Abdominal Flashcards
Acute diarrhea
Frequent liquid or loose stools lasting less than four weeks duration
Patho: Most commonly viral and self-limited. International travelers may acquire foodborne infection. Camping or well water exposes individuals to Peoria. Salmonella from under cooked poultry. Under cooked beef or unpasteurized milk may contain E. coli.
Subjective: Usually abrupt onset and less less than two weeks. Abdominal pain, nausea, vomiting, fever, to Nazmus, vomiting with in several hours of ingesting a particular food suggest food poisoning, bloody diarrhea may occur with Campylobacter and shigella.
Objective: Diffuse abdominal tenderness, examination can mimic peers Neil inflammation with right lower quadrant pain or guarding. If a severe, may have some signs of moderate to severe dehydration, especially in infants, children and older adults.
Gastroesophageal reflux disease
Backward flow of gastric contents, which are typically acidic, into the esophagus.
Patho: Relaxation or incompetence of the lower esophageal sphincter. Delayed gastric emptying it a predisposing factor.
Subjective: Heartburn or acid indigestion, bitter or sour taste of acid in the back of the throat, hoarseness. infants and toddlers exhibit back arching, fussiness with feeding, or regurgitation and vomiting. Can be severe enough to cause weight loss and failure to thrive. Can precipitate in acute asthma exacerbation or cause chronic respiratory problems from aspiration.
Objective: Generally on remarkable examination. With severe disease may have erythema or Adema to the posterior pharynx.
Irritable bowel syndrome
-Disorder of intestinal motility
Patho: Common, occurs in about one in five Americans, more often in women, usually begins in the late adolescence or early adult life in rarely appears for the first time after 50 years of age.
Subjective: Commonly report a cluster of symptoms, consisting of abdominal pain, bloating, constipation, and diarrhea. Some experience altering diarrhea and constipation. Mucus maybe present around or in the store. Belts me a current times of emotional distress.
Objective: Generally unremarkable exam. Diagnosis is typically made after excluding other potential causes. Diagnostic work criteria requires recurrent abdominal pain or discomfort at least three days per month during the previous three months associated with two or more of the following: relieved by defecation, on site associated with change and still frequency, onset associated with changes to form or appearance.
Hiatal hernia with esophagitis
-Part of the stomach passes through the esophageal hiatus in the diaphragm into the chest cavity
Patho: Very common, occurs most often in women and older adults. Associated with obesity, pregnancy, ascites, and the use of tight – fitting belts in clothes. Muscle weakness is a predisposing factor
Subjective: Epigastric pain and or heartburn that worsens when lying down and is relieved by sitting up or antacids. Water brash (Mouth filled with fluid from the esophagus). Dysphasia. Most are asymptomatic and discovered incidentally.
Objective: Generally unremarkable examination. With severe disease may have erythema of the posterior pharynx and a debit his vocal chords.
Peptic ulcer disease
-Includes gastric and duodenal.
Patho: ulcers. pylori and NSAIDs are common causes. Increased in smokers and people with cirrhosis, CRF, and lung disease
Subjective: Localize epigastric pain that occurs when the stomach is empty and is relieved by food or antacids. With upper G.I. bleeding, symptoms include hematemesis and melena.
Objective: Anterior wall ulcers may produce tenderness on palpation of the abdomen. Also took her on both the anterior and posterior your walls of the duodenal bulb. Anterior ulcers are more likely to perforate. Posterior ulcers are more likely to bleed.
Crohn disease
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Chronic inflammatory disorder that can affect any part of the gastrointestinal tract that produces ulceration, fibrosis, and malabsorption. Terminal ileum and colon are the most common sites.
Patho: Causes unknown but is that to occur from an in balance between inflammatory
Subjective: chronic diarrhea with compromise nutritional status. Other systemic manifestations may include arthritis, Otitus, and erythema nodosum some. Disease course characterized by unpredictable flayers intermissions
Objective: May have right lower quadrant tenderness. Abdominal mass may be palpated at secondary to thicken or inflamed bowel. Pierino skin tags, fistula and abscesses maybe seen. Extraintestinal examination findings include erythema nodosum and Pyrodema gangrenosum as well as arthritis involving the right large joints. Colonoscopy and pathology show characteristic cobblestone appearance of the mucosa.
