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Flashcards in Abdomin Exam Deck (123)
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1

Distention of the Upper abdomin: Which organs could be affected?

Stomach, Liver, GB, Spleen

2

Distention of the Lower abdomin: Possible diagnosis

Bladder, Hernia, Prego

3

Distention of both lower and upper abdomin is what pathology?

Ascities

4

Purple Striae in the abdomin could indicate?

Cushing's OR Adrenal tumor that produces cortisol

5

Describe INC/DEC in peristalsis in both early and late bowel obstruction?

INC = Early Obstruction
DEC = Late Obstruction

6

Pulsations in the abdomin could indicate

Abdominal aneurysm

7

Diastasis Recti (What is it and would you treat?)

It is a separation of the abdominal muscles towards the lateral sides caused by heavy lifting/Prego.
Not significant.

8

Grey Turner's sign (Located where and what doe sit indicate?)

Blood in Flanks
Indicates Pancreatitis (Rupture has already occurred)

9

Caput Medusa indicate?

Portal Hypertension

10

Definition of Borborygmi

Rumbling sounds heard in abdomin. Bowel sounds.

11

Tympani indicates?

Air

12

Dullness indicates?

Fluid

13

Liver size parasternal and midclavicular?

Parasternal = 4-8cm
Midclavicular = 6-12cm

14

Dullness over the spleen indicates?

Normal spleen unless enlarged.

15

How do you palpate the liver?

Start at zyphoid and go around coastal margin to posterior axillary line

16

How do you palpate the KD?

Entrapment -- Dr Beings pressing medially and with each breath out the dr moves lateral wo bunny hopping. Dr does this over 3 breaths. The other hand is placed underneath the PT. Dr always observes PTs face for pain.

17

How do you palpate the spleen?

Start at Anterior axillary line. Pull w left hand and push with right hand.

18

Name 3 tests and describe how they are performed for Ascities

Shifting dullness = Percuss horizontally across abdomen. If tympany changes to dullness over the center of the abdomen it could indicate air bubble. Have PT side-lying and repeat test. If there is no change in the location of the air then it is most likely gas trapped in the bowel and not from ascities. If it changes location it indicates ascities.
Fluid Wave = PT supine. Dr taps each side of the abdomen and observes for fluid wave indicating ascities.
Puddle Sign =

19

Name 3 tests and describe how they are performed for Ascities? Which sign is the most sensitive?

Shifting dullness = Percuss horizontally across abdomen. If tympany changes to dullness over the center of the abdomen it could indicate air bubble. Have PT side-lying and repeat test. If there is no change in the location of the air then it is most likely gas trapped in the bowel and not from ascities. If it changes location it indicates ascities.
Fluid Wave = PT supine. Dr taps each side of the abdomen and observes for fluid wave indicating ascities.
Puddle Sign = PT standing. Place Stethescope midline above umbilicus. Have PT forward flex. Percuss a few times to each side of the scope.
Puddle sign is the most sensitive test for Ascities.

20

Which condition is Blumberg's Test used for and describe the test?

Blumberg's Rebound tenderness for GB.
Palpate each of the 4 quadrants by pressing in slowly and releasing quickly. Go deep.

21

Describe how to perform Obturator and Psoas sign tests for GB

Psoas sign = PT side-lying. Hold PTs leg near knee and extend femur while bracing Hip w other hand. Pain near the GB indicates GB as pain generator bec psoas will irritate the GB.
Obturator sign = PT supine. Flex thigh to 90. To externally rot femur int rot leg.

22

What is the #1 cause of chest pain

Heart Burn

23

Hiatal hernia cause?

Weak Diaphragm

24

What is Achalasia? What disease causes it?

Distal narrowing of the Esophagus.
Cause = Scleroderma

25

Gastric Vs Duodenal ulcers (Course of pain after eating?)

Duodenal pain 2hrs after eating
Gastric pain during meal otherwise unpredictable.

26

Gastric Vs Duodenal ulcers (Course of pain after eating?)

Duodenal pain 2hrs after eating
Gastric pain during meal (Could also be cancer so ask if pain unrelieved by position or medication) otherwise unpredictable.

