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Role 2 > GI > Flashcards

GI Flashcards

1
Q

Parietal pain

A

sharp localized

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2
Q

colicky pain is usually felt with which problems?

A

intestinal obstruction, renal calculi

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3
Q

where does pancreatitis radiate?

A

to the back

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4
Q

where does renal calculi radiate?

A

to the groin

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5
Q

when does mesenteric ischemia begin?

A

within one hour of eating

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6
Q

How can a person relieve pancreatitis pain without medical intervention?

A

sit up and lean foreward

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7
Q

What is a normal AAA size?

A

2cm

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8
Q

How big does a AAA get for it to be considered dilated?

A

> 3cm

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9
Q

How big can a AAA get for it to be at risk for rupture?

A

> or equal to 5cm

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10
Q

what test do you do in order to diagnose a AAA?

A

CT test

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11
Q

How often do you do ultrasounds for a stable AAA >4cm?

A

q2 years

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12
Q

How often do you do ultrasounds for a AAA > or equal to 5cm?

A

q6months

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13
Q

When should you refer a AAA to a thoracic surgeon?

A

> 5.5cm

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14
Q

which in office tests should you do for appendicitis?

A

psoas sign, mcBurneys point, Rovsing sign, orbturator sign

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15
Q

what kind of lab work should you do for appendicitis?

A

CBC and CRP

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16
Q

Rosvings sign

A

pain in right lower quadrant when the left lower quadrant is palpated (appendicitis)

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17
Q

Orbturator sign

A

rotate hip inwardly while knee slightly bent (appendicitis)

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18
Q

Psoas sign

A

Lift leg while your hand is on the thigh, create resistance (appendicitis)

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19
Q

Murphys sign

A

palpate under rib cage while patient takes a deep breath, will elicit pain if gallbladder

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20
Q

McBurneys point

A

pain felt at umbilicus when RLQ pushed

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21
Q

2 main causes for a bowel obstruction

A 
#1 Adhesions from surgery
#2 Groin hernia incarceration
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22
Q

patient s/s of bowel obstruction

A

crampy, periumbilical or diffuse pain, unable to have BM or flatus, N/V sensation of fullness

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23
Q

physical findings of bowel obstruction

A

distention, tympany, absent, high pitched or tinkling bowel sounds

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24
Q

WBC greater than what suggests bowel necrosis or abscess or peritonitis?

A

> 20,000

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25
Q

What will an xray show with a bowel obstruction?

A

air fluid levels, dilated loops of bowel, lack of gas in distal bowel and rectum

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26
Q

What is the treatment for a bowel obstruction?

A

fluid resuscitation, NGT, surgical consult

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27
Q

what kind of lab work/tests should you do to diagnose a bowel obstruction?

A

abdominal xray series or CT scan

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28
Q

your chances of getting diverticulitis increase q___years starting at age 40

A

10 years

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29
Q

Diverticulitis treatment

A
  1. ) Cipro + flagyl
  2. ) Bactrim + flagyl
  3. ) Augmentin
  4. ) Moxifloxacin
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30
Q

which antibiotic should you avoid with renal patients and the elderly?

A

Bactrim

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31
Q

with severe diverticulitis what test should you do to determine severity? and what other thing might you have to do?

A

CT scan and hospitalization

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32
Q

s/s of cholecystitis/Cholelithiasis (patient may not have all symptoms)

A

n/v, sudden sharp pain in URQ, fever, positive Murphy sign, jaundice, palpable gallbladder

33
Q

a positive murphys sign helps to diagnose what problem?

A

cholecystitis/Cholelithiasis

34
Q

what lab findings will show with cholecystitis/Cholelithiasis

A

elevated WBC, elevated bilirubin, elevated serum aminotransferase and alk phos.

35
Q

A hepatobiliary (HIDA) scan is helpful for which problems

A

liver, gallbladder and bile ducts

36
Q

which type of scan is used to evaluate the rate at which bile is released from the gallbladder?

A

HIDA scan

37
Q

if radioactive tracer moves through the bile duct very slowly, what does this indicate?

A

there may be a blockage or obstruction or a problem with the liver function

38
Q

If the radioactive tracer isnt seen in your gallbladder, this may indicate what?

A

acute inflammation (acute cholecystitis)

39
Q

If the amount of radiotracer leaving the gallbladder is low after giving the medication CCK, what may this indicate?

