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Part 2/3 boards > General Diagnosis 5 > Flashcards

General Diagnosis 5 Flashcards

(61 cards)

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1
Q

direct/conjugated bilirubin

A

water soluble

increases with duct obstruction (gallstones), hepatic disease, pancreatic cancer

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2
Q

what might increased bilirubin in the blood lead to?

A

bilirubin in urine (urobilinogen(=)

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3
Q

indirect/unconjugated bilirubin

A

not water soluble

increases with hemolytic disease, drugs, spleen disorders

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4
Q

indirect/unconjugated bilirubin can be seen in what anemia?

A

hemolytic anemia

increase in reticulocyte count (coomb’s test)

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5
Q

gallbladder pain referral

A

to right shoulder or tip of right scapula (viscerosomatic)

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6
Q

cholecystitis

A

most commonly seen in overweight females

MC cause is cholelithiasis

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7
Q

s/s of cholecystitis

A

right upper quadrant pain
nausea
vomiting
precipitated by eating a large fatty meal

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8
Q

murphy’s sign

A

inspiratory arrest sign
breath in, push up on liver
they will stop breathing because it hurts
refer to gastroenterologist

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9
Q

porcelain gallbladder

A

calcification that can become malignant due to chronic inflammation

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10
Q

pancreatitis

A

epigastric pain going straight through the T10-12 area like a knife

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11
Q

chronic pancreatitis

A

seen with alcoholism

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12
Q

acute pancreatitis

A

911 emergency

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13
Q

grey turner sign

A

pancreatitis

bleeding into flank

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14
Q

cullen’s sign

A

periumbilial eccymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy
pancreatitis

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15
Q

lab tests for pancreatitis

A

increased amylase and lipase

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16
Q

pancreatic cancer

A

usually at head of pancreas

presents with dark urine, clay colored stools and jaundice

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17
Q

what position is usually most comfortable for pancreatic cancer?

A

flexed/fetal position

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18
Q

s/s of diabetes mellitus

A

polydypsia
polyphagia
polyuria

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19
Q

labs for diabetes mellitus

A

glucose tolerance test
fasting plasma glucose
HgA1C

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20
Q

insulin dependant type 1

A

juvenile
under 30
usually thin

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21
Q

non-insulin dependant type 2

A 
adult
over 40
usually obese
hyperinsulinemia
insulin resistance
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22
Q

diabetes insipidus

A

condition of posterior pituitary gland in which there is insufficient ADH
may have polydipsia, polyuria
NOT polyphagia

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23
Q

hiatal hernia

A

protrusion of the stomach above the diaphragm
presents with palpable tenderness in LUQ, reflux esophagitis, dyspepsia (indigestion)
made worse after eating a large meal or when lying down

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24
Q

reflux esophagitis

A

upward reflux of acid contents of the stomach into the esophagus
caused by sliding hiatal hernia
worse when lying down, after eating a big meal, valsalva, bearing down

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25
barrett's esophagus
destruction of esophagus due to reflux esophagitis | precursor to esophageal cancer)
26
tests for reflux esophagitis
xray or upper GI series
27
peptic ulcers
includes gastric and duodenal ulcers caused by H. pylori burning pinpoint epigastric pain coffee ground emesis
28
gastric ulcer
has no consistent pain pattern
29
duodenal ulcer
most common type of peptic ulcer pain occurs 2 hours after eating black/tarry stool
30
what test do you do if you suspect duodenal ulcer?
guiac test: occult blood in stool
31
pyloric stenosis
projectile vomiting in the newborn
32
gastric carcinoma
most common on the lesser curvature | virchow's node
33
virchow's node
left supraclavicular lymph node involvement
34
mono of caused by? s/s
HHV-4 seen in young adults fever, headache, fatigue, lymphadenopathy in cervical region, splenomegaly
35
labs for mono
atypical lymphocytes in blood (downey cells) monospot heterophile agglutination paul bunnell
36
osteopetrosis
bone marrow becomes sclerotic, thus RBCs are not made properly liver and spleen become enlarged
37
referral of pain for small intestine
periumbilical
38
regional ileitis
AKA chron's disease | nonspecific inflammatory disorder that affects distal ileum and colon
39
s/s of regional ileitis
RLQ pain chronic diarrhea cobblestone appearance on sigmoidoscopy leads to malabsorption of B12
40
what else can cause regional ileitis
non-tropical sprue/celiac sprue (gluten allergy) can cause chron's
41
ulcerative colitis
most common at the colon and rectum presents with bloody diarrhea diagnosed with sigmoidoscopy
42
irritable bowel syndrome
AKA spastic colon variable degrees of diarrhea in response to stress more common in females abdominal pain and gas relieved by bowel movements
43
appendicitis
dull periumbilical or epigastric pain that radiates to lower right quadrant (mcburney's point)
44
s/s of appendicitis
``` fever nausea vomiting anorexia increased WBC ```
45
tests for appendicitis
``` rebound tenderness rovsing's sign psoas sign obturator sign CT scan ```
46
diverticulitis
consequence of inadequate fiber in diet chronic constipation which causes small outpouchings within colon that become infected LLQ pain
47
meckel's
outpouching of ileum
48
zenker's
outpouching of esophagus
49
cushing's disease
inceased production of adrenal cortex hormone (hyperadrenalism, hypercortisolism)
50
s/s of cushing's disease
``` moon face buffalo hump pendulous abdomen with purple striae hirsutism weakness HTN increased cortisol decreased bone density more prominent in spine ```
51
addison's disease
decreased aldosterone hypoadrenalism hypocortisolism
52
s/s of addison's disease
``` increased ACTH causes melanin deposition thin person decreased blood pressure weakness fatigue lethargy nausea vomiting hair loss ```
53
pheochromocytoma
tumor of adrenal medulla increased catecholamine production (epinephrine, norepinephrine) may be similar to hyperthyroidism but this produces extreme HTN
54
nephrolithiasis
made of cacium flank pain (writhing) may radiate/travel to groin
55
murphy's test
kidney punch
56
labs for nephrolithiasis
increased BUN increased uric acid creatinine clearance KUB study
57
hydronephrosis can cause
staghorn calculi
58
acute glomerulonephritis
nephritic syndrome caused by group A hemolytic strep (ASO titer) RBC casts in urine with small amount of protein
59
nephrotic syndrome
HTN edema massive proteinuria in pregnant women is called pre-exlampsia
60
pyelonephritis
starts as an LUTI ecoli WBC/fatty casts in urine
61
pylycystic kidney disease
inherited disorder characterized by many bilateral renal cysts that increase renal size but reduce functioning renal tissue

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