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Flashcards in Clinical Features Deck (117):
1

- bulge in the groin that may be tender to palpate but generally has no pain
- heavy/discomfort in groin
- slight pelvic pain in women
- worst at end of day/ prolonged sitting
- radiating twinge of pain with sitting/standing

Groin hernia

2

- bulge in the groin that may be tender to palpate but generally has no pain
- can be moved in and out
- asymptomatic

Reducable groin hernia

3

-bulge in the groin
- +/- N/V, pain, block
- tenderness, bowels may not move due to obstruction
- fever

Incarcaerated groin hernia

4

- bulge in groin
- painful
- +/- N/V, pain, block
ischemia--> pain out of proportion

Strangulated groin hernia

5

- swelling lateral to the rectus muscle
- pain is dull/ constant

Spigelian hernia

6

- local inflammation initially
- overtime ischemia, gangrene, perforation

Richter’s Hernia

7

- bowels and intestine protrude out of stoma
- skin is clean and normal looking
- patient comfortable

Parastomal hernia

8

- Asymptomatic
- painless bleeding; bright red blood per rectum
- anal pruritis
- prolapse
- pain due to thrombosis

Hemorrhoids

9

- sudden onset of severe pain and swelling
- fluctuant mass that feels like fluid inside
- fever
- cellulitis possible

Rectal abscess

10

- pain
- purulent drainage
- perirectal skin lesion

rectal fistula

11

- straining
- lumpy hard stools
- sensation of incomplete evacuation
- use of digital maneuvers
- sensation of anorectal obstruction/ blockage
- decreased frequency
- abdominal discomfort or pain
- abdominal distention
- nausea

constipation

12

- Hematochezia
- obstructive symptoms
- acute onset of constipation
- severe persistent constipation that is unresponsive to tx
- weight loss more than 10 pounds
- change in stool caliber- pencil thin stool
- family hx of colon cancer or IBD

alarming sx of constipation

13

- abdominal cramping & bloating
- leakage of liquid or sudden episodes of watery diarrhea when normally constipated
- rectal bleeding
- small, semi-formed stools
- straining when trying to pass stools
- bladder pressure/ loss of control
- lower back pain
- fluid leaks out but no evacuation of bowels
- pressure on bladder and urethra--> can't void

fecal impact

14

- painless cyst or sinus opening at the top of the natal cleft
- acute abscess can form
- chronic cyst can form

pilonidal disease

15

- sudden onset of severe pain and swelling
- acutely inflamed and fluctuant mass overlying the sacrum or coccyx
- fever if cellulitis

pilonidal disease with acute abscess

16

- painless cyst or sinus opening at the top of the natal cleft
- persistent drainage from a sinus track connected to the cyst
- mucoid/ purulent material

pilonidal disease with cyst

17

- crampy abdominal pain
- nausea
- vomit a lot and feel better afterwards
- no passage of flatus/ stool
- more belching/hiccups
- abdominal distention
- abdominal tenderness

SBO

18

- vomit
- abdomen distended
- not passing gas
- Xray/CT show the whole bowel is dilated without a transition pt

ileus

19

- Crampy abdominal pain
- N/V
- low grade fever
- anorexia
- malaise

appendicitis

20

- abdominal distention and acute/chronic diarrhea
- radiographic evidence of colonic distention
- 3 of the following: fever over 38C, HR over 120, WBC over 10,500, anemia
- 1 of the following: dehydration, altered sensorium, electrolyte disturbances, hypotension

toxic megacolon

21

- rapid onset of severe, unrelenting periumbilical pain
- patient is writhing on bed, screaming in agony but stomach is soft and normal
- N/V
- forceful/urgent bowel evacuation

ischemic bowel disease

22

- fever
- person is writhing around and all of a sudden they are pain free due to bowel dieing

ischemic bowel disease to infarct

23

- crampy and tender abdominal pain
- nausea
- vomiting
- bloody diarrhea
- blood per rectum

colonic ischemia

24

- painless jaundice
- unintentional weight loss
- recent onset of atypical DM
- palpable mass (late stage)
- ascites (late stage)
- courvoisier's sign

pancreatic cancer

25

What is courvoisier’s sign

non-tender palpable gallbladder with jaundice

26

- Asymptomatic
- Biliary colic RUQ- Post-prandial after fatty meal; Steady pain that lasts at 30 min peaks at an hour and trends down and is gone at 6 hrs
- Non-specific abdominal pain
- Midepigastric pain
- Chest pain
- Fullness after meals
- Abdominal distention/bloating
- Nausea
- Vomiting
- Diaphoresis