Ulcerative colitis
-Chronic inflammatory disorder of the colon and rectal him that produces mucosal friability in areas of ulceration
Patho: Unknown, but immunologic and genetic factors happened implicated. Active chronic ulcerative colitis predisposes an individual to developing colon cancer
Subjective: Bloody, frequent, watery diarrhea, with as many as 20 to 30 diarrheal stools per day. May exhibit weight loss, fatigue, and general debilitation. May range from mild to severe, depending on the degree of: involvement. May remain in remission for years after an acute phase of the illness. Sclerosing cholangitis maybe present with fatigue and jaundice
Objective: generally do not have fistula or. It’ll disease. Contrast radiographs typically show loss of the normal mucosal pattern. Sclerosing cholangitis us may occur with a cholestatic Pattern of elevated transaminases levels. Endoscopic findings show mucosal edema with alterations and bleeding
Stomach cancer
-Arises from epithelial cells of the mucous membrane
Patho: excess salt intake, chronic gastritis, H pylori.
Subjective: rarely symptomatic until advanced.May have vague and nonspecific symptoms, including loss of appetite, feeling of fullness, weight loss, dysphasia, and persistent epigastric pain
Objective: May have a mid epigastric tenderness, hepato-megaly, and large superclavicular nodes, And ascites. And epigastric mass maybe palpable in the late stages of the. Diagnose on endoscopy
Diverticular disease
Patho: Diverticula are saclike mucosal outpouching’s. May involve any part of the gastrointestinal tract, the sigmoid is most common. Cause unknown, but may be caused by dysmotility, defective muscular structure, and defects in collagen and aging.
Subjective: Most patients are asymptomatic. With diverticulitis, may experience left lower quadrant pain, anorexia, nausea, vomiting and altered Bal habits, usually constipation. Pain usually at site of inflammation
Objective: May have abdominal distention and be tympanic To percussion with decreased bowel sounds and localized tenderness. Lower gastrointestinal bleeding may occur
Colon Cancer
Patho: May involve the rectum, sigmoid, proximal and descending colon. Second most common cancer in the US
Subjective: Symptoms depend on cancer location, size and presence of metastases. May describe abdominal pain, blood in the stool, or recent change in stalls. Earliest sign maybe occult blood in stool.
Objective: few early exam findings. If disease progressed, may have palpable abdominal mass in right or left lower quadrant or show signs of anemia. Rectal cancer maybe palpable buy digital rectal examination.
Hepatitis
-Inflammatory process characterized by diffuse or Patty have had a cellular
Patho: most commonly caused by viral infection, alcohol, drugs, or toxins
Subjective: Some are asymptomatic. Others report Janice, anorexia, abdominal pain, clay colored stools, tea colored urine, and fatigue
Objective: abnormal liver function tests. Jaundice and a paddle megaly. With advanced disease, cirrhosis
Cirrhosis
-Diffuse have Patrick process characterized by fibrosis and alteration of normal liver architecture into structurally abnormal nodules
Patho: Progression of liver disease can happen over weeks to years.
Subjective: Some are asymptomatic. Others have jaundice, anorexia, abdominal pain, clay color souls, tea colored urine. Made us cry prominent abdominal vasculature, cutaneous spider angiomas, hematemesis, and abdominal fullness
Objective: enlarged liver with a firm, nontender border on palpation. As scarring progresses, liver size is reduced, and generally cannot be palpated. Neurological exam may be altered. Portal hypertension and ascites may occur. Muscle wasting and nutritional deficiencies in late stages. May have abnormal lab values.
Primary hepatocellular carcinoma
Patho: often in the setting of cirrhosis, 20 to 30 years after liver injury or disease onset. Median diagnosis survival time is six months. Can metastasize to lungs, portal vein, periprotal nodes, bone, and brain.
Subjective: Symptoms may include jaundice, anorexia, fatigue, abdominal fullness, clay colored stools, and tea colored urine.
Objective: Hepatomehaly with a heard, irregular liver boarder. Liver nodules maybe present and palpable, and liver maybe 10 or nontender. Exam findings related to cirrhosis.
Cholelithiasis
-Stone formation in the gallbladder occurs when certain substances reach a high concentration and file and produced crystals
Patho: Crystals mix with mucus in form gallbladder sludge, overtime the crystals in large, mix and form stones. Usually cholesterol.
Subjective: many are asymptomatic. Symptoms may include indigestion, Colic, and mild transient jaundice
Objective: Come only produces episodes of acute cholecystitis
Cholecystitis
-Inflammatory process of a gallbladder most commonly due to obstruction of the cystic duct from Coley lithiasis, which maybe acute or chronic.
Patho: with cystic duct obstruction, the gallbladder becomes distended and blood flow is compromise, leading to ischemia and inflammation. Associated stone formation in 90% of cases. Without stones, results from any condition that affects the regular emptying and filling of the gallbladder.
Subjective: RUQ pain with radiation around the torso to the right scapula. abrupt and severe and last for 2 to 4 hours. May have fever, Jaundice, and anorexia. With chronic form, may exhibit fat intolerance, flatulence, nausea, anorexia, and nonspecific abdominal pain
Objective: positive Murphy’s sign. RUQ pain.
