APA GI And Cardiovascular Flashcards
Which type of vascular disease is relieved by dependent positioning of LE and how does the pt present?
Arterial, thin shiny legs and experienced pain with walking
Which type of vascular disease is relieved by dependent positioning of LE and how does the pt present?
Arterial, thin shiny legs and experienced pain with walking
Aortic Stenosis is common in which age group and how is it tolerated?
Elderly, ususally asymptomatic but once symptomatic outcomes are poor
Which valves are closed during systole?
Mitral/Tricuspid
Which valves are closed during diastole?
Aortic/Pulmonic
Systolic murmurs are head during which sound?
S1
Diastolic murmurs are heard during which sound?
S2
Pulmonic value is heard best at which location
2nd ICS L. Upper sternal border
Aortic valve is best heard at what border?
2nd ICS R. Upper sternal border
Which valve is best heard at 5th ICS L. sternal border?
Tricuspid
Which valve is best heard at 5th ICS L. midclavicular line?
Mitral valve
All functional murmurs are which type?
Systolic, but not all systolic are functional murmurs
How do statins work?
By blocking HMG-CoA reductase in the liver which promotes upregulation of LDL receptors, essentially liver processes more LDL which lowers circulating lipids.
What is the order of Abd exam?
Inspect, auscletate, percuss, palpate in all 4 quads
Diarrhea is the combination of what 2 factors?
Increase in frequency and fluid content
Is elevated bilirubin always evidence of something pathological?
No- adults can have idiopathic bilirubinemia known as Gilbert Syndrome
What 2 positive signs are associated with peritoneal findings in acute appendicitis?
Psoas sign- supine passive extention of R. Thigh against examiners counter pressure
Obturator sign- inward rotation of R. Hip causing RLQ pain. Pain w/ flexion/movement of hip
What is GERD?
The backflow of stomach contents into the esophagus, usually caused by weakened LES (lower esophageal sphincter)
For GERD, step up and step down treatment, what is the progression?
Lifestyle modification, antacids, H2 blockers, PPIs
For intense GERD, what drug therapy would be inititated?
PPIs for 8 weeks
If resolved- taper off
If unresolved or return- repeat anothe 8 week course
For mild to moderate GERD, what drug therapy would be initiated?
Antacids if occuring <1/week
H2 blockers for 2 weeks (increasing to PPI if not better)
What is triple therapy for H. Pylori?
10-14 days:
PPI BID
Clarithromycin 500mg bid
Amoxil 1000mg bid
If PCN allergic:
Flagyl 500mg bid
What is Bismuth quadruple therapy for H. Pylori?
10-14 days
PPI
Bismuth 525 qid
Metrondiazole 250 qid
Tetracycyline 500 qid
What is classic quadruple therapy for H. Pylori?
10-14 days
PPI
Amoxil 1mg bid
Metrondiazole 500 tid
Clarithromycin 500 bid
What is the treatment for hemorrhoids?
Topical anesthetics, sitz baths & increased fiber intake.
What are two further tests to perform to determine acute abdomen (peritoneal signs)
Rovsing sign-deep palpation of RLQ elicits pain in LLQ
Markle Test- R. heel jar elicits pain (jump in place test)
What are common risks for colon cancer?
Fm hx, low fiber and plants. High in fat, red meat, refined carbohydrates
Pain in the RUQ that radiates into the R. shoulder would commonly elicit which positive test?
Murphy sign
What labs would most likely be elevated with in a patient with positve murphy sign?
WBC, AST, ALT, alk phos and bilirubin
How does a pt with pancreatitis usually present?
Mid abd pain sharp and intense in nature w/ radiation into the back. Pt appears toxic, hypotensive tachycardic, tachypnic, fever, abd distension and hypoactive BoSo
Which labs in conjunction with physical findings are suggestive of pancreatitis?
Elevated amylase & lipase (2-3 x normal), WBC, HCT, BUN and glucose
Rome III criteria helps to diagnose what condition?
Irritable Bowel Disease (IBS)