Cholelithiasis

27

-RUQ pain or epigastric sudden onset; Typically post prandial fatty meal, but not always; Pain can be for 12-15hrs
- Typically sit still because movement aggravates pain
- Nausea/ Vomiting
- Murphy’s sign- push RUQ and breather and gall bladder touches the physician hand and they stop bleeding
- Fever
- Jaundice
- Courvoisier's sign

Cholecystitis

28

What is Courvoisier's sign?

palpable gallbladder on PE due to extreme dilation

29

Biliary-type pain
RUQ, midepigastric or shoulder pain
Afebrile

Nausea

Vomiting
Complicated (pancreatitis, cholangitis, etc)- jaundice and/or fever

Choledocolithiasis

30

- Abdominal pain
- Fever
- Yellow skin
- Weakness
- Charcot Triad
- Reynold’s Pentad

Acute Cholangitis

31

Charcot triad

Fever, abdominal pain and jaundice

32

Reynold's Pentad

Fever
Abdominal pain
Jaundice
Confusion
Hypotension

33

- Symptoms range from none to fatigue or pruritus
- asymptomatic
- jaundice
- splenomegaly

PSC

34

- Midepigastric pain; Patient laying forward and worsening when laying back
- Pain radiating to the back
- Nausea

- Vomiting
- Dyspnea
- Epigastric tenderness
- Jaundice
- N/V

Acute pancreatitis

35

- Midepigastric pain; Patient laying forward and worsening when laying back
- Pain radiating to the back
- Nausea

- Vomiting
- Dyspnea
- Epigastric tenderness
- Jaundice
- N/V
- Tachypnea

- Hypoxemia

- Hypotension
- ARDS

- Cullen’s Sign
- Grey Turner Sign

Severe sx acute pancreatitis

36

Cullen Sign

- Exomotic discoloration in periumbilical region due to bleeding intrabdominally
- Most likely have necrotizing pancreatitis

37

Grey Turner Sign

- Exomotic discoloration along the flanks due to hemorrhage
- Most likely have necrotizing pancreatitis

38

- Abdominal pain
- Anorexia
- Maldigestion
- Weight loss
- Nausea
- Vomiting
- Steatorrhea- fatty, fowl smelling stools
- Tenderness over pancreas during attacks

Chronic pancreatitis

39

- Typically Asymptomatic
- GI bleeding- polyp opens and lets loose
- Intestinal Obstruction- distended abdomen; rare
- Bright red blood per rectum
- Rectal Tenesmus
- Change in bowel habits- only if large polyp

Polyps

40

- Presenting at young age
- History of rectal bleeding, bowel 
obstruction, perforation
- Family history 

- Asymptomatic
- Occasionally abdominal pain or 
mass
- Poorly differentiated tumors in the right colon

Lynch syndrome

41

- Presenting at young age
- History of rectal bleeding, bowel obstruction, perforation
- Family history
- Asymptomatic
- >100adenomas on colonoscopy
- Extracolonic Manifestations

FAP

42

- Asymptomatic
- Painless rectal bleeding
- Rectal Prolapse
- Failure to Thrive
- Family history

Familial Juvenile Polyposis

43

- vague abdominal pain
- iron deficient anemia
- fatigue
- GI bleeding
- Weakness from chronic blood loss
- Rectal Bleeding
- Abdominal Pain
- Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease

R. side colon cancer

44

- obstructive symptoms
- colicky abdominal pain
- change in bowel habits
- constipation alternating with loose stools
- stool streaked with blood
- Rectal Bleeding
- Abdominal Pain
- Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease

L. side colon cancer

45

- rectal tenesmus
- urgency
- recurrent hematochezia
- narrow caliber stools
- Rectal Bleeding
- Abdominal Pain
-Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease

Rectal cancer

46

- RECTAL BLEEDING
- Anorectal pain
- Rectal mass sensation
- No symptoms
Physical Exam
- Rectal mass on Digital Rectal Exam (DRE)
- Condylomata
- Bleeding

Anal cancer

47

- Abdominal pain –LLQ
- Constant, several days
- Nausea/vomiting
- Fever
- Change in bowel habits
- Constipation to diarrhea or vice versa
- Dysuria
- Guarding, rigidity, rebound
- Tender palpable mass

