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Clin Med 2 > Clinical Features > Flashcards

Clinical Features Flashcards

1
Q
  • bulge in the groin that may be tender to palpate but generally has no pain
  • heavy/discomfort in groin
  • slight pelvic pain in women
  • worst at end of day/ prolonged sitting
  • radiating twinge of pain with sitting/standing
A

Groin hernia

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2
Q
  • bulge in the groin that may be tender to palpate but generally has no pain
  • can be moved in and out
  • asymptomatic
A

Reducable groin hernia

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3
Q
  • bulge in the groin
  • +/- N/V, pain, block
  • tenderness, bowels may not move due to obstruction
  • fever
A

Incarcaerated groin hernia

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4
Q
  • bulge in groin
  • painful
  • +/- N/V, pain, block
    ischemia–> pain out of proportion
A

Strangulated groin hernia

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5
Q
  • swelling lateral to the rectus muscle

- pain is dull/ constant

A

Spigelian hernia

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6
Q
  • local inflammation initially

- overtime ischemia, gangrene, perforation

A

Richter’s Hernia

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7
Q
  • bowels and intestine protrude out of stoma
  • skin is clean and normal looking
  • patient comfortable
A

Parastomal hernia

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8
Q
  • Asymptomatic
  • painless bleeding; bright red blood per rectum
  • anal pruritis
  • prolapse
  • pain due to thrombosis
A

Hemorrhoids

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9
Q
  • sudden onset of severe pain and swelling
  • fluctuant mass that feels like fluid inside
  • fever
  • cellulitis possible
A

Rectal abscess

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10
Q
  • pain
  • purulent drainage
  • perirectal skin lesion
A

rectal fistula

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11
Q
  • straining
  • lumpy hard stools
  • sensation of incomplete evacuation
  • use of digital maneuvers
  • sensation of anorectal obstruction/ blockage
  • decreased frequency
  • abdominal discomfort or pain
  • abdominal distention
  • nausea
A

constipation

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12
Q
  • Hematochezia
  • obstructive symptoms
  • acute onset of constipation
  • severe persistent constipation that is unresponsive to tx
  • weight loss more than 10 pounds
  • change in stool caliber- pencil thin stool
  • family hx of colon cancer or IBD
A

alarming sx of constipation

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13
Q
  • abdominal cramping & bloating
  • leakage of liquid or sudden episodes of watery diarrhea when normally constipated
  • rectal bleeding
  • small, semi-formed stools
  • straining when trying to pass stools
  • bladder pressure/ loss of control
  • lower back pain
  • fluid leaks out but no evacuation of bowels
  • pressure on bladder and urethra–> can’t void
A

fecal impact

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14
Q
  • painless cyst or sinus opening at the top of the natal cleft
  • acute abscess can form
  • chronic cyst can form
A

pilonidal disease

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15
Q
  • sudden onset of severe pain and swelling
  • acutely inflamed and fluctuant mass overlying the sacrum or coccyx
  • fever if cellulitis
A

pilonidal disease with acute abscess

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16
Q
  • painless cyst or sinus opening at the top of the natal cleft
  • persistent drainage from a sinus track connected to the cyst
  • mucoid/ purulent material
A

pilonidal disease with cyst

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17
Q
  • crampy abdominal pain
  • nausea
  • vomit a lot and feel better afterwards
  • no passage of flatus/ stool
  • more belching/hiccups
  • abdominal distention
  • abdominal tenderness
A

SBO

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18
Q
  • vomit
  • abdomen distended
  • not passing gas
  • Xray/CT show the whole bowel is dilated without a transition pt
A

ileus

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19
Q
  • Crampy abdominal pain
  • N/V
  • low grade fever
  • anorexia
  • malaise
A

appendicitis

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20
Q
  • abdominal distention and acute/chronic diarrhea
  • radiographic evidence of colonic distention
  • 3 of the following: fever over 38C, HR over 120, WBC over 10,500, anemia
  • 1 of the following: dehydration, altered sensorium, electrolyte disturbances, hypotension
A

toxic megacolon

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21
Q
  • rapid onset of severe, unrelenting periumbilical pain
  • patient is writhing on bed, screaming in agony but stomach is soft and normal
  • N/V
  • forceful/urgent bowel evacuation
A

ischemic bowel disease

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22
Q
  • fever

- person is writhing around and all of a sudden they are pain free due to bowel dieing

