Introduction Flashcards
1
Q
Diseases Gatroenterologist Treat
A
GERD GI CA Pancreatic CA Hepatitis Chirrhosis IBS Colitis Crohn's disease Inflammatory Bowel Disease (IBD)
2
Q
Symptoms of Digestive Problems
A
Constipation Nausea Vomiting Diarrhea Heartburn Indigestion Rectal bleeding Weight loss Abdominal pain
3
Q
Common Acute Pain Syndromes
A
Appendicitis Acute diverticulitis Cholecystitis Pancreatitis Perforation of an ulcer Intestinal obstruction Ruptured AAA Pelvic disorders
4
Q
Chronic Abdominal Pain Syndromes
A
IBS Chronic pancreatitis Diverticulosis GERD IBD Duodenal ulcer Gastric ulcer
5
Q
Epigastric Pain
A
PUD GERD MI AAA Pancreatic pain Gallbladder & common bile duct obstruction
6
Q
Right Upper Quadrant Pain
A
Acute Cholecystitis Biliary Colic Acute Hepatitis Hepatic Abscess Hepatomegaly due to CHF Perforated duodenal ulcer Herpes zoster Myocardial ischemia Right lower lobe pneumonia
7
Q
Left Upper Quadrant Pain
A
Acute pancreatitis Gastric Ulcer Gastritis Splenic enlargement, rupture or infarction Myocardial ischemia Left lower lobe pneumonia
8
Q
Right Lower Quadrant Pain
A
Appendicitis Regional Enteritis Small bowel obstruction Leaking Aneurysm Ruptured ectopic pregnancy PID Twisted ovarian cyst Ureteral calculi Hernia Testicular torsion
9
Q
Left Lower Quadrant Pain
A
Diverticulitis Leaking aneurysm Ruptured ectopic pregnancy PID Twisted ovarian cyst Ureteral calculi Hernia Testicular torsion
10
Q
Peri-umbilical Pain
A
Disease of transverse colon Gastroenteritis Small bowel pain Appendicitis Early bowel obstruction
11
Q
Diffuse Pain
A
Generalized peritonitis Acute pancreatitis Sickle cell crisis Mesenteric thrombosis Gastroenteritis Crohns/Ulcerative colitis Dissecting or rupturing aneurysm Intestinal Obstruction Psychogenic illness
12
Q
Visceral Abdominal Pain
A
Originates in abdominal organs covered by peritoneum
13
Q
Colic Abdominal Pain
A
Crampy pain
14
Q
Parietal Abdominal Pain
A
From irritation of parietal peritoneum
15
Q
Referred Abdominal Pain
A
Produced by pathology in one location felt at another location
16
Q
Laboratory & Diagnostic Tests of Abdominal Pain
A
UA CBC Amylase, lipase, LFT's, H. pylori Plain X-rays Contrast studies- barium Ultrasound CT scanning Endoscopy Sigmoidoscopy or colonoscopy
17
Q
Characteristics of Pain
A
Way it begins (sudden onset, insidious) Location of pain Pattern of pain Duration of pain Worsens the pain Relieves the pain Signs/Symptoms
18
Q
Where is Appendicitis Pain Found?
A
Peri-umbilical
RLQ
19
Q
Where is Diverticulitis Pain Found?
A
LLQ
20
Q
Gallbladder Pain is felt where?
A
RUQ
21
Q
What kind of pain does obstruction of the intestine cause?
A
Waves of crampy abdominal pain
22
Q
What kind of pain does obstruction of the bile ducts cause?
A
Upper abdominal pain that lasts minutes to hours
23
Q
What kind of pain does acute pancreatitis cause?
A
Severe, unrelenting, steady pain in the upper abdomen & upper back
24
Q
What kind of pain does acute appendicitis cause?
A
Start near the umbilicus and moves to the RLQ
Character of pain may change over time
25
How long does the pain of IBS last?
Waxes and wanes over months or years and may last decades
26
How long does biliary colic last?
No more than several hours
27
How long does the pain of pancreatitis last?
One or more days
28
Pain of acid-related disease
Show periodicity
| Period of weeks or months which pain is worse
29
Inflammation Pain Aggravated By:
Sneezing
Coughing
Jarring motion
30
What does the presence of a fever suggest?
