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GIGU Exam 1 > CIS GI Correlations - Dr. Arnce > Flashcards

CIS GI Correlations - Dr. Arnce Flashcards

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1
Q 
Eructation
Edentulous
Dysphagia
Odynophagia
Mittelsschmerz
A 
Burping 
X teeth
X Swallowing 
Painful Swallowing 
Ovulation at mid cycle
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2
Q

Icterous

A

Yellow Sclera
Due to liver failure and elevated bilirubin
Also jaundice of skin happens

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3
Q

Hematemesis

A

Blood vomit or coffee-ground like vomit

Ulcer in stomach, upper GI tract artery ulcer

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4
Q

Melena

A

Black tarry stools

90% due to UGIB (upper GI Bleed)

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5
Q

Hematochezia

A

Red or maroon Blood in stools

Usually due to Lower GI Bleeds
Or MASSIVE Upper GI Bleeds

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6
Q

Hemoccult/ Gastroccult

A

Exam to check if there is blood in the stool (Hemo) or vomit (gastro)

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7
Q 
Very big distended belly 
Capid  Medusa ( arterial darkening on the skin of tummy)
A

Acidis
Liver Failure
(Hepatic Portal HTN)

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8
Q

Keketsia

A

Very skinny bony

Due to chronic COPD or Cancer, or malnutrition

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9
Q

STOOLS:

  1. Light colored white
  2. Dark Black , positive for blood
  3. Karent Jelly Stool (Bloody bright red)
A
  1. Acolic Stool: especially alarming in newborn ( Biliary Atresia)- absence of Bile (newborn: congenital Biliary Atresia, Adult: Gallstones or something obstructing bile formation)
  2. UGIB
  3. Intussusception (in children)- one part of GI folds in to another part
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10
Q

Black stool that tests positive for blood, and there is no blood what can cause this

A

Iron pills
Pepto-Bismol

Beets and red food coloring- can cause red stool

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11
Q

18yo F right lower Quadrant ABD Pain , elevated WBCs
CT Scan
RLQ

A
  1. Appendicitis
  2. LQs
    - Ureteric Colic
    - Inguinal Hernia
    - IBD
    - UTI
    - Gynaecological Testicular Torsion
    - Ectopic Pregnancy
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12
Q

Differential Diagnosis

A

Most common things that can cause the CC and also life threats

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13
Q

LLQ Pain

A
  1. Diverticulitis
  2. LQs
    - Ureteric Colic
    - Inguinal Hernia
    - IBD
    - UTI
    - Ectopic Pregnancy
    - Gynaecological Testicular Torsion
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14
Q

RUQ

A 
GB/Liver -Cholecystitis
Hepatitis 
UQs
-Pyelonephrits
- Ureteric Colic
- Pneumonia
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15
Q

LUQ

A 
Stomach (Gastric Ulcer)
UQs
-Pyleonephritis
-Ureteric Colic
-Pneumonia
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16
Q

Epigastric Pain

A

Peptic Ulcer Disease
Cholecystitis
Pancreatitis
Myocardial Infarction

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17
Q

Peri-umbilical Region

A

Small- Bowel obstruction
Large-Bowl Obstruction
Appendicitis
ABD. Aortic Aneurysms

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18
Q

CBC
Chemistry
Urinalysis

A
  1. WBC Count
  2. Electrolytes and acidonic (HCO3)
  3. UTI
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19
Q

Projectile vomit in child

A

PYLORIC STENOSIS

Not normal - children

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20
Q

Bile Throw-up

A

Yellow

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21
Q

Poop looking color vomit and smells like poop

A

Feculent vomit

BOWL OBSTRUCTION

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22
Q

1Coffee ground looking vomit

2 bright red

A

PEPTIC ULCER DISEASE

Aortic Ulcer or verscial bleed

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23
Q

67yo F postmenopause, Periumbilical ABD Pain. N, V

X Bowl movement and many ABD surgeries in past

A

SI Obstruction- risk factor for many ABD surgeries

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24
Q

Small Bowl Obstruction
Risk Factors:
Sx:
Tx:

