Chapter 8 Highlights

Question 1

What is tenderness over McBurney’s point associated with?

Answer 1

Appendicitis

Question 2

Where is McBurney’s Point located?

Answer 2

1/2 of the distance from the ASIS to the umbilicus

Question 3

What are visceral pain fibers sensitive to?

Answer 3

Stretching or tension on the wall of the gut

Question 4

What is the position of comfort for patient with inflammation?

Answer 4

Knees bent / fetal position without movement

Question 5

How do you Differentiate esophagitis from coronary ischemia?

Answer 5

upright relieves esophagitis; nitro or supine relieves coronary ischemia

Question 6

What do you do if a pt reports blood in his/her stool?

Answer 6

refer to MD

Question 7

Drug induced diarrhea most commonly associated with what type of drugs?

Answer 7

antibiotics

Question 8

Many inflammatory GI conditions have an arthritic component affecting the joints (ulcerative colitis, Crohns disease). What types of joints are commonly affected?

Answer 8

Peripheral joint arthritis and spondylitis with sacroilitis

Question 9

Joint arthralgia associated with GI infection is usually…

Answer 9

asymmetric, migratory, oligoarticular

Question 10

List the joints most commonly affected by GI issues starting with the most frequent

Answer 10

Knee, ankle, shoulder, wrists, elbows, and small joints of hand/feet

Question 11

Pain in left shoulder can occur as result of free air following laparoscopic sx or blood in abdominal cavity usually from a ruptured spleen or retroperitoneal bleeding causing distention. name the sign.

Answer 11

o Kehr’s sign: pain with pressure on upper abdomen.

o Danforth sign: shoulder pain with inspiration

Question 12

Numbness and weakness of LEs

Answer 12

Vitamin B12 deficiency in aging adult, thiamine deficiency after gastric bypass

Question 13

protein pump inhibitors for gerd (list some examples)

Answer 13

protein pump inhibitors – Prilosec, Prevacid, Nexium, Zantac)

Question 14

Helicobacter pylori causes peptic (Loss of tissue lining the lower esophagus, stomach, and duodenum) ulcers. where are most located?

Answer 14

Primarily located in the lining of the duodenum

Question 15

Red Flag – PMH of peptic ulcers in pts with new onset of ____or ____ pain, requires further screening and possible referral

Answer 15

back or shoulder

Question 16

Typically asymptomatic but pt may have left lower quadrant pain.

Answer 16

Diverticulosis

Question 17

most common cause of chronic pancreatitis

Answer 17

Alcohol abuse

Question 18

Crohn’s disease

Answer 18

25% can present with arthritis or joint pain.

Question 19

Colorectal CA is ____ at first, then….

Answer 19

asymptomatic at first, then slight changes in bowel patterns, occasional rectal bleeding and vague cramping pain, increased evacuation frequency. Back pain that radiates down legs may be an early sign. Mahogany colored stools d/t bleeding in lower GI (not melena, which is from upper GI bleeding). Brighter red in stool may be from L colon. Bleeding may lead to iron deficiency anemia. Rectal CA may lead to thin stools.