Infection
31
What does diarrhea or rectal bleeding suggest?
Intestinal cause of the pain
32
What does the presence of fever and diarrhea suggest?
Inflammation of the intestines that may be infectious or non-infectious
33
What does an elevated white count suggest in abdominal pain?
Inflammation or infection: appendicitis, pancreatitis, diverticulitis, or colitis
34
What does elevated in amylase and lipase suggest in abdominal pain?
Pancreatitis
35
What may be elevated in a gallstone attack?
Liver enzymes
36
What does blood in the urine suggest?
Kidney stones
37
What are abdominal ultrasounds useful fin diagnosing?
Gallstones
Cholecystitis
Appendicitis
Ruptured ovarian cysts
38
What can a CT of the abdomen detect?
```
Pancreatitis
Pancreatic CA
Appendicitis
Diverticulitis
Abscesses of the abdomen
Crohn's disease
```
39
What can capsule enteroscopy be used to diagnose?
Crohn's disease
Small bowel tumors
Bleeding lesions
40
What can barium X-rays diagnose?
Ulcers
Reflux
Inflammation
Blockage in the intestines
41
What is an EGD useful for detecting?
Ulcers
Gastritis
Stomach CA
42
What is a colonoscopy or flexible sigmoidoscopy useful for diagnosing?
Infectious colitis
Ulcerative colitis
Colon CA
43
How is the cause of abdominal pain diagnosed?
Characteristics of pain
Findings on PE
Laboratory, radiological, & endoscopic testing
Surgery
44
Define Nausea
Sensations of unease and discomfort in the upper stomach with an urge to vomit
45
Define Qualm
Attack of nausea
46
Define Vomiting
Forcible voluntary or involuntary emptying of stomach contents through the mouth
47
Shortly after a meal, N/V may be caused by what?
Food poisoning
Gastritis
Ulcer
Bulimia
48
N/V 1-8 hours after a meal may indicate what?
Food poisoning
| Salmonella
49
Stimuli of Vomiting
Severe pain
Distention of stomach or duodenum
Torsion/trauma to ovary, testes, uterus, bladder, or kidney
Activation of chemoreceptor trigger zone in the medulla
50
Define Retching
Involuntary movement of abdominal muscles
51
Define Projectile Vomiting
Spontaneous vomiting not proceeded by nausea
52
N/V Etiologies
```
Pain
Viral gastroenteritis
GI inflammation, infection
Severe pain such as nephrolithiasis
Chemo
Neurologic
Cardiovascular
Medications
Post-operative
```
53
Physical Manifestations of N/V
```
Dehydration
Metabolic alkalosis
Hypokalemia
Hyponatremia
Hypochloremia
Symptoms with underlying etiology
```
54
Treatment for N/V
Antiemetic medications
55
What does a dilated esophagus with a distal "bird beak" appearance?
Achalasia
56
What is the multi month history of chronic nausea, early satiety, and postprandial bloating?
Diabetic gastroparesis
57
What is the clinical sign that can assist in the diagnosis of cholecystitis?
Murphy sign- pain on inspiration with palpation of the RUQ
58
Where is the most common site of pancreatic cancer?
Head of pancreas- painless jaundice
59
What is the tumor marker that can assist in diagnosing pancreatic cancer?
CA 19-9
60
What is the best study to screen for fat malabsorption?
Microscopic stool examination using Sudan stain
61
What gastrointestinal disease is most commonly associated with dermatitis herptiformis?
Celiac disease
62
What is the gold standard for identifying colorectal cancer?
Colonoscopy
63
What diagnosis is most likely with symptoms of worsening LLQ abdominal pain associated with constipation and chills?
Diverticulitis
64
What is the first-line treatment of C. difficile colitis?
Metronidazole (Flagyl)
65
What is the most likely diagnosis when plain film abdominal x-rays reveal thumb printing?
Ischemic colitis
66
What are the symptoms of ischemic colitis?
```
Crampy LLQ abdominal pain
Urge to defecate
Expulsion of bloody diarrhea
Nausea
Fever
Tachycardia
```
67
What two dermatologic signs may assist in the diagnosis of acute pancreatitis?
```
Cullens sign (peri-umbilical bruising)
Grey Turner sign (flank bruising)
```
68
What is the most common digestive complaint in the US?
Constipation