27

Cause of Acute Gastritis?

Allergies/Sensitivities

28

Name one thing to be concerned about in chronic gastritis?

B12 deficiency
Low B12 -> Pernicious anemia -> PLS

29

Gastric Cancer causes which lymh node to become enlarged?

Left Virchow

30

Diseases ass w head of pancreas

Pancreatitis, Cancer

31

Pancreatitis Acute Vs Chronic SS

Acute = Fever, Ridgid Abdomin, Labs
Chronic = Quiet, Normal Labs

32

SS of Pancreas Cancer (Head of pancreas)

Weight loss, jaundice, Pain at T10 straight through and knife like, Bruised flanks, Steatorrhea, Hx of drinking and smoking

33

If PT has Pain at T10 straight through and knife like think? But ask?

Pancreas; Do you have a Hx of drinking or smoking?

34

Cullen's Sign (Which Tests to order?)

CBC, CT, Amylase, Lipase

35

Diseases ass w tail of pancreas

DM1, DM2, Gestational DM

36

DM1 and 2 differences (General: Ages, body morphology, Tx)

DM1 = <35yo, thin, INSULIN DEPENDENT
DM2 = ?35yo, obese, Diet controled

37

SS of DM1 or DM2

3Ps: Polydypsia, polyuria, polyphagia

38

GB (Tests?)

CBC w/ Diff, Bilirubin, UA, Cholecystogram, US cystography

39

Name 2 conditions ass w Gallbladder

Cholecystitis (AKA Cholangitis) = infection
Cholelithiasis = Stones

40

Cholelithiasis and Cholangitis Tx

Adjust T5, Diet

41

Pt has pain in inferior right scapula. What GI organ should you be concerned about?

GB

42

Name 3/5 diseases ass w spleen

Cancer
Leukemia -- Spleen must handle excessive WBC
Hodgkin's -- Splenic Enlargement
Mono -- Splenic Enlargement
Rupture -- From Truama

43

SS of Spleen disorder

Anemia, Frequent infections, Fatigue, Chronic illness

44

Spleen (Tests)

CBC, US, Biopsy (Cancer), CT)

45

What is the function of the Spleen?

Destroy old RBCs, make, store and remove WBCs

46

Which 4 organs are WBCs made

Thymus (T Lymphocyte maturation), Spleen and Lymph nodes (T and B Lympho), Marrow

47

MC Cause of Hepatitis?

Viral

48

Labs for Viral Hepatits

DEC Leukocytes
INC Lymphocytes

49

Lymphocytes Vs Leukocytes

Lymphocytes are a type of Leukocyte with 3 major types: NK cells, T-cells (Thymus cells) and B-cells (Bone cells).
*Leukocytes refer to ALL WBC types.

50

Hep A

Oral; Scratch by butt eat my cookies

51

Viral Hepatitis: Which Ig will be high in Acute Vs Chronic hepatitis?

IgM is Acute
IgG is chronic

52

Acute Vs Chronic hepatitis tenderness?

Acute the liver is tender. Chronic = NO tenderness

53

Alcoholism causes which 3 liver conditions?

Cirrhosis and cancer

54

SS of alcoholic liver?

Jaundice, RUQ tenderness, right shoulder pain, varicosities

55

SS of alcoholic liver?

Jaundice, RUQ tenderness, right shoulder pain, varicosities (Portal (Liver) and splenic Veins)

56

Palpation for Cirrhosis and Cancer of liver reveals?

Cirrhosis = Nontender, hard and symmetrical enlargement
Cancer = Non-tender, hard and lumpy, not symmetrical

57

Labs for for Cirrhosis and Cancer of liver reveals?

Cancer = Labs variable
Cirrhosis = INC GGT

58

SGOT is?

1 of the 2 aminotransferases (SPGT and SPGT).
AST; Aspartate transaminase

59

SPGT is?

1 of the 2 aminotransferases (SPGT and SPGT).
ALT; Alanine transaminase
High after heart, pancreatitis, KD, or liver dx

60

GGT is?

Gamma-glutamyltransferase
Is a transport molecule that helps body in detox
High in liver cell or bile duct cell damage-- when these cells rupture they release GGT.

