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Module 9: Mali: GI > CA random facts! > Flashcards

CA random facts! Flashcards

1
Q

GERD

when does the person specifically get pain?

what 2 things make it worse?

three things to avoid?

A

AFTER FATTY MEALS!!

lying down and bending over make it worse

avoid:

  1. chocolate
  2. alcohol
  3. fatty meals
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2
Q

describe the pain see in PUD?

4

A

gnawing, burning achiing

HUNGER LIKE

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3
Q

what is the most common type of stomach cancer?

what doesn’t make it better?/

who in?

A

adenocarcinoma 90-95%

not relieved by food to antacids

50s-70s

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4
Q

acute appendicitis

where is the pain?

2 worse?

what if it stops?

progression?

A

periumbilical pain followed by lower right quadrant pain

worse:

  1. movement
  2. cough

if subsides temporairly suspect perforation of appendix

SXS:

nause vomiting followed by onset of pain and low fever

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5
Q

cholecystitis

where is the pain?

2 things make it worse

A

right upper quadrant pain that may radiate to right scular area

worse:

  1. jarring
  2. deep breathing
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6
Q

biliary colic

where it the pain?

pain?

pt might be….

A

right upper quadrant that radiates to right scapula and shoulder

NOT COLICKY

RESTLESSNES

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7
Q

acute pancreatitis

where is the pain?

1 improvement?

2 things in hx?

A

epigastric may radiate to back

improves: leaing forward to truck flexed

**may see hx of alcohol abuse or gallstones**

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8
Q

acute diverticulitis

where?

pain type?

progression?

A

left lower quadrant

crampy pain to steady

gradual onset

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9
Q

acute bowel obstruction

2 causes?

location of pain?

2 things that can happen in SI?

A

causes;

  1. adhesions or herias SMALL INTESTINE, periumbicial pain
  2. cancer or diverticulis: COLON, periumbicial at first then diffuse

these can happen in SMALL INTESTING OBSTRUCTION

**vomiting of bile and mucous=high obstruction

vomiting of feces=low obstruction**

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10
Q

what does oropharyngeal dysphagia mean?

what is this?

can cause?

3 causes of this?

A

motor disorders affecting the pharyngeal muscles

aspiration into the lungs or nose with attempt to swallow

stroke

bulbar palsy

neuromuscular dxs

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11
Q

esophageal dysphagia is…

A

mechanical narrowing

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12
Q

explain the dysphagia you would see with someone who has esophageal dysphagia from esophageal cancer?

A

starts with slids and progresses to liquids

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13
Q

explain the pain that you would see with esphageal spasm?

what can make it better?

A

chest pain that minics angina pectoris or MI and lasts minutes to hours

***NITRO CAN IMPROVE THIS**

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14
Q

what can you do to relieve the sxs associated with schleroderma

or

achalasia?

4

A
  1. repeated swallowing
  2. straightening the back
  3. raising arms
  4. valsalva maneuver straining down against closed glottis
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15
Q

what is a false expectation when it comes to bowel habits?

A

expectations of regularity

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16
Q

what are the requirements for dxing irritable bowel syndrome?

3/3

A

symptoms for 6 months

pain for 3 months

and 2 of 3:

1. improvement with defecation

2. onset with change in stool frequency

3. change in stool form and appearance

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17
Q

what are two manifestations you might see with rectal cancer?

A
  1. tenesmus
  2. pencil shaped stool!!
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18
Q

who is fecal impaction common in?

3

A

debilitated, bedridden and elderly patients

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19
Q

what might the stool look like in an intussusception?

A

currant jelly stools

RED WITH MUCOUS

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20
Q

what can painful anal lesions cause?

A

spasm of the external spincter and involuntary inhibition of the defecation reflex

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21
Q

what are the 3 medications that can cause constapation?

A
  1. opoids
  2. anticholinergics
  3. antacids with calcium or aluminum
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22
Q

what are 3 conditions that can neurological disorders that lead to constapation?

A
  1. spinal cord injuries
  2. multiple sclerosis
  3. hirschsprungs disease
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23
Q

what are three metabolic conditions that can lead to constapation?

A
  1. pregnany
  2. hpothyroidism
  3. hypercalemia
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24
Q

what is the difference between the stool and sxs of secretory infection and inflammatory infection?

A

secretory-watery w/o blood pus or mucous temp normal

inflammatory-watery/loose with blood, pus, or mucous urgency, tenemus, fever

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25
Q

what are 7 bacteria that cause secretory infection?

A
  1. s aureus
  2. b cereus
  3. c. perfringens
  4. e. coli
  5. vibrio
  6. giardia lamblia
  7. rotavirus
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26
Q

what type of bacteria typically cause secretory infection?

A

those that make bacterial toxins

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27
Q

what are 5 bacteria that typically cause inflammatory diarrhea?

A
  1. salmonella
  2. shigella
  3. campylobacter
  4. e.coli
  5. c.diff
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28
Q

irritable bowel syndrome

3 characteristics of the pain

A

worse in the morning, rare at night

pain relieved with defecation

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29
Q

who is cancer of the sigmoid colon common in?

A

those over 55

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30
Q

what are people with ulcerative collitis at increased risk for?

