Flashcards in Adult - GI II Deck (41):
inflammation or localized perforation of diverticula with abcess formation
diverticulitis - more common in men or women
Typical location of pain of diverticulitis?
Signs and symptoms of diverticulitis? (3)
low grade fever
constipation or loose stools
What is a potentially significant complication of diverticulitis?
bowel perforation --> peritonitis --> acute abdomen
What test rules out perforation of the bowel?
plain abdominal films
+ for perforation if free air under diapragm
What might lab work show in diverticulitis?
Management of diverticulitis (2)
patient may be NPO
may refer to GI
What is the cause of irritable bowel syndrome?
etiology is unknown but there is a stress theory
Irritable bowel syndrome - more common in men or women
What are the signs and symptoms of irritable bowel syndrome? (4)
abdominal cramping relieved by defecation
preoccupation with symptoms
anxiety or depression
Management of irritable bowel syndrome (3)
high fiber diet
What can be used in severe cases of irritable bowel syndrome? (2)
what often precipitates cholecystitis?
a large or fatty meal
What is the typical pain of cholecystitis?
steady, severe pain in RUQ
What is classic *SIGN* for cholecystitis?
Murphy's sign - pain on INspiration when fingers placed under the R rib cage
What is the gold standard for cholecystitis evaluation?
What is the management for cholecystitis? (6)
NG tube for gastric decompression
broad spectrum ABT
GI and surgical consult
Possible causes of bowel obstruction (6)
volvulus - in children - twisting/malrotation of bowel
ileus (functional obstruction)
Vomiting with minutes of pain indicates what about the location of the obstruction?
More marked distention indicates what about the location of the obstruction?
Bowel sounds of obstruction?
high-pitched tinkling...going around the obstruction
Bowel sounds of perforation?
Patient with obstruction will tell you what about their stool or gas?
"unable to even pass gas"
What will plain abdominal films show in obstruction?
dilated loops of bowel
What does management include in obstruction? (5)
broad spectrum ABT
GI - surgical consult
What is hallmark symptom of ulcerative colitis?
What test establishes the diagnosis of ulcerative colitis?
What factors are associated with increased risk of colon cancer?
family history of colon cancer or other adenocarcinomas
inflammatory bowel disease
high fat diet
refined carb diet
What are common early symptoms of colon cancer?
None - often asymptomatic in early stage
What are late symptoms of colon cancer?
changes in bowel habits
What is the marker for colon cancer?
CEA - carcinoembryonic antigen
nonsmokers < 2.5 ng/mL
smoker < 5 ng/mL
Who presents most commonly with appendicitis?
men 18 - 30 years old
What are possible triggers for appendicitis?
fecalith - food bits like diverticulitis
Early pain of appendicitis?
vague, colicky umbilical pain
Late pain of appendicitis?
pain with R thigh extension
pain with R thigh internal rotation
RLQ pain when LLQ is pressed
Is frequent vomiting associated with appendicitis?
no - more than one or two episodes suggests a different diagnosis