Gallbladder, Appendicits, Stomach Flashcards Preview

Part 2 NBS - General Diagnosis > Gallbladder, Appendicits, Stomach > Flashcards

Flashcards in Gallbladder, Appendicits, Stomach Deck (15)
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1

Murphy’s sign

RUQ
Gallbladder test

2

Cholecystitis and cholelithiasis

Female
Multiparous
Flatulence
Distention
Obese
Right scapular pain
Jaundice
Steatorrhea

3

Appendicitis

WBC 17,500
Neutrophilia
Schillings shift = increase WBC’s rapidly
RLQ pain

4

Appendicitis pain/test

Periumbilical => McBurney’s => relief (burst) => peritonitis (rebound tenderness)

5

Appendicitis tests continued

Psoas test
Blumberg’s (rebound tenderness)
Rosvings (pressure LLQ)
Markle (heel jar) => up on toes, drop hard to heels

6

Stomach location

Epigastric region

7

Peptic ulcers two types

Gastric and duodenal

Duodenal = more common; pain 2 hours after eating

8

Peptic ulcers

- barium study
- infection
- H. Pylori

9

Stomach cancer

- virchow’s node on left
- occult blood
- pt reports: “eating and losing weight”

10

Gastritis

Elderly
Alcohol
B12 absorption problems
PLS (posterolateral sclerosis)

11

B12 story

1. Extrinsic factor, diet (animal products) = cyanocobalamin
2. Gut has parietal cells that secrete HCL and intrinsic factor (makes B12 absorbable)

12

B12 (cobalt) responsibilities

1. RBC maturation (reticulocyte is big, immature RBC)
2. Myelination of nerves (demyelination is sclerosis)

13

B12 pathology progression

Chronic gastritis (parietal cell degradation) from chronic diet abuse, proton inhibitory pump, meds (Nexium)

Pernicious anemia (reticulocytosis); pale and fatigue

Posterolateral sclerosis (combined systems disease), stocking and glove paresthesia

14

B12 tests

B12 assay
Schillings test: confirmatory test
Achlorhydria

15

B12 treatment

B12 intramuscular injections