Clin - RUQ Pain Flashcards
sx cholelithiasis
biliary colic - severe steady ache in RUQ or epigastrium that occurs 30-90 mins after meals, lasts for several hours, and occasionally radiates to the right scapula or back
N/V
lab and imaging results of cholelithiasis
normal or occasionally mild transient increase in bilirubin
US: acoustic shadow showing stones
HIDA: assessed patency of cystic duct and gallbladder emptying function
best diagnostic test for cholelithiasis
US
6 F’s of gallstones
Family hx Fat Female Fertile Forty Fair (?)
most common demographic for gallstones
female, older, american indian, obese
risk factors for gallstones
- obesity
- DM
- hypertriglyceridemia
- crohn dz
- rapid weight loss from bariatric surgery
- pregnancy
- oral contraceptives
protective measures against gallstones
- low carb diet
- physical activity
- consumption of coffee (in women)
- ASA, NSAIDs
compare cullen and grey turner sign
cullen: ecchymosis of umbilicus from retroperitoneum fluid and bleeding
grey turner: ecchymosis of flank from fluid and blood in retroperitoneum
describe what emphysematous pancreatitis is and what is its tx
infected pancreatic necrosis with secondary gas formation
surgical debridement and antibiotics
what are the pancreatic function tests
trypsinogen: low in insufficiency (<20)
fecal elastase: low in insufficiency (<100)
pancreatic malabsorption
stimulation tests: (cholecystokinin/secretin)
sx pancreatic cancer
PAINLESS JAUNDICE
N/V, fatigue, weight loss, steatorrhea
what is trousseau’s sign of malignancy
repeated attacks of multiple venous thrombosis at different and changing sites due to procoagulant factors formed by cancer cells
seen in pancreatic cancer
what is courvoisier sign
palpable gallbladder
risk factors for pancreatic CA
- smoking
- obesity
- male, african american
- > 65 y/o
- DM
