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ECOS II Exam 1 > 5/6: Abdominal Complaint > Flashcards

5/6: Abdominal Complaint Flashcards

1
Q

Where do duodenal and pancreatic pain refer to?

A

Back

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2
Q

Where does biliary tree pain refer to?

A

Right shoulder

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3
Q

Specific GI ROS sx to ask

A

N/V/D, black stools, blood in stool, blood in vomit

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4
Q

Specific GU ROS sx to ask

A

Dysuria, polyuria, hematuria, flank pain

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5
Q

Specific GYN ROS sx to ask

A

Vaginal bleeding, vaginal discharge, LMP, possibility of pregnancy

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6
Q

Important meds to ask about for a GI complaint

A

GI prescriptions, OTC GI meds, NSAIDs, blood thinners, narcotics, steroids

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7
Q

Important social questions to ask for a GI complaint

A

Smoking, drugs, alcohol, stress, travel, well water outside the US, undercooked meat ingestion

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8
Q

What’s crucial about the abdominal physical exam?

A

Must be done in the specific order: inspection, auscultation, percussion, palpation

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9
Q

Abdominal bruits

A

Vascular sounds like a heart murmur, typically from vascular obstruction in abdomen

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10
Q

Friction rub

A

Grating sound with respiratory variation, typically due to inflammation of the peritoneal surface of an organ

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11
Q

Venous hum

A

Soft humming noise due to increased collateral circulation between portal and systemic venous systems

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12
Q

A protuberant abdomen that is tympanic throughout might indicate what?

A

Intestinal obstruction

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13
Q

What % of adults can the tip of the spleen be palpated in?

A

5%

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14
Q

Fluid wave test

A

Pt rests their hand over the chest, place one hand on one side of the abdomen and tap the other side sharply with finger tips, feeling for impulse transmission to the other hand

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15
Q

Shifting dullness test

A

Percuss for dullness with patient supine, then have pt lay on side and percuss again

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16
Q

What is a positive shifting dullness test

A

Dullness shifts to dependent side and tympany shifts to top side -> ascites

17
Q

McBurney’s point tenderness

A

Draw an imaginary line between ASIS and umbilicus, palpate two inches medial to ASIS on that line; tenderness -> positive test

18
Q

Rovsing’s sign

A

Palpate deeply in LLQ and if pain is felt in RLQ -> positive test

19
Q

Murphy’s sign

A

Palpate deeply under pts right costal margin, ask pt to take a deep breath in and palpate deeper -> sharp increase in tenderness is a positive test

20
Q

Lloyd’s sign/punch

A

Hit pts back (deep percussion) in area of costovertebral angle -> pain is a positive test

21
Q

What do guarding, rigidity, and rebound tenderness indicate

A

Acute abdomen / peritoneal inflammation

22
Q

Rigidity

A

Involuntary reflex contraction of abdominal wall, becomes stiff or board-like

23
Q

Rebound tenderness

A

Push down deep into abdomen and let go -> more tenderness in letting go is rebound tenderness

24
Q

Enteritis

A

SI inflammation

25
Q

Colitis

A

Colon inflammation

26
Q

Cystitis

A

Inflammation of urinary bladder

27
Q

Borborygmi

A

Significant increase in peristalsis which can cause audible or palpable bowel activity (hunger sounds)

28
Q

How to do pain scale for vomiting or diarrhea

A

Dont do the pain scale, ask questions like “what does this keep you from doing? How has this affected your life?”

29
Q

What is important to consider for the ROS of a pt with diarrhea or vomiting?

A

How much fluid they’ve lost - do they have dizziness or light-headedness, syncope, dehydration, muscle aches, or fever?

30
Q

Behavioral model to treat diarrhea

A

Gut rest (frequent small amounts of food and liquid), hydration with clear liquids, eliminate possible offending agent, address SD as needed

31
Q

Things that can cause osmotic diarrhea

A

Mannitol/sorbitol (in sugar free candy), Mg, lactose intolerance

32
Q

Two things that can cause secretory diarrhea

A

C. Diff, E. Coli

33
Q

Rome Criteria of constipation

A

Two of the following:

  1. Fewer than 3 BM/week
  2. 25%+ defecations with straining or sensation of incomplete emptying
  3. Lumpy/hard stools
  4. Manual facilitation/disimpaction
34
Q

Bristol Stool Scale

A

Pediatric stool scale to standardize look and feel of BM

35
Q

Four symptoms associated with constipation that could be urgent

A

Vomiting, rectal bleed, severe abd pain, inability to pass flatus

36
Q

Constipation + dizziness or syncope could mean?

A

Anemia or blood loss

37
Q

Delayed defecation

A

Waiting to defecate can cause dryer stools -> constipation

38
Q

Constipation treatment

A

Assess dietary needs (adding fiber), increase water, go to the bathroom when you feel you need to, exercise, address SD as needed

ECOS II Exam 1 (18 decks)

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