8 Clinical Correlations GI Flashcards by Abby Finder

Absence of secretion of bile (acholic stools are white clay colored stools in cholelithiasis)

Acholic

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Lack of appetite

Anorexia

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Any serious acute intraabdominal condition (appendicitis) attended by pain, tenderness, muscular rigidity and needs emergency surgery

Acute abdomen

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Rumbling noise caused by propulsion of gas through the intestines

Borborygmi

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A profound and marked state of constitutional disorder; general ill and malnutrition

Cachexia

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Stoppage or suppression of bile flow due to factors within or outside the liver

Cholestasis

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Denotes blood congealed and separated within gastric contents that takes them form of coffee grounds when in contact with the acidic environment

Coffee-ground emesis

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Acute paroxysmal abdominal pain

Colic

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Enlarged non-tender gallbladder secondary to pancreatic disease or cancer

Courvoiser’s sign

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Ecchymosis around the umbilicus secondary to hemorrhage

Cullen sign

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Stress ulcer/peptic ulcer of the duodenum in a pt with extensive superficial burns

Curling ulcer

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Stress ulcer/peptic ulcer occurring from severe head injury or with other lesions of the CNS

Cushing ulcer

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Postprandial epigastric discomfort

Dyspepsia

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Difficulty swallowing

Dysphasgia

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Abnormal tissue development, alteration in size, shape, and organization

Dysplasia

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Having no teeth

Edentulous

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Inflammation of the esophagus

Esophagitis

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Endoscopic retrograde cholangiopancreatography

ERCP

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Expulsion of swallowed air

Eructation

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Endoscopic ultrasound

EUS

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Gas or air in the GI tract expelled through the anus

Flatus

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Inflammation of the stomach with distinctive histology can and endoscopic features

Gastropathy

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Gamma-glutamyl transferase, used to determine the cause elevated alkaline phosphatase (ALP)

GGT

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Flank ecchymosis secondary to hemorrhage

Grey turner sign

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Foreign body sensation localized in the neck that does not interfere with swallowing and can be relieved by swallowing; often occurs in the setting of anxiety of ODC

Globus pharyngeus

Protective response in muscle resulting from pain or fear of movement

Guarding

Could indicate appendicitis

Heel strike

Vomiting blood

Hematemesis

Passage of bright red blood stool

Hematochezia

Yellow staining of Integument, sclera, deeper tissues, and excretions with bile pigments which are increased in plasma

Icterus

Pt flexes hip against your resistance; increased abdominal pain positive test; irritation of psoas muscle from inflammation of the appendix

Iliopsoas muscle test

Plain abdominal x-ray of kidney, ureters, and bladder

KUB Xray

Lower gastrointestinal bleeding

LGIB

Tap the area of the back over the kidney, positivity produces pain, infection around kidney

Lloyd punch

Rebound tenderness 1/3 away from ASIS and umbilicus, appendicitis/peritoneal irritation

McBurneys Point

Dark colored stool, broken down hemosiderin in bowl, tarry

Melina

Lower abdominal pain in the middle of the menstrual cycle doesn’t cause rebound tenderness

Mittelschmerz

Magnetic resonance choliangiopancreatography

MRCP

Palpate deeply under R costal margin during inspiration and observe pain; tests for acute cholecystitis or cholelithiasis

Murphys sign

Sensation of impeding urge to vomit

Nausea

Severe intractable constipation caused by intestinal obstruction

Obstipation

Flex pts R thigh with knee bent and internally rotate hip; R hypogastric pain is positive; irritation of obturator m from inflamed appendix

Obturator muscle test

Painful swallowing

Odynophagia

Abnormal presence of gas in biliary system/bile ducts

Pneumobilia

Abnormal presence of air/gas in mediastinum; may interfere with respiration and circulation; lead to pneumothorax’ pneumopericardium

Pneumomediastinum

Abnormal presence of air or gas in peritoneal cavity

Pneumoperitoneum

Retrocecal appendix; RLQ pain with passive R hip extension

Psoas sign

Substernal burning sensation, heartburn

Pyrosis

Pain upon removal of pressure rather than application of pressure; tests for peritoneal inflammation or acute abdomen

Rebound tenderness

Effortless reflux of liquid or gastric or esophageal food contents in the absence of N/V; spontaneous reflux of gastric contents into mouth

Regurgitation

Peristalsis of stomach and esophagus conducted with a closed glottis

Retching

Hard abdomen, involuntary reflex contraction of abdominal wall

Rigidity

Pain in the RLQ during left sided pressure, referred to rebound tenderness seen in appendicitis

Rovsing’s sign

Fatty, greasy stools

Steatorrhea

Ineffectual and painful straining at stool or urination

Tenesmus

Upper gastrointestinal bleed

UGIB

Local defect, of the surface of an organ or tissue that is produced by the sloughing of inflamed necrotic tissue

Ulcer

Stone from kidney making its way through ureter to bladder, urine analysis will show hematuria

Ureterolithiasis

Palpable mass, lymph node in the L supraclavicular/sternoclavicula fossa

Virchow’s node

Queasiness, retching, forceful ejection of upper gut contents from mouth

Vomiting/emesis

Onset of pain .5-1.5 hours after the inciting event like food or NSAIDS Located along the lesser curvature of the stomach H. Pylori risk for complications

Gastric ulcer

Most common Common to proximal duodenum Can be from gastronomic (Zollinger-Ellison syndrome) Onset of pain 3-5 hours after inching event H. Pylori risk for complications

Duodenal ulcer

Causes of peptic ulcer disease

H. Pylori, NSAIDS, tobacco, EtOH, neoplasia,

Alarm features in dyspepsia

Unintentional weight loss Progressive dysphagia Odynophagia Unexplained iron deficiency anemia Persistent vomiting Palpable mass, lymphadenopathy Family history of upper GI cancer

Inflammation with mucosal injury Infections agents like H. Pylori due to increase gastric acid secretion Epithelial cell damage and regeneration without inflammation

Gastritis Gastropathy

Loss of peristalsis in the distal 2/3 of the esophagus; incomplete LES relaxation during swallowing ***birds beak sign?

Achalasia

Chagas disease causes

Secondary alchalasia

Most prevalent chronic bacterial disease PUD, chronic gastritis, gastric adenocarcinoma, gastric MALT Detection?

H. Pylori Urea breath test

Releases cytotoxins that breakdown the mucosal barrier and underlying cells Uses the enzyme ___.

H. Pylori Urease