A

colon cancer

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31
Q

crohns disease

2 places this occurs

characteristic of diarreah

what group of people more prevalent in

A

terminal ileum

proximal colon

**diarreah can awaken patient in night**

MORE COMMON IN PEOPLE OF JEWISH DESCENT

32
Q

malabsorption syndrome

describe the stool

6

A

bulky, soft, yellow to gray

greasy oily and frothy

**foul smelling**

floats in toilet

33
Q

vitamin K deficiencies cause

A

bleeding

34
Q

vitamin D deficiciencies can cause

A

fractures

35
Q

vitamin B deficiencies can cause…

A

glottitis

36
Q

a protein deficiency can cause

A

edema

37
Q

people with lactose intolerance lack…

A

lactase and have an issue after drinking milk or milk products

38
Q

what are the 3 racial groups particullary influenced by lactose intolerance?

A

african americans

asians

native americans

39
Q

melena qualifications

A

at least 60 mL of blood into gastrointestinal tract usually from esophagus, stomach, duodenum

40
Q

when would you typically get pain after eating with duodenal ulcer?

A

2-3 hours later

41
Q

what is the main cause of esophageal or gastric varices?

A

cirrhosis of the liver

42
Q

what is mallory- weiss tear attributed to?

A

retching and vomiting after recent ingestion of alcohol

43
Q

what are 3 things that can cause a black stool that is negative for occult?

A
  1. iron
  2. bismuth salts
  3. licorice
44
Q

what is melena?

A

black tarry stool

45
Q

what is hematochezia

A

red blood in the stool originating form the colon, rectum, and anus

46
Q

hemmoroids and anal fissure

3 ways you might see the blood

A

blood on the toilet paper or on surface of stool or dripping into the toilet

47
Q

what does the ingestion of beets do you the urine and stool? why?

A

turns in pink and turns the stool reddish from poor metabolism of betacyanin

48
Q

what is a umbilical hernia? in who?

A

protrusion thought defective unmilcal ring MC in infants

49
Q

incesional hernia

A

protrusion through an opertive scar

50
Q

what is an epigastric hernia?

when is it seen the best?

A

small midline protrusion though a defect in the linea alba between the xiphoid and umbilicus

**seen better with patients head and shoulders raised**

51
Q

diastasis recti

what is this?

when does it occur?

3 things common in?

A

separation of the two rectus abdominis mucles through which the abdominal contents for a midline ridge when the patient raises head and shoudlers

common in:

  1. pregancy
  2. obesity
  3. chronic lung disease
52
Q

lipoma

what do they feel/look like?

A

soft and often lobulated

**if you push down on it, it likely will slip out from underneath**

53
Q

what is a pannus?

what can happen to the umbilicus?

A

apron of fatty tissue

umbilicus amy be sunken

54
Q

abdominal tumor

explain the percussion pattern common with this? why?

A

dullness over the abdominen, typmpani above

**this is because the tumor displaces the air upwars**

55
Q

ascitic fluid

what does this person show?

what is characteristic of the pattern?

A

goes to the lowest point in the abdomen that causes bulging flanks taht are dull to precussion

when person terns on their side, detect a fluid shift

56
Q

increased bowel sounds indicated…2

A

diarreah

early intestinal obstruction

57
Q

decreased bowel obstruction indicates…2

A

adynamic ileus

peritonitis

58
Q

how long must you listen before determining there is no bowel sounds?

A

2 minutes

59
Q

what do high pitched tinkling sounds in the bowel suggest?

A

intestinal fluid and air under tension in dilated bowel

60
Q

what do rushes of high-pitched sounds with cramping indicate?

A

intestinal obstruction

61
Q

a hepatic bruit suggests…2

A

carcinoma of the liver or alcholic hepatitis

62
Q

arterial bruits with both systolic and diastolic compents suggest….

A

partial occlusion of the aorta or large arteries

63
Q

what does a venous hum indicate? ex?

A

increased collateral circulation between the portal and systemic venous system

seen in hepatic cirrhosis

64
Q

where do you hear a venoux hum?

A

epigastic and umbical

65
Q

what is a friction rub and what does it indicate?

A

grating sound with repiratory variation

indicates inflammation of the peritoneal surface of an organ

66
Q

where are two places you might hear a friction rub?

A

hepatic and splenic

67
Q

if you hear a systolic bruit and hepatic friction rub what should you suspect?

A

carcinoma of the liver

68
Q

acute salpingitis

what are the sxs?

where does it occur?

A

motion of the uterus causes pain

(inflammation of fallopian tubes)

just above the inguinal ligaments

69
Q

where do you look for acute cholecystisits?

sign?

A

upper right quadrant

murphys sign

70
Q

where does pain from acute pancreatitis occur?

may also have?

A

EPIGASTRIC REGION

CAN HAVE REBOUND TENDERNESS

71
Q

where does the pain from acute apendicitis occur?

specifically?

sign?

A

RIGHT LOWER QUADRANT

****BETWEEN LINE JOINING UMBILICUS AND ACIS****

MCBURNEYS POINT

72
Q

where does diverticularits occur?

A

lower left quandrant

73
Q

explain a normal variation of liver shape and who might you find this in?

A

riedels love which means that the liver is elongated but no change in volume or size

typically in lanky people!! stretches it out!!

**this makes the liver palpable since it points towards the iliac**

74
Q

what conditions can produce a smooth, large liver?

2 subcategories

3 ex

1 ex

A
  1. NONTENDER EDGE

cirrhosis

amyloidosis

lympoma

  1. TENDER EDGE

venous congestion in right heart failure

75
Q

what does a enlarged, hard, irregular edge of liver suggest?

A

hepatocellular carincome

Module 9: Mali: GI (6 decks)

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