Diverticulitis

48

- Painless hematochezia
- Painless maroon-color blood mixed with stool
- Bloating, cramping, urge to defecate
- Hemodynamically unstable: syncope, lightheadedness, postural dizziness
- Due to bleeding significantly
Signs
- Abdomen – benign; soft and non-tender
-BRBPR or dark
- Hemodynamically unstable: Hypotension, tachycardia, pallor

Diverticular bleed

49

- Rectal bleeding*
- Diarrhea (hallmark bloody diarrhea)*
- Fecal urgency
- Tenesmus- crampy, rectal pain; urgency to go to the bathroom all the time
- Abdominal pain* - LLQ and suprapubic pain
- More rarely can see fistulas, weight loss, more common in CD
- In severe or advanced cases, patients may present with fever 

Physical exam
- Abdominal tenderness ?peritonitis
- DRE = BRB
(bright red blood)

Ulcerative colitis general

50

- Gradual onset diarrhea (<4/day) and intermittent bloody mucoid stool
- Urgency and tenesmus
- No significant abdominal pain but LLQ cramping normal often relieved by BM (bowel movement)
- Mild fever, anemia, hypoalbunemia possible 


Ulcerative colitis mild

51

- Gradual onset diarrhea (<6/day) and intermittent bloody mucoid stool
- Urgency and tenesmus
- No significant abdominal pain but LLQ cramping normal often relieved by BM (bowel movement)
- Mild fever, anemia, hypoalbunemia possible 


ulcerative colitis moderate

52

- >6 bloody diarrhea stools/day
- Severe anemia, hypovolemia, hypoalbunemia with nutritional deficit (marker for malnutrition)
- Abdominal pain/tenderness
- Fulminant colitis = subset of severe disease which is rapidly worsening sx’s with toxicity
- Distended abdomen, tender leukocytosis, severe diarrhea, fever


Severe ulcerative colitis

53

- Aphthous oral ulcers,
- Iritis/uveitis/episcleritis- severe eye pain, photophobia
- Seronegative arthritis, ankylosing spondylitis, sacroiliitis; As the GI flares up, so does the arthritis
- Erythema nodosum, pyoderma gangrenosum; firm nodular raised areas located in lower extremities on extensor surfaces
- Autoimmune hemolytic anemias
- Primary sclerosing cholangitis

Ulcerative colitis

54

- can affect any portion of the GI tract
- Abdominal pain (intermittent and often RLQ /periumbilical)
- Diarrhea (watery/nonbloody typically and ?# per day) – not bloody
- Incontinence due to so much diarrhea
- Low grade fevers
- Weight loss/anorexia/malnutrition
- Weakness/fatigue/malaise (anemia)
- Bone loss
- SBO presentation (Nausea and vomiting with abd pain) w/ active disease or later in disease w/ strictures and chronic fibrosis
- Abscess or fistula presentation (perianal disease)
- Anal fissure/skin tag/abscess/fistula (perianal presentation)
- Dermatologic, ophthalmologic, orthopedic manifestation

Crohn Disease

55

- <2 yrs malabsorption presentation
- can be severe- growth retardation, weight loss, distention
- Diarrhea - 45-85%
- Flatulence - 28%
- Borborygmus - 35-72%
- Weight loss - 45% of patients; in infants and young children with untreated celiac disease, 
failure to thrive and growth retardation are common (classic malabsorption)
- Weakness and fatigue - 78-80% usually related to general poor nutrition
- Severe abdominal pain - 34-64%
- Fatigue, depression, Fe-deficiency anemia
- Anemia - 10-15% of patients
- Osteopenia and osteoporosis - 1-34% of patients
- Neurologic symptoms - 8-14% of patients; include motor weakness, paresthesias with sensory 
loss, and ataxia; seizures may develop
- Skin disorders - 10-20% of patients; including dermatitis herpetiformis, a condition with 
pruritic, papulovesicular skin lesions involving the extensor surfaces of the extremities, trunk, 
buttocks, scalp, and neck
- Hormonal disorders - Including amenorrhea, delayed puberty, and infertility in women and impotence and infertility in men

