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#Clinical Assesment > Abdomen > Flashcards

Abdomen Flashcards

1
Q

What environmental exposures, or lifestyle factors predispose ppl to liver dz

A

meds, enviro toxins(indust w/job), anesthesia, alcohol

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2
Q

_______ surgery or dz can lead to hepatic dz

A

gallbladder

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3
Q

Hep ____ travels fecal-oral, d/t contamination

A

Hep A

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4
Q

Hep ___ is transfered via fluid contact with mucous membrane (blood, saliva, semen)

A

Hep B

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5
Q

Hep ____ is associated with IV drug use, or blood transfusion

A

Hep C

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6
Q

Consider doing a CAGE questionaire if pt reports > ____ drinks per day for over a year

A

4-5

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7
Q 
unsafe # for drinks for women = >\_\_\_drinks/day and \_\_\_drinks per week
# for men= >\_\_\_\_ drinks a day and \_\_\_ drinks per week
A

> 3 and >7 per week

> 4 and >14 per week

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8
Q

what # drinks is considered a binge for m vs w

A

> 4 for women, >5 for men in one sitting.

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9
Q

Hep ___ and ____ have vaccinations; Hep ___ has no vaccination

A

A &B = vaccine

C = NO vaccine

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10
Q

Hep ____ exposure requires you treat sexual contacts

A

B

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11
Q

What are high rsik groups for Hep B

A

IV drug, household contact with + pt, travelers to endemic areas, ppl w/chronic liver dz, HIV +

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12
Q

Risk factors for colorectal CA

A

inc Age, adenometous polyps, long standing IBD, fam Hx

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13
Q

“weak” risk factors for colorectal CA

A

obesity, excess ETOH, male, red meat, tobacco use, AA race

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14
Q

Non-high risk ppl should begin colorectal screening at age ___—____

A

50-75

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15
Q

2 options for colorectal screening

A

annual stool tests or endoscopy(colonoscopy or sigmoidoscopy)

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16
Q

Sigmoidoscopy s/b done every ___ years w/ _____done every 3 years

A

5 years, FOBT done every 3 yrs

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17
Q

colonoscopy is done every ___ years

A

10

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18
Q

As you get older esophageal mobility is diminished which can lead to ____ and _____

A

esophagitis(d/t food stasis), and aspiration

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19
Q

as you age you have an increased risk for ____ gastritis and ulcers (d/t delayed gastric emptying)

A

atrophic

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20
Q

as you get older there is a dec ability to absorb ____ leading to osteoporosis

A

Ca2+

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21
Q

w/ aging there is reduced anal distention and perception and slowed colonic transit time leading to ____and ____

A

inc constipation and impaction

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22
Q

As you age what happens to the pancreas

A

reduced beta cell response = inc insulin resistance and dec insulin secretion

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23
Q

what happens to the liver as you age

A

dec hepatic blood flow= dec albumin synth, dec drug elimination. less hepatic extraction of LDL (leads to CAD), gallstones,

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24
Q

Describe visceral pain

A

in the hollow organs, d/t ischemia/stretching, – gnawing cramping, aching, burning. also with n/v sweating and pallor

