Abdominal

Question 1

SBO

Answer 1

Dilated air filled loops = SBO

s/s: nausea

Question 2

Diverticulitis

Answer 2

Mild to moderate LLQ pain, nausea and elevated sed rate,

Question 3

Cholecystitis

Answer 3

Pain most prominent in RUQ, sig pain after fatty meal, elevated LFTs

Murphy’s sign: breath in c gallbladder palpation if this elicits pain think Cholecystitis

Question 4

Appendicitis

Answer 4

Pain from umbilicus to RLQ, mild fever

Markel’s sign: pain c running or dropping from toes to heels

Blumberg sign= rebound tenderness

Question 5

Hep C

Answer 5

50% transmitted thru IV drug use
Mom to child @ birth, tattoos, transfusions & sex

S/s: RUQ pain, fatigue, nausea, HA, anorexia & weight loss, elevated LFTs & hepatospleenomegaly

PCR testing to differentiate past exposure from acute hep C

Question 6

Hep B

Answer 6

Transmitted through blood, sex, mom to child @ birth

HBsAg serum test confirms Hep B infxn, +HBsAg= infectious

Chronic vs acute? Anti-HBc, IgM anti-HBc, hep B surface antibody,

Question 7

Ulcerative colitis

Answer 7

S/s: bloody diarrhea

Question 8

Acid reducers

Answer 8

Zantac: H-2 receptor agonist blocks acid production
Tx: 1st line tx for GERD

Prevacid: PPI inhibits production of gastric acid
*use before meal or bedtime to inhibit acid

Maalox: antacid that works to neutralize acid

Sucralfate: cytoprotective agent used in presence of duadonal ulcers

• must take 2hrs before meal
• use for 6-8wks after H. Pylori is tx

Misoprostol: prostaglandin E1 analog
Tx: prevent gastric ulcers, induce labor/abortion, missed miscarriage, NSAID induced ulcer prophylactic
*used to prevent gastric ulcers

Question 9

Cancer

Answer 9

Significant unintentional weight loss c bloody, pencil stool rule out Cancer

Lab:

Question 10

Duodenal ulcer

Answer 10

Most common 30-55yo
Pain relieved by eating but returns 3-5hrs after meal, gnawing pain

M>W

90% caused by H. Pylori

Question 11

PUD and GERD

Answer 11

Both irritated by eating

Question 12

H. pylori

Answer 12

Flagyl, amoxicillin & omeprozole together to treat H. Pylori

Question 13

LFT
Aspartate aminotransferase (elevated c ETOH abuse)

Alkaline phosphatase (elevated c Cholecystitis)

Answer 13

Elevation is caused by things that stress the liver such as ETOH, Tylenol, hepatitis & statins

Alkaline phosphatase elevation c RUQ indicates Cholecystitis