Chpt 16-GI/GU

Question 1

Epigastric, may radiate to the back; Cause pain that wakes patient at night; Food and antacids may bring relief;

N/V/Belching/blaoting/heartburn;

30-60 years old

Answer 1

Duodenal ulcer

Question 2

Epigastric, may radiate to the back;

Not relieved by food or antacids;

weight loss;

usually over 50

Answer 2

Gastric ulcer

Question 3

acute inflammation;

Epigastric, may radiate to the back;

lying supine may aggravate;

leaning forward with trunk flexed may relieve;

N/V/adn distention, fever, PMH of aalcohol abuse or gallstones

Answer 3

Actue pancreatitis

Question 4

Epigastric and radiating through the back, chronic or recurrent course, alcohol or heavy fatty meals may aggravate, diarrhea wtih fatty stools

Answer 4

Chronic Pancreatitis

Question 5

RUQ or upper abd; may radiate tothe right scapular area; gradual onset; jarring, deep breathing my aggravate (Murphy’s sign); Anorexia, N/V, fever

Answer 5

Acute Cholecystitis

Question 6

A sac-like mucosal outpouching through the colonic muscle; LLQ; Fever/Constipation. There may be brief diarrhea

Answer 6

Acute Diverticulitis

Question 7

Poorly localized periumbilical pain, followedusually by RLQ pain; Movement or cough may aggravate (Psoas/Rovsing–>referred rebound); vomiting bile and Mucus (high obstuction), Vomiting fecal matter (lower obsttruction)

Answer 7

Acute Appendicitis

Question 8

loose stool; may show mucus but no blood. Small, hard stools with constipation; often worse in the morning, rarely wakes patient at night; usually affects middle age adults (esp women)

Answer 8

Irritable Bowel Syndrome

Question 9

Inflammation of the mucosa and submucosa of
the rectum and colon with ulceration; typically
extends proximally from the rectum;

Soft to watery, often containing
blood; diarrhea may wake patient at night; increases risk of colon caner

Answer 9

Ulcerative Colitis

Question 10

Chronic transmural inflammation of the small bowel
wall, in a skip pattern typically involving the
terminal ileum and/or proximal colon;

Small, soft to loose or watery,
usually free of gross blood (enteritis); diarrhea may wake patient at night;

RLQ; often affects the young-esp Jewish descent

Answer 10

Crohn’s disease

Question 11

passage of black, tarry (sticky and
shiny) stools. Tests for occult blood are
positive.

usually from the
esophagus, stomach, or duodenum. (upper GI)

Answer 11

Melena

Question 12

Ingestion of iron, bismuth
salts as in Pepto-Bismol,
licorice, or even commercial
chocolate cookies;

negative results when tested for occult blood;

These stools have no
pathologic significance.

Answer 12

Black, nonsticky stools

Question 13

Usually originates in the colon, rectum, or
anus, and much less frequently in the jejunum
or ileum. (lower GI)

Answer 13

Red Blood in Stools (frank)

Question 14

Ingestion of beets

Answer 14

Reddish, nonbloody stools

Question 15

Momentary leakage of small amounts of urine when coughing, laughing, and sneezing;

In women, often a weakness of the pelvic floor with
inadequate muscular support of the bladder and proximal
urethra and a change in the angle between the bladder and
the urethra. Causes include childbirth and surgery

Answer 15

Stress Incontinence

Question 16

Detrusor contractions are stronger than normal and overcome the
normal urethral resistance. The bladder is typically small.

Deconditioning of voiding reflexes,

Incontinence preceded by an urge to void

Answer 16

Urge Incontinence

Question 17

Detrusor contractions are insufficient to overcome urethral
resistance. The bladder is typically large, even after an effort to void;

Obstruction of the bladder outlet, as in benign prostatic
hyperplasia or tumor; a continuous dripping or dribbling

Answer 17

Overflow Incontinence

Question 18

inability to get to the toilet in time because of
impaired health or environmental conditions;

Problems in mobility resulting from weakness, arthritis, poor
vision, or other conditions. Environmental factors such as an
unfamiliar setting, distant bathroom facilities, bed rails, or
physical restraints

Answer 18

Functional Incontinence

Question 19

Drugs may contribute, a careful history and chart review is important

Answer 19

Incontinence Secondary to Medication

Question 20

Tranmission is Fecal-oral; immune serum globulin can be adm for prophylaxis and can within 2 weeks of contact

vaccine available

children asymtomatic

Answer 20

Hep A

Question 21

Sexual contact or exposure; People with percutaneous or mucosal exposure to blood; Others: travelers, patients with chronic liver disease or HIV infection,

Vaccine availabe

Answer 21

Hep B

Question 22

repeated percutaneous exposure to blood; no vaccine

Answer 22

Hep C

Question 23

Pain in the RLQ uring Left-sided pressure

Answer 23

+

Rovsing sign

Appendicitis

Question 24

Place your hand just above the patient’s right knee
and ask the patient to raise that thigh against your hand. Alternatively,
ask the patient to turn onto the left side. Then extend the patient’s right
leg at the hip.; increased Abd pain on either move is what?

Answer 24

Psoas Sign

Appendicitis

Question 25

A sharp increase in tenderness with a sudden stop in inspiratory effort.

Answer 25

positive Murphy sign of acute cholecystitis.

Question 26

a collateral pathway of recanalized umbilical veins radiating up the abdomen that decompresses portal vein hypertension.

Answer 26

caput medusa: enlargement of the liver due to cirrhosis or hep.

Question 27

Inflammation of the GI tract (mouth, esophagus, stomach, and intestines).

Answer 27

Gastroenteritis

Question 28

6 F's of a Protuberant Abd

Answer 28

Fat Fluid Flatus Fetus Feces Fatal growths