61

ALP is?

Alkaline Phos

62

Hep A and C Labs values for SPGT and SGOT?

Hep A: Very High SPGT and SGOT
Hep C: Mild elevated SPGT and SGOT
*Note: The levels of SPGT and SGOT do not correlate with the exact amount of liver damage. EX: Hep A PTs typically fully recover and Hep C PTs have extensive liver damage

63

Bilirubin: Direct abnormal (Organs affected and then SS)

Conjugated; Soluble; Post-hepatic: Liver, GB, Pancreas
SS Jaundice, Pale feces, yellow urine

64

Bilirubin: Indirect abnormal (Organs affected and then SS)

Unconjugated; Insoluble; Pre-hepatic: Liver, spleen, blood, rx
SS Jaundice, green urine

65

Name 3/5 spleen diseases

Cancer
Leukemia - Spleen makes excessive WBC
Hodgkins - Spleen enlarged
Mono - Spleen enlarged
Rupture - trauma

66

Name a few SS of spleen diseases?

Anemia
Frequent infections
Fatigue
Chronic Illness

67

What is Coomb's test for?

Tests for Antibodies to RBCs (IE Anti-globulin test); 2 Types: Direct and indirect
Indirect tests for blood transfusion compatibility. Done before transfusion. Tests blood SERUM.
**Direct tests for autoimmune-hemolytic anemia**
Tests RBCs and not serum.

68

Name a few Hemolytic diseases

1. Hereditary Spherocytosis
2. Hereditary Elliptocytosis
3. Sickle Cell
4. G6PD deficiency
5. Pyruvate kinase deficiency

Autoimmune-hemolytic anemia (IgG attached to RBC which causes the problem):
SLE
RA
IBD
Leukemia
Infectious (IgM agglutination)

69

KD Diseases: Name 3 types:

Nephritic KD/Nephritis -- Infection
Stones
Nephrotic -- Death

70

Name 6 tests for KD (Includes Labs)

IVP - Intravenous pyelogram
Helical CT
UA
Creatinine Clearence
Cystometric
US

71

WHich has RBC casts: Nephritic or Nephrotic disease?

Nephritic

72

WHich has RBC casts: Nephritic or Nephrotic disease?

Nephritic

73

Nephrotic Syndrome = KD death.
Name 3 SS?

HTN
Edema (Lots)
Proteinuria (Positive UA)

*Mnemonic is "HEP HEP HEP Me"

74

Toxemia of Prego will cause: Nephritic or Nephrotic disease?

Nephrotic bec KD will get smashed and will result in death of the KD
"Not only eating for 2 but peeing for 2" -- Extra stress on KD

75

DID you know that Strep throat first infects the throat Then the KD!, Lastly the heart valves

If PT has Fever and LBP ask about "Have you had a sore throat in the last 2 weeks". Its not the first thing you think when a PT has LBP but fever and LBP could be a strep infection inside the KD!

76

Strep infection: Nephritic or Nephrotic disease?

Nephritic

77

Nephritic disease. Name a SS?

Fever
Proteinuria (Not always)
Strep MC cause (Dentist or Infection)
RBC Casts

78

Name a few labs for diagnosis of Glomerular nephritis?

ASLO = Anti-streptolysin
ANCA = Anti-neutrophil cytoplasmic antibodies -- Tests for IgG
Anti-GBM = Glomerular basement mem -- Remember thinning of the basement membrane is what occur sin this dx
Complement levels
Anti-nuclear antibodies -- Tests for Autoimmune Antibodies

79

Medical name for Bladder infection?

Cystitis

80

KD Cancer: Name 2 SS

PainLESS bleeding, unexplained weight loss

81

KD Stones: Name 3 SS

Painful bleeding
Colicky pain -- no position of relief
Writhing Pain = PT cant stop moving or trying to find a position of relief
PT hurts everywhere

82

KD Stones: Age and Gender

Male; 20s

83

MC Type of KD stones?

Oxalic Acid

84

Stones Tx:

INC Fluid
DEC VIT C
DEC Calcium
DEC Green Vegi

85

Cystitis MC bacteria?