A

ischemic bowel disease to infarct

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23
Q
  • crampy and tender abdominal pain
  • nausea
  • vomiting
  • bloody diarrhea
  • blood per rectum
A

colonic ischemia

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24
Q
  • painless jaundice
  • unintentional weight loss
  • recent onset of atypical DM
  • palpable mass (late stage)
  • ascites (late stage)
  • courvoisier’s sign
A

pancreatic cancer

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25
Q

What is courvoisier’s sign

A

non-tender palpable gallbladder with jaundice

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26
Q
  • Asymptomatic
  • Biliary colic RUQ- Post-prandial after fatty meal; Steady pain that lasts at 30 min peaks at an hour and trends down and is gone at 6 hrs
  • Non-specific abdominal pain
  • Midepigastric pain
  • Chest pain
  • Fullness after meals
  • Abdominal distention/bloating
  • Nausea
  • Vomiting
  • Diaphoresis
A

Cholelithiasis

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27
Q
  • RUQ pain or epigastric sudden onset; Typically post prandial fatty meal, but not always; Pain can be for 12-15hrs
  • Typically sit still because movement aggravates pain
  • Nausea/ Vomiting
  • Murphy’s sign- push RUQ and breather and gall bladder touches the physician hand and they stop bleeding
  • Fever
  • Jaundice
  • Courvoisier’s sign
A

Cholecystitis

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28
Q

What is Courvoisier’s sign?

A

palpable gallbladder on PE due to extreme dilation

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29
Q 
Biliary-type pain
RUQ, midepigastric or shoulder pain
Afebrile

Nausea

Vomiting
Complicated (pancreatitis, cholangitis, etc)- jaundice and/or fever
A

Choledocolithiasis

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30
Q
  • Abdominal pain
  • Fever
  • Yellow skin
  • Weakness
  • Charcot Triad
  • Reynold’s Pentad
A

Acute Cholangitis

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31
Q

Charcot triad

A

Fever, abdominal pain and jaundice

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32
Q

Reynold’s Pentad

A 
Fever 
Abdominal pain 
Jaundice 
Confusion 
Hypotension
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33
Q
  • Symptoms range from none to fatigue or pruritus
  • asymptomatic
  • jaundice
  • splenomegaly
A

PSC

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34
Q
  • Midepigastric pain; Patient laying forward and worsening when laying back
  • Pain radiating to the back
  • Nausea

  • Vomiting
  • Dyspnea
  • Epigastric tenderness
  • Jaundice
  • N/V
A

Acute pancreatitis

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35
Q
  • Midepigastric pain; Patient laying forward and worsening when laying back
  • Pain radiating to the back
  • Nausea

  • Vomiting
  • Dyspnea
  • Epigastric tenderness
  • Jaundice
  • N/V
  • Tachypnea

  • Hypoxemia

  • Hypotension
  • ARDS

  • Cullen’s Sign
  • Grey Turner Sign
A

Severe sx acute pancreatitis

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36
Q

Cullen Sign

A
  • Exomotic discoloration in periumbilical region due to bleeding intrabdominally
  • Most likely have necrotizing pancreatitis
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37
Q

Grey Turner Sign

A
  • Exomotic discoloration along the flanks due to hemorrhage

- Most likely have necrotizing pancreatitis

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38
Q
  • Abdominal pain
  • Anorexia
  • Maldigestion
  • Weight loss
  • Nausea
  • Vomiting
  • Steatorrhea- fatty, fowl smelling stools
  • Tenderness over pancreas during attacks
A

Chronic pancreatitis

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39
Q
  • Typically Asymptomatic
  • GI bleeding- polyp opens and lets loose
  • Intestinal Obstruction- distended abdomen; rare
  • Bright red blood per rectum
  • Rectal Tenesmus
  • Change in bowel habits- only if large polyp
A

Polyps

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40
Q
  • Presenting at young age
  • History of rectal bleeding, bowel 
obstruction, perforation
  • Family history 

  • Asymptomatic
  • Occasionally abdominal pain or 
mass
  • Poorly differentiated tumors in the right colon
A

Lynch syndrome

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41
Q
  • Presenting at young age
  • History of rectal bleeding, bowel obstruction, perforation
  • Family history
  • Asymptomatic
  • > 100adenomas on colonoscopy
  • Extracolonic Manifestations
A

FAP

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42
Q
  • Asymptomatic
  • Painless rectal bleeding
  • Rectal Prolapse
  • Failure to Thrive
  • Family history
A

Familial Juvenile Polyposis

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43
Q
  • vague abdominal pain
  • iron deficient anemia
  • fatigue
  • GI bleeding
  • Weakness from chronic blood loss
  • Rectal Bleeding
  • Abdominal Pain
  • Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease
A

