APPROACH TO GIT Flashcards

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1
Q

PAIN LOCATION:
Substernal, may radiate to the back, jaw left shoulder and arm

A
  • esophagitis
  • Esophageal motility
  • esophageal neoplasm
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2
Q

PAIN LOCATION:
Epigastric

A
  • Peptic ulcer Disease
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3
Q

PAIN LOCATION:
Periumbilical

A
  • Colon
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4
Q

PAIN LOCATION:
Right Upper Quadrant Pain

A
  • Liver
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5
Q

PAIN LOCATION:
Epigastric and RUQ

A
  • Gallbladder bile duct, cholecystitis
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6
Q

PAIN LOCATION:
Epigastrium with radiation to the back

A
  • Pancreatitis
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7
Q

PAIN LOCATION:
Midline then move to the mcburney point in the right lower abdomen

A

appendicitis

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8
Q

PAIN LOCATION:
Costovertebral angle, flank

A

Renal

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9
Q

PAIN LOCATION:
Radiation of ulcer to the back

A

Posterior penetrating duodenal ulcer

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10
Q

PAIN QUALITY:
Burning or warm

A

esophagitis

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11
Q

PAIN QUALITY:
Colicky or crampy, may be associated with abdominal distention and audile bowel sounds

A

Small intestinal obstruction or inflammation

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12
Q

PAIN QUALITY:
Colicky, but usually constant dull ache

A

Appendicitis

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13
Q

PAIN QUALITY:
Squeezing pain

A

Acute cholecystitis

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14
Q

PAIN QUALITY:
Penetrating or boring pain

A

Pancreatitis

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15
Q

PAIN QUALITY:
Sharp or cutting pain

A

nephrolithiasis

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16
Q

PAIN INTENSITY:
Extremely severe abdominal pain

A
  • Perforated PUD
  • Acute pancreatitis
  • Passage of renal stone
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17
Q

PAIN INTENSITY:
Severe acute pain

A

Small intestinal obstruction
- cholecystitis
- appendicitis

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18
Q

PAIN INTENSITY:
Moderate acute pain

A
  • PUD
  • Gastroenteritis
  • Esophagitis
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19
Q

PAIN CHRONOLOGY:
intermitted, occurs in the morning or before meals

A
  • PUD
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20
Q

PAIN CHRONOLOGY:
Develops during sleep, may be preceded by months

A
  • Acute cholecystitis
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21
Q

PAIN CHRONOLOGY:
Nocturnal pain rarely occurs

A
  • IBS
  • Functional abdominal pain
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22
Q

PAIN CHRONOLOGY:
Progressive pain 10-15 minutes wihtout remission

A
  • Acute appendicitis
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23
Q

PAIN CHRONOLOGY:
Pain reaching peak intensity within minutes

A
  • Perforated PUD
  • Rupture AAA
  • Passage of renal stones
  • Ruptured ectopic preganancy
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24
Q

PAIN CHRONOLOGY:
Peak pain intensity reached in 10-60 minutes

A
  • Acute pancreatitis
  • Intestinal obstruction
  • Cholecystitis
  • Mesenteric occlusion
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25
Q

PAIN CHRONOLOGY:
Chronic, most intense after meal

A
  • Irritable bowel syndrome
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26
Q

ALLEVIATING:
Antacids, acid supressing

A
  • Esophagitis
  • PUD
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27
Q

ALLEVIATING:
Ingesting food

A
  • Duodenal ulcer
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28
Q

ALLEVIATING:
Leaning forward

A
  • Pancreatic pain
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29
Q

ALLEVIATING:
Hyperextension on spine, massaging the abdomen, passing of feces or flatus