E-Coli

86

Cystitis: Age and Gender

Younger Female
Older Male esp w prostate problems

87

Cystitis Name 2 SS

Urinary Urgency
Burning

88

SI VS LI issue: Endoscopy or Colonoscopy

LI = Colonoscopy

89

Colon Cancer SS

Painless Bleeding

90

TX for all Colon issues?

Fiber

91

Crohns Disease marked by lesions where?

Skip Lesions
MC in Distal ileum

92

String Sign AKA

Skip Lesions

93

Crohns Disease invovles narrowing of the lumen forming strictures called Skip lesions
Name 2 SS

Rectal bleeding - Red streaks
INC WBC

94

Ulcerative Colitis (UC) is marked by?

Local Megacolon

95

How does Megacolon occur in UC?

Sacral Plexus becomes damaged so GI cant contract and the colon spreads out. Can also be caused by repetitive straining or holding of stool -- IE waiting 30min to finish a move.

96

How does Megacolon occur in UC?

Sacral Plexus becomes damaged so GI cant contract and the colon spreads out.

97

Name MC location of UC

Descending Colon

98

Name 3 SS of UC? (BAI)

Bloody Diarrhea
Arthritis (Large Joints)
Iritis/Uveitis

99

HLA-B27 Suggests?

UC or Crohns

100

Crohns Tx:

Restrict Raw foods and high calorie foods
Adjust
Fecal Transplant -- Taking Stool from healthy person and implanting it into Crohns PT to restore GI microbiota -- For C. difficile colitis

101

UC Tx:

Electrolytes bec diarrhea
Avoid Milk
Adjust
Fecal Transplant

102

IBS AKA?

Spastic Colon
Mucous Colitis

103

IBS is defined by what SS?

Alternating Diarrhea and constipation

104

Diverticulosis cause:

Repetitive straining or holding of stool -- IE waiting 30min to finish a move. This weakens the lumen and allows out-pouching

105

Outpouching occurs MC where?

Distal Colon

106

Outpouching is a SS of?

Diverticulosis

107

Diverticulosis Tx:

Avoid Nuts and seeds and popcorn
INC Water intake

108

Diarrhea lasting 2-4 hrs indicates?

Staph food poisoning

109

Diarrhea lasting a full day indicates?

Salmonella Food poisoning

110

What is an IVP

Intravenous pyelogram
Used to look for KD Stones
Uses Radiography and a dye

111

Describe Cystometric test?

Pumps water into the bladder. The device then measures the amount of fluid present in the bladder when you first feel the need to urinate, when you are able to sense fullness, and when your bladder is completely full.
The time required to begin voiding and the size, force, and continuity of the urinary stream is recorded. The amount of urine, how long the voiding took, and the presence of straining, hesitancy, and dribbling are also recorded.

112

What is the Cystometric test for?

Urinary Incontinence

113

UA is used as a KD screen

Looks for Proteinuria

114

Creatinine Clearance

For End stage Renal disease
PT will be very Swollen
Used to determine if PT needs dialysis that day and if they need a KD transplant

115

UCRAPE B27

AKA
U CRAPe B27

Ulcerative Collitis
Crohn's
Reiter's
AS
Psoriatic
Enteropathic

116

HLA - B27

*Neg sign means its Seroneg

Seroneg arthritis:

117

Which are the Seroneg arthritis?

RAPE from UCRAPE
Reiters, AS, Psoriatic, Enteropathic
**These are the arthritides that attack the spine and make SYNDESMOPHYTES

118

Which conditions Make Syndesmophytes?

RAPE

Reiter's
AS
Psoriatic
Enteropathic

119

Which conditions Make Syndesmophytes?

RAPE

Reiter's
AS
Psoriatic
Enteropathic

120

What are Syndesmophytes?

Calcified ligs of the spine

121

Name 2 SS of enteropathic arthritis?

Back Ache and Bloody Diarrhea

122

Calcification of the Lig around the spine indicate what radiological finding?

Osteophytes unless Reiter's, AS, Psoriatic, or Enteropathic
Then Syndesmophytes

123

What tissue does RA and OA target?

RA -- Synovium of joints (Cartilage)
OA -- Targets end plates and Joints