R. side colon cancer

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44
Q
  • obstructive symptoms
  • colicky abdominal pain
  • change in bowel habits
  • constipation alternating with loose stools
  • stool streaked with blood
  • Rectal Bleeding
  • Abdominal Pain
  • Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease
A

L. side colon cancer

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45
Q
  • rectal tenesmus
  • urgency
  • recurrent hematochezia
  • narrow caliber stools
  • Rectal Bleeding
  • Abdominal Pain
  • Cachexia, weight loss, back pain, urine or bowel changes, ascites, pallor indicative of progressive disease
A

Rectal cancer

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46
Q
  • RECTAL BLEEDING
  • Anorectal pain
  • Rectal mass sensation
  • No symptoms
    Physical Exam
  • Rectal mass on Digital Rectal Exam (DRE)
  • Condylomata
  • Bleeding
A

Anal cancer

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47
Q
  • Abdominal pain –LLQ
  • Constant, several days
  • Nausea/vomiting
  • Fever
  • Change in bowel habits
  • Constipation to diarrhea or vice versa
  • Dysuria
  • Guarding, rigidity, rebound
  • Tender palpable mass
A

Diverticulitis

48
Q
  • Painless hematochezia
  • Painless maroon-color blood mixed with stool
  • Bloating, cramping, urge to defecate
  • Hemodynamically unstable: syncope, lightheadedness, postural dizziness
  • Due to bleeding significantly
    Signs
  • Abdomen – benign; soft and non-tender
    -BRBPR or dark
  • Hemodynamically unstable: Hypotension, tachycardia, pallor
A

Diverticular bleed

49
Q
  • Rectal bleeding*
  • Diarrhea (hallmark bloody diarrhea)*
  • Fecal urgency
  • Tenesmus- crampy, rectal pain; urgency to go to the bathroom all the time
  • Abdominal pain* - LLQ and suprapubic pain
  • More rarely can see fistulas, weight loss, more common in CD
  • In severe or advanced cases, patients may present with fever 

    Physical exam
  • Abdominal tenderness ?peritonitis
  • DRE = BRB
(bright red blood)
A

Ulcerative colitis general

50
Q
  • Gradual onset diarrhea (<4/day) and intermittent bloody mucoid stool
  • Urgency and tenesmus
  • No significant abdominal pain but LLQ cramping normal often relieved by BM (bowel movement)
  • Mild fever, anemia, hypoalbunemia possible 

A

Ulcerative colitis mild

51
Q
  • Gradual onset diarrhea (<6/day) and intermittent bloody mucoid stool
  • Urgency and tenesmus
  • No significant abdominal pain but LLQ cramping normal often relieved by BM (bowel movement)
  • Mild fever, anemia, hypoalbunemia possible 

A

ulcerative colitis moderate

52
Q
  • > 6 bloody diarrhea stools/day
  • Severe anemia, hypovolemia, hypoalbunemia with nutritional deficit (marker for malnutrition)
  • Abdominal pain/tenderness
  • Fulminant colitis = subset of severe disease which is rapidly worsening sx’s with toxicity
  • Distended abdomen, tender leukocytosis, severe diarrhea, fever

A

Severe ulcerative colitis

53
Q
  • Aphthous oral ulcers,
  • Iritis/uveitis/episcleritis- severe eye pain, photophobia
  • Seronegative arthritis, ankylosing spondylitis, sacroiliitis; As the GI flares up, so does the arthritis
  • Erythema nodosum, pyoderma gangrenosum; firm nodular raised areas located in lower extremities on extensor surfaces
  • Autoimmune hemolytic anemias
  • Primary sclerosing cholangitis
A

Ulcerative colitis

54
Q
  • can affect any portion of the GI tract
  • Abdominal pain (intermittent and often RLQ /periumbilical)
  • Diarrhea (watery/nonbloody typically and ?# per day) – not bloody
  • Incontinence due to so much diarrhea
  • Low grade fevers
  • Weight loss/anorexia/malnutrition
  • Weakness/fatigue/malaise (anemia)
  • Bone loss
  • SBO presentation (Nausea and vomiting with abd pain) w/ active disease or later in disease w/ strictures and chronic fibrosis
  • Abscess or fistula presentation (perianal disease)
  • Anal fissure/skin tag/abscess/fistula (perianal presentation)
  • Dermatologic, ophthalmologic, orthopedic manifestation
A

