Flashcards in Adult - GI II Deck (41):
1
inflammation or localized perforation of diverticula with abcess formation
diverticulitis
2
diverticulitis - more common in men or women
women
3
Typical location of pain of diverticulitis?
LLQ
4
Signs and symptoms of diverticulitis? (3)
LLQ pain
low grade fever
nausea, vomiting
constipation or loose stools
5
What is a potentially significant complication of diverticulitis?
bowel perforation --> peritonitis --> acute abdomen
6
What test rules out perforation of the bowel?
plain abdominal films
+ for perforation if free air under diapragm
7
What might lab work show in diverticulitis?
leukocytosis
elevated ESR
8
Management of diverticulitis (2)
patient may be NPO
may refer to GI
9
What is the cause of irritable bowel syndrome?
etiology is unknown but there is a stress theory
10
Irritable bowel syndrome - more common in men or women
women
11
What are the signs and symptoms of irritable bowel syndrome? (4)
abdominal cramping relieved by defecation
preoccupation with symptoms
fatigue
anxiety or depression
12
Management of irritable bowel syndrome (3)
emotional support
high fiber diet
SSRIs
13
What can be used in severe cases of irritable bowel syndrome? (2)
anticholinergics
antidiarrheals
14
what often precipitates cholecystitis?
a large or fatty meal
15
What is the typical pain of cholecystitis?
steady, severe pain in RUQ
16
What is classic *SIGN* for cholecystitis?
Murphy's sign - pain on INspiration when fingers placed under the R rib cage
17
What is the gold standard for cholecystitis evaluation?
ultrasound
18
What is the management for cholecystitis? (6)
Refer for:
pain management
NG tube for gastric decompression
IV crystalloids
broad spectrum ABT
GI and surgical consult
19
Possible causes of bowel obstruction (6)
tumor
hernia
fecal impaction
adhesions
volvulus - in children - twisting/malrotation of bowel
ileus (functional obstruction)
20
Vomiting with minutes of pain indicates what about the location of the obstruction?
proximal location
21
More marked distention indicates what about the location of the obstruction?
distal location
22
Bowel sounds of obstruction?
high-pitched tinkling...going around the obstruction
23
Bowel sounds of perforation?
quiet....ominous
24
Patient with obstruction will tell you what about their stool or gas?
"unable to even pass gas"
25
What will plain abdominal films show in obstruction?
dilated loops of bowel
and
air-fluid levels
26
What does management include in obstruction? (5)
Refer for:
NG tube
broad spectrum ABT
fluid resuscitation
GI - surgical consult
27
What is hallmark symptom of ulcerative colitis?
bloody diarrhea
28
What test establishes the diagnosis of ulcerative colitis?
sigmoidoscopy
29
What factors are associated with increased risk of colon cancer?
family history of colon cancer or other adenocarcinomas
inflammatory bowel disease
polyps
high fat diet
refined carb diet
30
What are common early symptoms of colon cancer?
None - often asymptomatic in early stage
31
What are late symptoms of colon cancer?
changes in bowel habits
thin stools
weight loss
32
What is the marker for colon cancer?
CEA - carcinoembryonic antigen
nonsmokers < 2.5 ng/mL
smoker < 5 ng/mL
33
Who presents most commonly with appendicitis?
men 18 - 30 years old
34
What are possible triggers for appendicitis?
fecalith - food bits like diverticulitis
neoplasm (rarely)
35
Early pain of appendicitis?
vague, colicky umbilical pain
36
Late pain of appendicitis?
RLQ
37
Psoas sign
pain with R thigh extension
+ appendicitis
38
Obturator sign
pain with R thigh internal rotation
+ appendicitis
39
Rovsing's sign
RLQ pain when LLQ is pressed
+ appendicitis
40
Is frequent vomiting associated with appendicitis?
no - more than one or two episodes suggests a different diagnosis
41