A
  • IBS
30
Q

AGGRAVATING:
Ingesting food

A
  • Gastric ulcer
31
Q

AGGRAVATING:
meal ingestion

A
  • Pancreatic disease
  • Intestinal obstruction
  • Mesenteric ischemia
32
Q

AGGRAVATING:
Within minutes after eating

A
  • Duodenal obstruction
33
Q

AGGRAVATING:
1-2 hours after meal

A
  • Ileum
34
Q

AGGRAVATING:
Intensified after meal

A
  • mesenteric ischemia
35
Q

AGGRAVATING:
Consumption of dairy products

A
  • Lactase deficiency
36
Q

AGGRAVATING:
Reclining or straining

A
  • Heartburn
37
Q

AGGRAVATING:
Worse in supine position

A
  • pancreatic pain
38
Q

AGGRAVATING:
Eating or stress

A
  • IBS
39
Q

ASSOCIATED SYMPTOMS:
Abdominal pain precedes nausea

A
  • Ultimately require surgery
40
Q

ASSOCIATED SYMPTOMS:
Nausea occur before abdominal pain

A
  • May not require surgery
41
Q

ASSOCIATED SYMPTOMS:
Diarrhea (appendicitis exception to the rule_

A
  • non surgical
42
Q

ASSOCIATED SYMPTOMS:
acute left-sided abdominal pain and bloody stools in elderly

A
  • ischemic colitis
43
Q

ASSOCIATED SYMPTOMS:
chronic abdominal pain with rectal bleeding

A
  • colonic neoplasm
  • inflammatory bowel disease
44
Q

ASSOCIATED SYMPTOMS:
abdominal pain with recent constipation

A
  • colonic obstruction
45
Q

ASSOCIATED SYMPTOMS:
long standing constipation

A
  • IBS
46
Q

ASSOCIATED SYMPTOMS:
anorexia, weight loss

A
  • malignancy
47
Q

ASSOCIATED SYMPTOMS:
high fever (39.5’C) early in the course

A
  • Cholangitis
  • UTI
  • infectious enteritis
48
Q

ASSOCIATED SYMPTOMS:
Jaundice

A
  • Disease of the liver, biliary tree
  • and pancreas
49
Q

RISK FACTOR:
heavy alcohol intake for prolonged period

A
  • acute pancreatitis
50
Q

RISK FACTOR:
Analgesics

A
  • Ulcer disease
51
Q

RISK FACTOR:
Cocaine

A
  • mesenteric ischemia
52
Q

RISK FACTOR:
gallstone

A

-distal intestinal obstruction (gallstone ileus)

53
Q

RISK FACTOR:
Cardiovascular disease

A
  • mesenteric ischemia
54
Q

RISK FACTOR:
prior abdominal surgery

A
  • likelihood to intestinal obstruction
55
Q

RISK FACTOR:
cirrhosis and ascites

A
  • spontaneous bacterial peritonitis
56
Q

HISTORY:
Symptoms of short duration

A
  • acute infection
  • toxin exposure
  • abrupt inflammation or ischemia
57
Q

HISTORY:
Long-standing symptoms

A
  • chronic inflammatory
  • neoplastic conditions
  • functional bowel disorders
58
Q

HISTORY:
Symptoms from mechanical obstruction

A
  • ischemia
  • IBD
  • functional bowel disorders (worsened by meals)
59
Q

HISTORY:
relieved by eating or antacids. Pain is intermittent lasting weeks to months

A
  • Ulcer symptoms
60
Q

HISTORY:
sudden onset and lasts up to several hours

A
  • biliary colic
61
Q

HISTORY:
Severe pain and persists for days to week

A
  • acute inflammation - acute pancreatitis
62
Q

HISTORY:
Meal elicit diarrhea

A
  • IBD
  • IBS
63
Q

HISTORY:
Defecation relieves discomfort

A
  • IBD and IBS
64
Q

HISTORY:
Exacerbated by stress

A
  • Functional bowel disorders
65
Q

HISTORY:
Sudden awakening from sound sleep

A
  • organic than functional diseasse
66
Q

HISTORY:
Obstructive symptoms with prior abdominal surgery

A
  • Adhesions
67
Q

HISTORY:
Loose stools after gastrectomy or gallbladder excision

A
  • dumping syndrome or postcholecystectomy diarrhea
68
Q

HISTORY:
Symptom onset after travel

A
  • enteric infection
69
Q

HISTORY:
Medication may produce pain

A
  • Altered bowel habits
  • GI bleeding
70
Q

HISTORY:
Lower GI bleeding in an older person

A
  • Neoplasms,
  • Diverticula
  • Vascular lesions
71
Q

HISTORY:
LGIB in younger individuals

A
  • anorectal abnormalities or IBD
72
Q

HISTORY:
Sexual history

A
  • STD or immunodeficiency