Crohn Disease

55
Q
  • <2 yrs malabsorption presentation
  • can be severe- growth retardation, weight loss, distention
  • Diarrhea - 45-85%
  • Flatulence - 28%
  • Borborygmus - 35-72%
  • Weight loss - 45% of patients; in infants and young children with untreated celiac disease, 
failure to thrive and growth retardation are common (classic malabsorption)
  • Weakness and fatigue - 78-80% usually related to general poor nutrition
  • Severe abdominal pain - 34-64%
  • Fatigue, depression, Fe-deficiency anemia
  • Anemia - 10-15% of patients
  • Osteopenia and osteoporosis - 1-34% of patients
  • Neurologic symptoms - 8-14% of patients; include motor weakness, paresthesias with sensory 
loss, and ataxia; seizures may develop
  • Skin disorders - 10-20% of patients; including dermatitis herpetiformis, a condition with 
pruritic, papulovesicular skin lesions involving the extensor surfaces of the extremities, trunk, 
buttocks, scalp, and neck
  • Hormonal disorders - Including amenorrhea, delayed puberty, and infertility in women and impotence and infertility in men
A

Celiac disease

56
Q
  • A protuberant and tympanic abdomen
  • Evidence of weight loss (loss of muscle mass or subcutaneous fat)
  • Orthostatic hypotension
  • Peripheral edema (protein malabsorption)
  • Ecchymoses (vit K deficiency)
  • Hyperkeratosis (vit A deficiency) or dermatitis herpetiformis
  • Cheilosis and glossitis (Fe-defcy)
  • Evidence of peripheral neuropathy or ataxia (vit 
B12 or E defcy)
  • Chvostek or Trousseau sign, tetany (Ca++ deficiency
A

Malabsorption

57
Q
  • Abdominal bloating
  • Abdominal cramping
  • Flatulence
  • Diarrhea/loose stool (with higher intake of lactose)
  • Nausea
  • Borborygmi
  • Severity of symptoms depends on quantity ingested and severity of deficiency 
Lactose intolerance diagnosis and management
A

lactose intolerance

58
Q
  • Watery

  • Large volume

  • Abdominal cramping

  • Bloating

  • Gas

  • Weight loss with persistent diarrhea

  • Rarely occurs with fever, occult blood or inflammatory cells in stool
A

diarrhea of the small bowel

59
Q
  • Frequent, regular

  • Small volume

  • Painful bowel movements
  • Fever
  • Bloody or mucoid stools common
  • Inflammatory and red blood cells seen on microscopy
A

diarrhea of the large bowel

60
Q
  • Symptoms develop within 12-48 hours after being exposed
  • Acute onset nausea and vomiting, watery, non-bloody diarrhea with abdominal cramps
  • Symptoms of gastroenteritis last 24-72 hours
A

norovirus

61
Q
  • Symptoms may develop while still on abx therapy or 5-10 days after
  • Watery diarrhea
A

C. diff

62
Q
  • Incubation period is about 3 days (1-7)
  • Abrupt onset abdominal pain and diarrhea (bloody or mucoid)
  • Pain goes around the intestines as the bacteria goes trough the intestines
  • Prodrome of fever, chills, aches in 30%
  • Can mimic appendicitis
  • recently ate chicken
A

Camphylobacter

63
Q
  • Nausea,
  • Vomiting

  • Diarrhea (pea soup) not grossly bloody but may have blood
  • Abdominal cramping
  • Fever
  • Fever resolves in 48-72 hours
  • Gastroenteritis is self-limiting 4-10 days
A

salmonella

64
Q
  • High fever

  • Diarrhea (small volume, bloody and mucoid) initially may be watery
  • Abdominal cramping

  • Tenesmus- frequent desire to go to the bathroom
  • daycare center, MSM
A

shigella

65
Q
  • Onset of symptoms 12-36 hours
  • Nausea, vomiting, diarrhea

  • Abdominal pain and cramping

  • Dry mouth and sore throat

  • Bilateral cranial nerve involvement/palsies
  • home canning of fruits, veggies and fish
A

Botulism

66
Q
  • abdominal pain
  • borborygmi (rumbling/gurgling of intestines)
  • vomiting
  • diarrhea is profuse watery “rice-water” stool-mucous, fishy smell
A

cholera

67
Q
  • diarrhea to severe dysentery
  • abdominal pain
  • weight loss
  • fever
  • Complication includes fulminant colitis with bowel necrosis leading to perforation and peritonitis
A

intestinal entomoeba

68
Q
  • Malaise, anorexia, abdominal cramps and watery diarrhea

- diarrhea that develops during or within 10 days of returning from travel

A

travelers diarrhea

69
Q
  • Chronic abdominal pain and altered bowel habits in absence of any organic cause
A

IBS

70
Q
  • Asymptomatic
  • Abdominal Pain
  • Weight Loss
  • Nausea and Vomiting
  • Gastrointestinal Bleeding
  • Intestinal Obstruction
A