Celiac disease

56

- A protuberant and tympanic abdomen
- Evidence of weight loss (loss of muscle mass or subcutaneous fat)
- Orthostatic hypotension
- Peripheral edema (protein malabsorption)
- Ecchymoses (vit K deficiency)
- Hyperkeratosis (vit A deficiency) or dermatitis herpetiformis
- Cheilosis and glossitis (Fe-defcy)
- Evidence of peripheral neuropathy or ataxia (vit 
B12 or E defcy)
- Chvostek or Trousseau sign, tetany (Ca++ deficiency

Malabsorption

57

- Abdominal bloating
- Abdominal cramping
- Flatulence
- Diarrhea/loose stool (with higher intake of lactose)
- Nausea
- Borborygmi
- Severity of symptoms depends on quantity ingested and severity of deficiency 
Lactose intolerance diagnosis and management

lactose intolerance

58

- Watery

- Large volume

- Abdominal cramping

- Bloating

- Gas

- Weight loss with persistent diarrhea

- Rarely occurs with fever, occult blood or inflammatory cells in stool

diarrhea of the small bowel

59

- Frequent, regular

- Small volume

- Painful bowel movements
- Fever
- Bloody or mucoid stools common
- Inflammatory and red blood cells seen on microscopy

diarrhea of the large bowel

60

- Symptoms develop within 12-48 hours after being exposed
- Acute onset nausea and vomiting, watery, non-bloody diarrhea with abdominal cramps
- Symptoms of gastroenteritis last 24-72 hours

norovirus

61

- Symptoms may develop while still on abx therapy or 5-10 days after
- Watery diarrhea

C. diff

62

- Incubation period is about 3 days (1-7)
- Abrupt onset abdominal pain and diarrhea (bloody or mucoid)
- Pain goes around the intestines as the bacteria goes trough the intestines
- Prodrome of fever, chills, aches in 30%
- Can mimic appendicitis
- recently ate chicken

Camphylobacter

63

- Nausea,
- Vomiting

- Diarrhea (pea soup) not grossly bloody but may have blood
- Abdominal cramping
- Fever
- Fever resolves in 48-72 hours
- Gastroenteritis is self-limiting 4-10 days

salmonella

64

- High fever

- Diarrhea (small volume, bloody and mucoid) initially may be watery
- Abdominal cramping

- Tenesmus- frequent desire to go to the bathroom
- daycare center, MSM

shigella

65

- Onset of symptoms 12-36 hours
- Nausea, vomiting, diarrhea

- Abdominal pain and cramping

- Dry mouth and sore throat

- Bilateral cranial nerve involvement/palsies
- home canning of fruits, veggies and fish

Botulism

66

- abdominal pain
- borborygmi (rumbling/gurgling of intestines)
- vomiting
- diarrhea is profuse watery “rice-water” stool-mucous, fishy smell

cholera

67

- diarrhea to severe dysentery
- abdominal pain
- weight loss
- fever
- Complication includes fulminant colitis with bowel necrosis leading to perforation and peritonitis

intestinal entomoeba

68

- Malaise, anorexia, abdominal cramps and watery diarrhea
- diarrhea that develops during or within 10 days of returning from travel

travelers diarrhea

69

- Chronic abdominal pain and altered bowel habits in absence of any organic cause

IBS

70

- Asymptomatic
- Abdominal Pain
- Weight Loss
- Nausea and Vomiting
- Gastrointestinal Bleeding
- Intestinal Obstruction

Small Bowel Cancer

71

- Watery diarrhea
- flushing
- sweating
- wheezing
- dyspnea
- abdominal pain
- hypotension
- Urinary excretion of 5-HIAA

carcinoid syndrome

72

Orthostatic dizziness
confusion
angina
palpitations
cold/clammy extremities.

UGIB- severe bleed

73

Epigastric or RUQ pain

UGIB- PUD

74

odynophagia
GERD
dysphagia

UGIB- Esophageal ulcer

75

emesis
retching
coughing prior to hematemesis

UGIB- Mallory- Weiss tear

76

Jaundice
weakness
fatigue
anorexia
abdominal distention

UGIB- variceal hemorrhage or portal HTN gastropathy

77

Dysphagia
early satiety
involuntary weight loss
cachexia

UGIB-Malignancy

78

- Painless bleeding most common
- May sense abdominal fullness and urge to pass stool
- Hematochezia
- Clots per rectum
- Maroon colored or mixed blood with stool
- Melena (rare, may occur with right sided bleeds)

