Block 32 Week 1

Question 1

differentials for retrosternal chest pain?

Answer 1

• reflux: spicy food, lying down better w milk and sitting up
• caffine, smoking, very overweight
• pregnancy raises the diagphramtic pressure causing sphincter weakening
• diaphragmatic hernia: stomach comes through hiatus

Question 2

dysphasia?

Answer 2

can’t speak

Question 3

dysphagia?

Answer 3

can’t swallow (stricture, malignancy etc)

Question 4

Tx for h pylori?

Answer 4

• amoxicillin and metrozidonale

Question 5

ulcer pain?

Answer 5

Question 6

types of ulcers

Answer 6

Question 7

gastric vs duodenal ulcer pain?

Answer 7

Question 8

5 Fs of gallstones

Answer 8

Question 9

gallstone pain?

Answer 9

• biliary colic
• severe and cramping right upper quadrant pain which may radiate to the back in the interscapular region
• may also be felt in epigastrium, LUQ, and occassionally praecordially

Question 10

how long does gallstone pain last?

Answer 10

• may last mins to hours - not more than 6 hrs

Question 11

when does gallstone pain often come on?

Answer 11

• often post-prandially(belching, bloating, dyspepsia and flatulence)

Question 12

acute cholecystitis pain?

Answer 12

• right upper quadrant pain which may radiate to the right shoulder
• may be preceded by attacks of biliary colic
• pain lasts for more than 12 hours

Question 13

what exacerbates AC pain?

Answer 13

• worse on movemen and inspiration

Question 14

Other symptoms of AC?

Answer 14

• nausea, vomiting
• fever

Question 15

signs of AC?

Answer 15

• tenderness, guarding in the right upper quadrant and occasionally a palpable, tender mass
• Murphys sign may be positive

Question 16

Test for BC?

Answer 16

FIT

Question 17

Test for IBD?

Answer 17

• fecal calprotectin for IBD (borderline most likely IBS - can be caused by NSAIDs)

Question 18

Tests for pancreatic cancer?

Answer 18

• amylase in blood for PC
• fecal elastase - low in PC

Question 19

test for inflammation?

Answer 19

• CRP for inflammarion

Question 20

which type of anemia is caused by bleeding?

Answer 20

• hypochromic microcyctic anemia for iron deficiency anemia from bleeding

Question 21

B12 and B9?

Answer 21

• B12 and B9 for macrocytic anemia (think malabs)
• can see this in celiac disease

Question 22

Acute pancreatitis pain?

Answer 22

• central pain radiates to back
• very severe pain, low BP, tachycardia

Question 23

AP causes?

Answer 23

Question 24

appendicitis pain?

Answer 24

• starts central, moves down and right
• rebound tenderness
• younger ppl

Question 25

sign of pertonitis?

Answer 25

• rebound tenderness
• guarding

Question 26

diverticulitis?

Answer 26

• diverticulitis (pockets inflamed, diverticular disease = pockets form)
• more common w age
• left sided abd pain, diarrhoea, bleeding
• can be from low fibre/constipation
• can perforate

Question 27

kidney stones - renal colic

Answer 27

• extreme pain
• colicky pain

Question 28

Pyelonephritis?

Answer 28

• temperature
• tender kidney