A

chronic inflammation (chronic cholecystitis)

40
Q

if the radioactive tracer is found in other areas outside the biliary system, what could this indicate?

A

a leak

41
Q

Cholelithiasis

A

gallstones

42
Q

cholecystitis

A

gallbladder

43
Q

Treatment for acute Cholelithiasis

A

laparoscopic cholecystectomy

44
Q

Treatment for cholecystitis

A

will subside on own (will come back),need to go on a low fat diet. Cipro and flagyl BID with low grade fever

45
Q

first line treatment for GERD

A

antacids

46
Q

antacids

A

maalox, mylanta, tums, gelusil

47
Q

function of H2 receptors and PPIs

A

they block acid production

48
Q

H2 receptors

A

cimetidine (tagament), famotideine (pepcid), ranitidine (zantac)

49
Q

PPI

A

lansoprazole (prevacid), omeprazole (prilosec)

50
Q

what kind of drugs put a patient at risk for pancreatitis

A

amiodarone, antivirals, diuretics, NSAIDS, antibiotics

51
Q

risk factors for pancreatitis

A

alcohol, gallstones, severe hyperlipidemia, certain drugs

52
Q

s/s of pancreatitis

A

epigastric pain, constant boring pain, radiates to back, severe, n/v, bloating

53
Q

physical findings of pancreatitis

A

low grade fever, tachycardia, hypotension, respiratory symptoms such as pleural effusion, atelectasis, illeus

54
Q

late physical finding of pancreatitis

A

peritonitis

55
Q

cullens sign

A

bluish discoloration around the umbilicus

56
Q

grey turner sign

A

bluish discoloration of the flanks

57
Q

what lab are indicative of pancreatitis and what lab is not

A

lipase, level will be 2 times elevated, amylase is not specific..dont bother with it

58
Q

what kinds of tests can you do for pancreatitis

A

RUQ ultrasound, CT scan (not necessary to diagnose pancreatitis, not useful in the early stages, helpful in evaluating complications)

59
Q

what are the pros and cons of a CT scan for pancreatitis

A

not necessary to diagnose pancreatitis, not useful in the early stages, helpful in evaluating complications

60
Q

Pancreatitis treatment

A

NPO, fluid resuscitation, maintain urine output of 100cc/hr, no antibiotics unless severe

61
Q

antibiotics for pancreatitis treatment in severe cases

A

imipenem or cipro with flagyl

62
Q

mild disease treatment for pancreatitis

A

discharge on liquid diet, follow up in 24-48 hours, all others admit

63
Q

are gastric ulcers relieved by food or do they feel worse after eating?

A

worse after eating

64
Q

which ulcers are associated with obstruction (bloating, N/V) which are caused by edema and scarring?

A

pyloric channel ulcers

65
Q

are duodenal ulcers relieved by food or do they feel worse after eating?

A

relieved by food, hurts again 2-3 hours after meal

66
Q

when do duodenal ulcers usually appear?

A

mid morning, usually awakens a patient at night

67
Q

what do serologic assays show? but what are the negatives about this test?

A

antibodies to H.pylori BUT these tests can be positive for up to 3 years after treatment of an infection and antibody levels don’t decline for up to 6-12 months after treatment these tests aren’t used

68
Q

why are PPIs good for use of H.pylori treatment?

A

they suppress H.pylori, they decrease acid production causing an increase in stomach pH which is a hostile environment for H.pylori

69
Q

antibiotic treatment for H.pylori

A

PPI (Prilosec or prevacid) plus clarithromycin (Biaxin) plus amoxicillin (or flagyl if allergic to PCN) for 14 days

70
Q

most common GI surgical emergency in elderly?

A

acute cholecystitis

71
Q

a lack of free airon chest xray does or does not rule out perforation?

A

does not

72
Q

what do you suspect if patient has biliary colic that lasts more than 6 hours?

A

early cholecystitis

73
Q

what do you have to rule out in the elderly that have renal colic symptoms?

A

AAA

74
Q

ovarian torsion s/s

A

tachycardia, decreased bowel sounds, fever, acute rigid abdomen, peritonitis

75
Q

do ovarian torsions have an acute onset?

A

yes

76
Q

when does a testicular torsion need to be repaired in order to salvage the testicle?

A

6 hours

77
Q

treatment for testicular torsion

A

emergent urology consult, ultrasound with doppler

78
Q

ovarian torsion treatment

A

GYN consult, IV fluids, NPO, pain medications, ultrasound

Role 2 (13 decks)

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