LGIB

79

- resting tachycardia
- orthostatic hypotension (HR increase 20pts and systolic BP decrease 10-20mmHg)
- pale conjunctiva
- pale oral mucosa
- dry mucosa
- pale, grey, clammy, cool extremities
- Abdomen: normal ->distention->caput medusa->ascites - >tenderness->rebound
- guaic + melena

GIB

80

- Fatigue
- Sleep disturbance
- Muscle cramps
- Weight loss/wasting
- Skin
- Spider telangiectasias
- caput medusa
- Palmar erythema
- Dupuytren contracture
- Abdominal pain
- Liver enlargement or Stetch of Glisson capsule
- Ascites
- Anorexia, nausea/vomiting (more advanced)
- Hematemesis
- Amenorrhea
- Erectile dysfunction
- Loss of libido
- Gynecomastia
- Jaundice
- icteric sclera
- pruritis without a rash
- Confusion/altered mental
- Thenar wasting

cirrhosis

81

- Appearance of chronic illness
- Palpable/firm liver (hard sharp nodular edge) -70%
- Hepatomegaly
- Splenomegaly – 35-50%
- Abdominal and thoracic superficial veins are dilated
- Ascites
- Pleural effusion
- Peripheral edema
- signs of right sided failure
- Jaundice/Icterus
- palmar erythema
- Esophageal/gastric varices – hematemesis, melena

cirrhosis

82

- need abt 1500ml for PE dx so relatively inaccurate
– Abdominal distension
– Bulging flanks
– Shifting dullness to percussion
– Fluid wave

ascites

83

- Symptoms range from alert w/ minor impairment memory, coordination, cognition 
to coma
- asterixis
- twitchiness

hepatic encephalopathy

84

- Hematemesis/melena/hematochezia
- Pale, hypotensive, lightheaded, syncope, orthostatic, tachycardic, any signs/symptoms of hemorrhagic shock
- Liver disease/Cirrhosis signs

GI varicies

85

- Fatigue/Malaise
- Anorexia
- Nausea and vomiting
- Fever
- Enlarged tender liver
- Jaundice
- Normal to low WBC
- Markedly elevated aminotransferase (>1000U/L)
- Hyperbilirubinemia
- Elevated PT? INR? (>1.5)
- Encephalopathy

Acute hepatitis

86

Anti-HAV appears early

Hep A

87

- asymptomatic or mild clinical illness w/ 6-7 wk incubation
- Anti-HCV ELISA
- HCV RNA PCR serology

Hep C

88

anti-HDV

Hep D

89

- Aminotransferase >1000
- Positive ANA and/or smooth muscle Ab most common type
- IgG elevated

Autoimmune hepatitis

90

- Macrocytic anemia
- Thrombocytopenia
- AST/ALT ratio 2/1 and mildly elevated (not greater than 300)
- TB elevated
- PT/INR elevated

Alcoholic hepatitis

91

HBsAg and anti-HBc IgG

Chronic Hep B

92

- Insidious until perhaps cirrhotic pt deteriorates
- Weakness, weight loss, anorexia
- Ascites
- Jaundice, Icterus, pruritis
- Tender enlarged liver +/-mass

HCC

93

- associated with illnesses where the body is in a hypermetabolic state, i.e. trauma, sepsis, burns
- progressive muscle loss
- organ dysfunction

Kwashiorkor-like deficiency

94

- results from chronic diseases like heart failure, cancer, COPD, AIDS
- organ dysfunction
- Progressive muscle wasting in setting of early weight loss to severe cachexia
- Temporal wasting

Marasmus-like deficiency

95

- Weight loss leading to body weight 15% below expected
- In female patients, amenorrhea is almost always present
- Constipation
- Cold intolerance
- Bradycardia
- Hypotension
- Loss of body fat
- Dry and scaly skin

anorexia

96

- Body weight fluctuations but generally within 20% of normal body weight
- Commonly describe family and psychological issues
- Impulsive or antisocial behavior may be present
- Menstruation is typically preserved
- Gastric dilatation, pancreatitis after binges
- Poor dentition, esophagitis secondary to vomiting
- Electrolyte abnormalities, dehydration secondary to diuretics and cathartics
- Constipation

Bulimia Nervosa

97

- Fatigue
- Tachycardia
- Palpitations
- Dyspnea on exertion
- Skin and mucosal changes
- Smooth tongue
- Brittle nails
- Spooning of nails
- Cheilosis
- Many patients develop pica, a craving for specific foods

iron-deficient

98

- Anorexia
- Muscle cramps
- Paresthesias
- Irritability
- Cardiovascular dysfunction – wet beriberi
- Neurological dysfunction – dry beriberi

