10: Right Abdomen Flashcards

1
Q

Onset of jaundice occurs in what relation to pulse and fever in Hep A and B?

A

Jaundice occurs when fever breaks + alongside elevated pulse

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2
Q

ROME Criteria of IBS abdominal pain.. must have 2 of what 3?

A
  1. Related to defecation
  2. Associated with change in stool frequency
  3. Associated with change in form/appearance of stool
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3
Q

Appendicitis pain in pregnancy

A

Uterine displaces appendix -> moves pain superiorly

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4
Q

Elderly appendicitis

A

Dxed later due to vague/mild sx

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5
Q

Retrocecal appendicitis

A

Less pain, poorly localized, may be left sided or flank pain

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6
Q

Pelvic appendicitis

A

Pelvic pain, urge to urinate/defecate, tenderness on rectal/pelvic exam

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7
Q

Complications of Hep A

A

Acute chole, pancreatitis, AKI, arthritis, vasculitis, aplastic anemia

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8
Q

DDx for Hepatitis**

A
  1. The other two hepatitis’s (A, B, C)
  2. Mono, CMV, HSV
  3. Flu, Ebola
  4. Spirochete or rickettsia infection
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9
Q

What % of chronic hep B develops into cirrhosis?

A

40%

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10
Q

What two hepatitis’s together are synergistically bad

A

Hep B + D

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11
Q

Complications of Hepatitis C**

A
  1. Membranoproliferative glomerulonephritis
  2. Lichen planus
  3. Autoimmune thyroiditis
  4. Lymphocytic sialadenitis
  5. Idiopathic pulmonary fibrosis
  6. Sporadic porphyria cutanea tarda
  7. Monoclonal gammopathy especially
  8. Increased risk of non Hodgkin lymphoma
  9. Increased risk of ESRD
  10. Hepatic steatosis
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12
Q

What % of the time does acute Hep C become chronic?

A

85% of the time

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13
Q

Two condiitons that Hep C can lead to

A
  1. Cirrhosis

2. Hepatocellular carcinoma

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14
Q

DDx for cholecystitis

A

Perforated peptic ulcer, pancreatitis, high appendicitis, liver abscess, hepatitis, PNA, MI, CA of hepatic flexure, hepatocellular jaundice

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15
Q

Four labs/imaging to do for IBS American GI Association Guidelines and what theyre for

A
  1. CBC -> anemia?
  2. Fecal calprotein-> IBD?
  3. Serum TG IgA -> Celiac?
  4. Stool specimen in daycare workers, foreign travelers, campers -> parasite?
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16
Q

DDx for IBS

A
  1. Colon neoplasia
  2. IBD
  3. Bile acid diarrhea
  4. Thyroid issues
  5. Parasites
  6. Malabsorption
  7. Carcinoid
  8. Gynecological issues
  9. Depression/anxiety
17
Q

Antispasmodic drug for IBS

A

Anticholinergic drugs

18
Q

Two anti-constipation drugs for IBS

A
  1. Polyethylene glycol

2. Lactulose/sorbitol

19
Q

Two types of psychotropic agents for IBS

A
  1. Low dose tricyclic antidepressants: alter motility and sensitivity (only for IBS diarrhea)
  2. SSRIs: increase GI transit (only for IBS constipation)
20
Q

When are serotonin receptor antagonists used in IBS

A

Diarrhea

21
Q

Example of a non-absorbable Abx

A

Rifaximin

22
Q

Three types of psychological treatment for IBS

A
  1. Cognitive behavioral therapy
  2. Relaxation
  3. Hypnotherapy
23
Q

Two major complications in appendicitis

A
  1. Perforation

2. Thrombophlebitis of the portal system

24
Q

Signs of appendix perforation

A

High fever, diffuse tenderness, palpable mass, elevated WBC, sx for 36+ hours