would you expect to see in a patient with pre-renal AKI?

A

vomiting, diarrhea, history of NSAID use or blood pressure medication, dry mucous membranes, poor skin turgor

44
Q

when might you test the urine albumin/creatinine ratio?

A

only if there was protein in the urine

45
Q

what is a BUN: Cr ratio greater than 20:1 suggestive of?

A

pre-renal AKI

46
Q

what do pre-renal patients need in their treatment plan?

A

IV fluids and NO NSAIDs

47
Q

what might you suspect if the OSE findings were tight paraspinal musculature on the right at the level of T10-L2, Anterior Chapman’s Point noted 1 inch above and 1 inch to the right of the umbilicus?

A

pyelonephritis

48
Q

what might you suspect if the OSE findings were an anterior Chapmans point at the 9th ICS on the right?

A

an obstructed bowel

49
Q

what is an example of a functional obstruction?

A

an ileus

50
Q

what is an ileus and what is it commonly caused by?

A

it is a dysmotility that prevents intestinal content from moving distally; common occurrence post-operatively

51
Q

where should you evaluate the posterior chapman points for a small bowel obstruction/ileus? aka the posterior chapman points for the small intestine

A

lateral to the spinous process of T8-T10 bilaterally

52
Q

where are the posterior chapman points for the colon?

A

transverse process of L2-L4 bilaterally

ECOS II Midterm (19 decks)

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