Thiamine deficient

99

Wet beriberi

- Marked peripheral vasodilation caused high output heart failure
- Dyspnea, tachycardia, cardiomegaly, edema

100

Dry beriberi

Peripheral nerve involvement causing motor and sensory neuropathy, 
paresthesias and loss of reflexes

101

- megaloblastic anemia
- Glossitis occurs and vague GI symptoms occur
- Paresthesias
- Balance difficulty
- Cerebral dysfunction: dementia 

- low B12

B12 deficiency

102

- GI symptoms

- Swollen, painful tongue
- Neurologic symptoms such as cognitive impairment, dementia, depression
- low folic acid
- megaloblastic anemia

folic acid deficiency

103

osteomalacia

Vitamin D deficiency

104

- Asymptomatic
- Epigastric pain
o Gastric – while eating
o Duodenal – hours after eating or middle of the night
- Early satiety
- Nausea +/- vomiting
- Belching, bloating, distention
- Chest pain/heartburn
- GI bleed– hematemesis, melena
- Guaic + stools
- Perforation – sudden onset of pain +/- peritoneal signs

PUD

105

- Epigastric pain
- Burning sensation
- Gnawing Sensation
- Nausea +/- vomiting
- +/- Hematemesis (BR or coffee ground)

gastritis

106

- retrosternal pain
- heart burn
- odynophagia
- dysphagia
WATER BRUSH
- globus densation
- food impaction
LARYNGITIS
- chronic cough
- hematemesis
- abdominal pain
- weight loss

GERD

107

odynophagia
Immunocompromised ptn
Thrush

candida esophagitis

108

- retrosternal pain
- heart burn
- odynophagia
- dysphagia
- water bursh
- globus densation
- food impaction
- laryngitis
- chronic cough
- hematemesis
- abdominal pain
- weight loss

esophagitis

109

- Hematemesis
- melena
- hematochezia
- Pale, hypotensive, lightheaded, syncope, orthostatic, tachycardic
- Liver disease/Cirrhosis signs : jaundice, pruritus, ascites, encephalopathy/MS changes, muscle cramps, anorexia, spontaneous bleeding/easy bruising, abdominal pain, nausea/vomiting

esophageal varicies

110

- repeated episodes of retching and vomiting
- severe chest pain lower thorax and upper abdomen radiating to the back or left shoulder.
- Swallowing aggravates the pain
- Shortness of breath
- Mackler triad
- Neck pain, upper chest pain, epigastric pain
- rales (pleural effusion)

Boerhaave syndrome

111

Hematemesis 85%
o Vomit/retch then hematemesis classic- blood streaked vomit
Melena
Hematochezia
Syncope/Assoc GI hemorrhagic hypovolemia
Guaic stool positive

Mallory Weiss tear

112

halitosis
regurgitation of undigested food
gurgling in throat

Zenker diverticulum

113

- Dysphagia*- intermittent, non-progressive, solids only
- Odynophagia
- Heartburn
- Food impaction
- Chest pain
- Chronic cough, asthma

Schatzki ring

114

• Dysphagia*- slow onset, solid to liquid
• Odynophagia
• Heartburn
• Food impaction
• Chest pain
• Chronic cough, asthma

esophageal strictures

115

dysphagia
- progressive solid to liquid
- regurg at night and supine
- long duration of sx
Chest pain
- sudden, squeezing in the retrosternal
exacerbated by food and stress

dysmotility disorder

116

- Dysphagia*- Progression from solid food to liquids; Rapid
- Weight loss >50%
- Regurgitate food- Epigastric pain/retrosternal pain/bone pain from mets
- Chronic cough
- Hoarseness/dysphonia
- Virschow node- lymph node in left supraclavicular fossa
- Cachectic

esophageal carcinoma

117

- Insidious presentation
- Indigestion
- Nausea/Vomiting
- Dysphagia
- Early satiety/Anorexia
- Weight loss
- Melena/Hematemesis
- Local spread to omenta, pancreas, diaphragm, mesocolon, transverse colon, duodenum
- GOO- gastric outlet obstruction
- SBO
- Palpable enlarged stomach
- Hematogenous spread liver
- Sister Mary Joseph Node- periumbilical lymph node
- Virchow Node- supraclavicular node
- Hepatomegaly

gastric cancer