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25
describe parietal pain
direct irritation of parietal peritoneum; d/t pus, bile, urine, gi secretions. steady and severe pain, aggravated by movement/cough t prefers to lie still
26
LLQ pain (1)
sigmoid diverticulitits
27
RLQ pain (3)
appendicitis, cecal diverticulitis, mesenteric adenitits
28
LUQ pain (3)
gastritis, splenic do, abcess/rupture
29
RUQ pain
cholecistitis/billiary colic, hepatitis, perf duodenal ulcer,
30
where can pancreatits be felt
RUQ or LUQ
31
dyspepsia aka _____ is characterized by (3)
indigestion, post prandial fullness, early satiety, epigastric pain/burning
32
______ is retrosternal burning aggravated by foods or position
heartburn
33
_____ + ______ >1x per weeks suspect GERD
heart burn + regurgitation
34
Chronic upper abdom pain/discomfort = suggests GERD... what are the red flags? (6)
``` dysphagia/odynophagia reccurent vomiting, early satiety/wt loss evident GI bleeding/anemia painless jaundice/palpable mass PMH or FHx GI cancer ```
35
dysphagia triggered by solids is likely _______ | whereas liquids/solids is likely _______
structural | a motility issue
36
what is odynophagia (caused by 2 things)
pain when swallowing that can be caused by caustic ingestion or oral infection
37
what is tenesmus
rectal cramping/pain, urge to go with little output and straining.
38
hematochezia, what is it indicative of
streaking of blood in stool ---- likely do to anal bleeding
39
how is bilirubin eliminated
processed in the liver and excrete out with bile
40
what is post hepatic jaundice and what 4 things cause it
conjugated hyperbilirubinemia, caused by gallstones, biliary tract infxn, pancreatitis, or malignancy
41
what does suprapubic pain indicate
bladder distention/UTI, dull pressure-like pain
42
dysuria, w/ urgency, f/c, hesitancy, red stream, straining to void, and/or driblling could indicate (3)
bladder iritation/infection, urethritis, prostatitis
43
where is McBurney's point?
just superior to the inguinal ligament
44
very thick looking stretch marks could indicate
cushings dz
45
do you perform palpation, percussion or auscultation of the abdomen first?
auscultation (to gauge pressure/pain)
46
what are normoactive gut sounds?
5-34 clicks/gurgles per min at RLQ most loud
47
what is borborygmi
loud gurging often d/t hyper peristalsis
48
liver/spleen friction rubs can be heard with... (4)
hepatic carcinoma, splenic infarct, chlamydia or gonococcal perihepititis (Fitz-Hugh-Curtis syndrome)
49
Bruits can be heard with ______ or ________ ; where do you need to listen (4)
HTN or PAD | listen at aorta, iliac, renal, and femoral arteries
50
sounds s/b _____ over the liver and _____ above an below
dull | resonant
51
normal liver size is
6-12cm
52
how do you percuss the spleen
at the last ICS percus ant to the axillary line (s/b tympanic), have pt inhale deeply shoudl remain tympanic (if becomes dull then could be splenomegaly)
53
how to distinguish abdominal mass vs abdom wall mass
have pt raise crunch, if mass no longer palpable this is an abdominal mass as it is obscured by the ab muscles.
54
what does CVA tenderness indicate (3)
pyelonephritis, MSK, or calculi
55
what is the psoas sign and what can it indicate
pain on same side with passive/active flexion of hip, on rt side= appendicitis
56
what is the obturator test and what can it indicate
pain when flex hip and int rotate knee, appendicitis on the rt side
57
what is rovsing's sign
RLQ pain wiht pressure on the LLQ = appendicitis
58
what is murphy's sign?
hook under the right costal margin and ask pt to inhale = if sudden stop d/t pain could be cholecystitis
59
what are the 3 tests for acities
flank dullness, shifting dullness (dull on left bottom when roll to left), and fluid wave test
60
what is the normal size/positioning of the abdom aorta?
just left of midline, <3cm
61
appendicitis pain start/end
starts at umbilicus and moves to RLQ
62
GERD results from ______ which can be caused by (3)
prolonged esoph exposure to gastric acid; | caused by: abnorm LES, esophagus dysfxn motility, or H. pylori infxn
63
what is the timing of GERD pain? what are the 3 aggravators?
timing is post prandial | aggravate: supine, bending over, other issues with LES
64
what are 5 poss associated sx of GERD
cough, wheeze, hoarse, dysphagia, halitosis
65
what is barretts esophagus
change in the cells of esophagus dt GERD, alcoholism, inc risk of CA
66
where can peptic ulcer pain be felt, what's the quality
epigastric and radiation tot he back; gnawing or burning
67
gastic CA/adenocarcinoma, timing of pain, and assoc sx
perisitent slowly progressive, | NV, early satiety, wt loss
68
what is acute cholecystitis
inflam of gall bladder d/t obstruction at cystic duct by stone
69
acute cholecystitis loc of pain, quality and timing
RUQ w/ radiation to rt scapula, steady ache, grad onset
70
what aggravates acute cholecystitis, assoc sx?
breathing aggravates | assoc anorexia, nv, and female gender
71
______ often preceeds acute cholecystitis; w/ acute cholecystitis_______ sign is present
``` billiary collic(cystic/common bile duct obstructed, pain w/fatty foods) Murphy's is + = pt can't complete breath ```
72
Acute vs Chronic Pancreatitis
Acute: autodigest, worse supine, better w/forward flexion; assoc: NV distension Chronic: fibrosis d/t inflam, worse w/etoh and fat meals, pain is intractable(no relief), assoc: foul, fatty, stoolwt loss
73
where is acute pancreatitis felt
epigastric radiation to back
74
where is pancreatic CA pain felt, assoc sx?
RUQ or LUQ w/radiation to back | jaundice anorexia, wt loss
75
pain of acute diverticulitis is felt as _____ in the _ _Q; what 2 things may be found on PE
steady or collicky cramping pain, in the LLQ | may find palpable mass at LLQ and pos rebound tenderness
76
small bowel obstructions have ______ timed pain
paroxysmal - which means it comes in sudden severe bursts
77
what does the pt vomit with a high bowel obstruction? low?
high: bile or mucus vomit low: fecal vomit
78
what is obstipation?
inability ot pass hard dry stool (late stage of sbo)
79
what is messenteric ischemia? how does it present>
small bowel artery occlusion (sup messenteric) | periumbillical then diffuse painfelt as a steady cramping, after meals abrupt onset. vomiting, distension, food fear
80
what infectious agents could cause acute watery stool wiht nv and cramping? (4)
giardia, staph, e. coli, rotavirus
81
______, ______, and ______ can cause loose/watery stool with blood/pus cramping, tenesmus, and fever.
shigella, salmonella, and campylobacter
82
IBS is due to failed ______
motility
83
sigmoid CA causes ___ stools or ....
pencil, melana, hematochezia, unexplained anemia
84
chron's dz is an example of ____
inflamm bowel dz
85
____ (5) can cause an increase in urinary freq
tumor, stones, infection, scar tissue, or obstruction
86
high volume nocturia could indicate
dec renal fxn, HF, cirrhosis, or CVI
87
polyuria suggests
diabetes insipidus
88
overflow vs urge incontinence
detrusor bladder contractions cannot overcome urethra resistance urge: detrusor contractions are too strong

#Clinical Assesment (5 decks)

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