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Clinical Exams 2013 Fall > Abdomen (the rest) > Flashcards

Abdomen (the rest) Flashcards

1
Q

What are ways for assessing possible appendicities?

A
  • localized pain in RLQ
  • guarding, involuntary muscular rogidity
  • Rectal/Pelvic Exam
  • (+) Rosving’s Sign (rebound tenderness in LLQ results in RLQ pain)
  • (+) Psoas Sign: raise right knee to hand
  • (+) Obturator sign: internally rotate leg at hip
  • Cutaneous Hyper anesthesia (painful response by picking up skin only)
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2
Q

You find an abominal mass with pulsations that are 3+ centimeters wide, what is this indicative of?

A

adominal aneurysm

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3
Q

If an abdominal aneurysm enlarges, sensitivity increases or decreases?

A

increases

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4
Q

If an aneurysm is >4m in diameter, what is very likely

A

Rupture (15x more likely)

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5
Q

What are causes of Ascites?

A
  • increased hydrostatic pressure in cirrhosis
  • congestive heart failure
  • constrictive pericarditis
  • inferior vena cava or hepatic vein obstruction (decreased osmostic pressure in nephrotic syndrome)
  • malnutrition
  • ovarian cancer
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6
Q

What are causes of constipation?

A
  • Life activities and habits (deficiency of fiber in diet)
  • Irritable Bowel Syndrome
  • Mechanical obstruction
  • Painful Anal lesions
  • Drugs
  • Depression
  • Neurologic disorders
  • Metabolic conditions
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7
Q

What are causes of Dysphagia?

A

Motor disorders

  • Diffuse esophageal spasm
  • scleroderma
  • achalasia

Esophageal Dysphagia (mechanical narrowing)

  • mucosal rings and webs
  • esophageal stricture/cancer

Oropharyngeal Dysphagia

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8
Q

What are casuses of CVA Tenderness?

A

Kidney stones

Polynephritis

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9
Q

What are causes of kidney enlargement?

A

Hydronephrosis
Cysts & Tumors
Bilateral enlargement : polycystic kidney disease

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10
Q

What are some abnormal palpatory liver findings? what are their indications?

A
  • Downward displacement of liver ==> COPD
  • Smooth Nontender large liver ==> Cirrhosis
  • Smooth Tender large liver ==> inflammation by hepatitis or venous congestion (Right side heart failure)
  • Irregular Large Liver ==> malignancy w/ possible nodules
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11
Q

What is abdominal involuntary rigidity and it’s indication?

A

Abdominal involuntary rigidity is a muscular spasm of the abdomen that persists. Indicative of peritoneal inflammation.

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12
Q

If you find dark urine what does this indicate?

A

Conjugated bilirubin in the urine makes it dark indicates impaired excretion of bilirubin into the GI tract.

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13
Q

What is the significance of acholic stools?

A

viral hepatitis and obstructive juandice, which is obstruction of bile secretion into the intestine.

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14
Q

What are the main symptoms of uriary tract disease and urinary partial obstruction?

A

frequency, pain, color/smell [urinary tract disease]

difficulty to start urinaring (men) or leaking of urine (women) [urinary partial obstruction]

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15
Q

What is hematuria?

A

bloody urine

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16
Q

What is situs inversus?

A

Abdominal viscera in the opposite sides of the body

17
Q

What is overflow incontinence?

A

Detrusor contractions insufficient to overcome urethral resistance = large bladder = can’t void

18
Q

Which is more painful and localized: visceral pain or parietal pain?

A

Parietal pain

19
Q

What is hematemesis?

A

bloody vomit

20
Q

What id dysphasia?

A

Difficulty swallowing

21
Q

What is tenesmus?

A

constant urge to defecate

22
Q

What qualifies as constipation?

A

Fever than 3 bowel movements per week with 35% or more defecations with straining for 12 weeks

23
Q

What is hematochezia?

A

red or maroon-colored stools?

24
Q

What is melena?

A

black tarry stools

25
Q

What is urinary incontinence?

A

involuntary voiding

26
Q

What is stress incontinence?

A

urethral spincter weakening resulting in intra-abdominal pressure raising the bladder pressure to levels that exceed urethral resistance. (pee when coughing/lauhing/sneezing)

27
Q

What is urge incontinence?

A

detrusor contractions stronger than normal; small bladder. Results in urgency, frequency, nocturia, and tends to have moderate urine volume.

28
Q

How do you perform an obturator test? What does a positive test mean?

A

Flex patient’s thigh and rotate leg internally at the hip

(+) results = Pain in RLQ = appendicitis

29
Q

How do you perform a iliopsoas test? What does a positive test mean?

A

Place hand above patient’s right knee and have them raise thigh against hand.

(+) = Pain in RLQ = appendicitis

30
Q

What is the significance of a positive rebound tenderness?

A

peritonitis

31
Q

Describe a bruit and the significance of a hepatic bruit and arterial bruit.

A

Bruit = whooshing of heart murmurs at bifurcations.

Hepatic Bruit = carcinoma of the liver or alcoholic hepatitis
Arterial Bruit - partial occlusion of aorta. If of renal artery, explains hypertension.

32
Q

What are normal bowel sounds?

A

clicks and gurgles 5-34 times per minute

33
Q

What are abnormal bowel sounds?

A
  • Absent: Decreased sounds (none for 2minutes) ==> adynamic ileus and peritonitis
  • Increased ==> diarrhea and early intestinal obstruction
34
Q

What is borborygmi?

A

stomach growling and prolonged gurgles of hyperperistalsis

35
Q

What is a succession splash?

A

fluid sloshing around the abdomen

36
Q

What is a Rosving’s sign? What is the diagnostic meaning of a positive sign?

A

Piain in RLQ during left sided application of pressure leads to referred rebound tendernous in LLQ.

Positive sign = appendicitis

37
Q

What is a Murphy’s sign? What is the diagnostic meaning of a positive sign?

A

RUQ pain and tenderness

(+) sign : acute cholecytstitis

38
Q

Describe main symptoms of abdominal disease (GI and Urinary/Renal)

A

GI Disorders:
- Abomdinal pain, ingestion, nasuea, vomiting, loss of appetite, dysphagia, odynophagia, change in vowel function, diarrhea, constipation, juandice

Urinary and renal disorders:
Suprapubic pain, dysuria, hesitancy, polyuria, nocturia, urinary incontinence, hematuria, kidney or flank pain, ureteral colic

Clinical Exams 2013 Fall (6 decks)

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