Abdominal/Visceral/Endocrine conditions

Question 1

diabetes mellitus ss

Answer 1

polyuria (excess urine), Polydispia (thirst), Polyphagia (hunger), Weight loss, blurry vision

Question 2

diagnostic criteria for diabetes mellitus

Answer 2

FPG >7.0mmol

2h 75 OGTT >11.1

Random pg >11.1

HbA1c >6.5

Question 3

What is diabetes insipidus

Answer 3

decreased production of antidiuretic hormone or peripheral resistance to ADH, resulting in passage of large volumes of dilute urine

Question 4

What are the 2 types of diabetes insipidus

Answer 4

Central- insufficient ADH due to pituitary surgery, trauma etc

Nephrogenic DI- resistance of the collecting tubules in kidneys to ADH

Question 5

Diabetes insipidus ss

Answer 5

ss- urine will be clear, decreased osmolarity, plydispia, polyuria

Question 6

adison’s disease, cause and ss

Answer 6

inadequate cortisol and aldosterone production by adrenals

dark skin
high pot, low sodium
weakness, fatigue, weight loss

Question 7

pheochromocytoma clinical features and cause

Answer 7

-catacholamine recreating tumor of adrenal medulla

1.HTN
2.Pounding headache, palpitations, excessive sweating `

Question 8

Acromegaly ss, px

Answer 8

GH after growth plates closed

ss- enlargement of hands/feet, coarse facial features

px- elevated serum insulin like growth factor (best initial test)

Question 9

hashimotos disease- cause, ss

Answer 9

thyroid gland doesnt produce due to autoimmune

(TSH HIGH, Thyroid hormone LOW) (primary)

ss- fatigue, increased sensitivety to cold, dry skin, weight gain, puffy face

Question 10

primary hyperthyroidism ss, px

Answer 10

• when thyroid produces too much thyroxine (graves)

ss- unitentional weight loss, rapid heartbeat, increased appetite etc

px- decreased TSH and high T3/4

Question 11

Cushings disease cause

Answer 11

pituitary adenoma causing increased ACTH

(secondary due to endogenous glutocorticoid excess)

Question 12

GERD ss, px

Answer 12

due to excessive relaxation of LES resulting in back flow of acidic stomach contents

ss- heart burns chest pain difficulty swallowing

Question 13

Barrets esophagus cause, ss

Answer 13

Metaplasia of normal squamous esophageal epithelium to columnar epithelium due to long standing GERD

Question 14

Diffuse esophageal spasm- ss, px

Answer 14

Idiopathic neuronal conduction resulting in esophageal spasm

ss-intermittent pain, no relation to swallowing

px- barium xray corkscrew pattern

Question 15

Dsymenorrhea ss,

Answer 15

ss- painful menstrual cramping in lower abdomen during period. Starts 1-3 days before period, peaks 24hrs after onset

Question 16

Chrons disease, ss, location, px appearence

Answer 16

ss- diarhea (non bloody), right lower quad pain

px- cobblestone appearance, fistulae, fissures, Gum to bum location

Question 17

Ulceratiev colitis, ss, location , complications

Answer 17

specifically in colon and rectus

ss- diarehaa with blood or pus*

complications- toxic megacolon

Question 18

Irritable bowel syndrome ss, px

Answer 18

chronic pain relieved by bowel

ss- recuurent abdominal pain for more than 6m at least 1/day/week, related to dedication

Question 19

Hiatal hernia- mc type, ss, px

Answer 19

occurs when upper part of stomach bulges thru diaphragm
-type 1 sliding mc

ss-majority asymptomatic, also ass. w gerd

Question 20

UTI ss, px

Answer 20

ss- increased frequency, dysuria (pain), burning micturitation, hesitesty, dribbling, suprapubic pain

px- urinalysis, E.coli mc

Question 21

Pyelonephritis-ss, px

Answer 21

Inf of kidney, ascending inf

ss- rapid onset, hematuria, (no painful urination), fever, chills, CVJ tenderness, flank pain

px- urinalysis, positive culture

Question 22

types of incontinence (4)

Answer 22

Stress- involuntary leakage w sudden increases in intra abdominal pressure (cough, sneeze etc)

Urgency- preceded by strong sudden urge to void

Mixed- of stress+urgency

Overflow- increased retention due to BPH

Question 23

Enuresis- normal age

Answer 23

ss- normal in children up to 5

Question 24

kidney stone ss

Answer 24

ss- pain in flank, radiating from flank to groin, hematuria, frequency.urgency

Question 25

kidney stones mc cause

Answer 25

calcium oxalate

Question 26

prostatatis acute ss

Answer 26

systemic symptoms, Storage symptoms (frequency, urge, voiding issues)

Question 27

prostatisis chronic ss

Answer 27

recurrent exacerbations of acute pelvic pain, storage issues, ejaculatory pain, post ejaculatory pain

Question 28

BPH- ss, px

Answer 28

ss- frequency, urgen, nocturna, incomplete feeling of emptying

px- DRE, PSA

Question 29

Peptic ulcer def, mc cause of gastric/duodenal

Answer 29

damage to mucosa
gastric= H pylori
Duodenal= NSAIDs

Question 30

peptic ulcer ss (gastic + duodenal)

Answer 30

ss- mc symptom indigestion, bleeding/blood in stool

duodenal- burning, develops 1-3 hrs post meal

gastric- pain increases after meal

Question 31

what is zollinger ellison syndrome

Answer 31

gastro tumors cause increase in gastrin

Question 32

Choleistatis- mc pop and location

Answer 32

4 Fs= fat, female, fertile, forties

25% biliary colic= gallstones transiently impacted in cystic duct , RUQ pain

Question 33

Acute cholecystitis ss, px

Answer 33

ss- severe constate (>6hrs) epigastric/RUQ pain, may radiate to R shoulder

Px- murphys sign

Question 34

acute pancreatitis- ss (pos of relief), px

Answer 34

ss- epigastric, radiate to back, improve when leaning forward

px- tender rigid abdomen, Cullens sign (periumbilical bruises), Grey turner (flank bruising), CT best

Question 35

Chronic pancreatitis- mc cause, ss, px (test used)

Answer 35

mc cause- alcohol abuse

ss- recurrent attacks of abdominal pain, later will have malabsorption, steatorrhea, weight loss

px- U/s, CT, Secretin test (gold)

Question 36

Appendicitis ss

Answer 36

low grade fever, abdominal pain (first poorly localized, then well localized over McBurneys point), flexed knee and hip in severe pain

Question 37

Appendicitis px

Answer 37

1. Mcburneys sign
2. Rovsings sign (pressure on left also causes pain)
3. Psoas sign (pain on flex of hip against resistance)
4. Obturator sign (flex hip then ext/int rot causes pain )

Question 38

AAA- ss, px

Answer 38

75% asymptomatic
-severe tearing abdominal pain, hypotension, palpable pulsitule mass above umbilicus

Question 39

Liver cirrhosis- causes

Answer 39

alcoholic or non alcoholic fatty liver disease,

chronic viral hepatitis (B, C, B+D)