A
  1. Past pelvic- ADHESIONS or ABD surgery, hernia, Intestinal inf., neoplasm, past irradiation
  2. N, V, Cramping pain in ABD, distended ABD, obstipation (X pass flatus or stool)
  3. Nasogastric Tube
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25
58yo M vomiting blood | Qs to ask
``` Cough vs vomit Coffee ground or bright red Picture of it Have you done this in the past Past out or lightheaded COP, ABD pain, SOB ```
26
Peptic Ulcer Disease | What should you order for Diagnostic
NOT CT EGD
27
Esophageal Varices | Order what
EGD Bright red stool and distended ABD
28
Oropharyngeal Dysphagia -invitation of swallowing | Can be Sx of what
Parkinson’s
29
Esophageal Dysphagia can be Sx of what
Esophageal Cancer Schatzki Ring- ring in esophagus Achalasia Scleroderma
30
Sinkers Diverticulum
Ring that is higher up and in the Diverticulum pouch | Can cause food regurgitation or bad breath, aspirations
31
Dysphagia worsening over time
PROGRESSIVE DYSPHAGIA
32
45yo M progressive dysphagia, travels to centra America a lot Regurgitation at night Blood smear: Trypanosoma Cruzi
ACHALASIA: throwing up food (not going into stomach) - stay in esophagus due to lower sphincter does not relax and lower 2/3 motility disorder Esophageal Dysphagia: Motility Disorder Bird beak appearance in imaging
33
Regurgitation at night Progressive dysphagia No travel history Lower sphincter does not relax of esophagus
ACHALASIA
34
H Pylori physiological happenings
Mucosal barrier breakdown from cytotoxin producing motile flagellated microaerophilic gram- Rod
35
Duodenum Ulcer physiology
Decreased Gastric Acid secretion -> loss of protective mucosal barrier
36
ACHALASIA physiology
Loss of Nitric Oxide- producing inhibitory neurons in the myenteric plexus
37
Zollinger Ellison Syndrome physiology
Gastric producing tumor
38
GERD Physiology
= abnormally weak lower esophageal sphincter allowing gastric contents into the esophagus
39
25yo M pituitary neoplasm HPI, comes CC of constipation, weight loss, Steatorrhea N, epigastric pain Elevated CA+2, 1cm tumor in the pancreas Diagnose definitely how:
ZOLLINGER ELLISON SYNDROME High Gastrin level + Secretin stimulation test
40
Blood smear with trypanosoma cruzi
Chagas disease
41
45yo M Dysphagia, sharp burning epigastric pain, pain 45min after eating. V. Takes ibuprofen and has osteoarthritis Where is the disease
Chronic steroidal use Coffee ground poop UGIB
42
18yo F severe ABD pain for 6 hours, N no V, fever, elevated WBCs RLQ pain when LLQ is palpated
Positive Rovsing’s sign | Appendicitis at T12- sympathetic of the appendix
43
Murphy sign
Gallbladder
44
Tenderness at McBurney’s Point
RLQ tenderness only - appendicitis
45
Rovsing’s sign
LLQ palpating causes RLQ pain
46
Tenderness over Costovertebral angles
Lloyd’s punch
47
35yo M from Guatemala 6mos dyspepsia, epigastric ABD pain CBC: microcytic anemia EGD: and biopsy = malt lymphoma (bulges in the esophagus)
H Pylori Infection
48
56yo F postmenopause dyspepsia, epigastric ABD pain for 3mos progressive, when eating initially helps and then 3.5hrs after eating gnawing pain, What should we order
Urea Breath test - for H pylori
49
Barium Esophagram
ACHOLASIA or regurgitating food (esophageal motility dysfunction)
50
When do you do a Urea breath test
Looking for H Pylori
51
Dyspepsia
Indigestion | Burning, bloated, N, upper ABD pain after start of eating
52
What can help you visualize the biliary tree and provide an intervention (theraputic)
(Gallbladder pancreas) ERCP= Endoscopic Retrograde Cholangiopancreatography Diagnostic and therapeutic for the biliary tree
53
Magnetic Resonance Cholangiopancreatography
``` Can only used to Dx biliary tree No intervention (therapeutic = fix something) ```
54
Kidney-ureter-bladder X-ray
Diagnostic
55
Colonoscopy
Dx and Theraputic however nothing to do with biliary tree
56
Esophagoduodenoscopy (EGD)
Dx peptic ulcer, not theraputic | However not anything to do with biliary tree
57
``` 40 yo F RUQ pain Ultrasound= gallstones Elevated lipase and LFT’s Can there be a stone any other place How to test ```
Elevated Lipase= Pancreas problem (blocked pancreatic duct) Elevated LFT’s = Liver problem (blocked biliary system, common bile duct) TO GET BOTH: blocked at common bile duct under pancreatic duct, PROXIMAL TO SPHINCTER OF ODDI Test= MRCP or ERCP
58
Air in the diaphragm medical term = free air
Pneumoperitoneum | Usually due to gastric or duodenal ulcer
59
CMP shows (comprehensive metabolic panel)
Total Bilirubin - liver function test also, AST, ALT, alkaline phosphatase
60
Low CO2 Elevated Creatinine Low GFR elevated lactic acid
Acidonic Kidney problems Kidney failure Septic or dehydrated
61
Normal Bilirubin level And also what does high ammonia show
1.4 H | Liver failure

GIGU Exam 1 (19 decks)

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