Small Bowel Cancer

71
Q
  • Watery diarrhea
  • flushing
  • sweating
  • wheezing
  • dyspnea
  • abdominal pain
  • hypotension
  • Urinary excretion of 5-HIAA
A

carcinoid syndrome

72
Q 
Orthostatic dizziness
confusion
angina
palpitations
cold/clammy extremities.
A

UGIB- severe bleed

73
Q

Epigastric or RUQ pain

A

UGIB- PUD

74
Q

odynophagia
GERD
dysphagia

A

UGIB- Esophageal ulcer

75
Q

emesis
retching
coughing prior to hematemesis

A

UGIB- Mallory- Weiss tear

76
Q 
Jaundice
weakness
fatigue
anorexia
abdominal distention
A

UGIB- variceal hemorrhage or portal HTN gastropathy

77
Q

Dysphagia
early satiety
involuntary weight loss
cachexia

A

UGIB-Malignancy

78
Q
  • Painless bleeding most common
  • May sense abdominal fullness and urge to pass stool
  • Hematochezia
  • Clots per rectum
  • Maroon colored or mixed blood with stool
  • Melena (rare, may occur with right sided bleeds)
A

LGIB

79
Q
  • resting tachycardia
  • orthostatic hypotension (HR increase 20pts and systolic BP decrease 10-20mmHg)
  • pale conjunctiva
  • pale oral mucosa
  • dry mucosa
  • pale, grey, clammy, cool extremities
  • Abdomen: normal ->distention->caput medusa->ascites - >tenderness->rebound
  • guaic + melena
A

GIB

80
Q
  • Fatigue
  • Sleep disturbance
  • Muscle cramps
  • Weight loss/wasting
  • Skin
  • Spider telangiectasias
  • caput medusa
  • Palmar erythema
  • Dupuytren contracture
  • Abdominal pain
  • Liver enlargement or Stetch of Glisson capsule
  • Ascites
  • Anorexia, nausea/vomiting (more advanced)
  • Hematemesis
  • Amenorrhea
  • Erectile dysfunction
  • Loss of libido
  • Gynecomastia
  • Jaundice
  • icteric sclera
  • pruritis without a rash
  • Confusion/altered mental
  • Thenar wasting
A

cirrhosis

81
Q
  • Appearance of chronic illness
  • Palpable/firm liver (hard sharp nodular edge) -70%
  • Hepatomegaly
  • Splenomegaly – 35-50%
  • Abdominal and thoracic superficial veins are dilated
  • Ascites
  • Pleural effusion
  • Peripheral edema
  • signs of right sided failure
  • Jaundice/Icterus
  • palmar erythema
  • Esophageal/gastric varices – hematemesis, melena
A

cirrhosis

82
Q 
- need abt 1500ml for PE dx so relatively inaccurate 
–	Abdominal distension 
–	Bulging flanks 
–	Shifting dullness to percussion 
–	Fluid wave
A

ascites

83
Q
  • Symptoms range from alert w/ minor impairment memory, coordination, cognition 
to coma
  • asterixis
  • twitchiness
A

hepatic encephalopathy

84
Q
  • Hematemesis/melena/hematochezia
  • Pale, hypotensive, lightheaded, syncope, orthostatic, tachycardic, any signs/symptoms of hemorrhagic shock
  • Liver disease/Cirrhosis signs
A

GI varicies

85
Q
  • Fatigue/Malaise
  • Anorexia
  • Nausea and vomiting
  • Fever
  • Enlarged tender liver
  • Jaundice
  • Normal to low WBC
  • Markedly elevated aminotransferase (>1000U/L)
  • Hyperbilirubinemia
  • Elevated PT? INR? (>1.5)
  • Encephalopathy
A

Acute hepatitis

86
Q

Anti-HAV appears early

A

Hep A

87
Q
  • asymptomatic or mild clinical illness w/ 6-7 wk incubation
  • Anti-HCV ELISA
  • HCV RNA PCR serology
A

Hep C

88
Q

anti-HDV

A

Hep D

89
Q
  • Aminotransferase >1000
  • Positive ANA and/or smooth muscle Ab most common type
  • IgG elevated
A

Autoimmune hepatitis

90
Q
  • Macrocytic anemia
  • Thrombocytopenia
  • AST/ALT ratio 2/1 and mildly elevated (not greater than 300)
  • TB elevated
  • PT/INR elevated
A

Alcoholic hepatitis

91
Q

HBsAg and anti-HBc IgG

A

Chronic Hep B

92
Q
  • Insidious until perhaps cirrhotic pt deteriorates
  • Weakness, weight loss, anorexia
  • Ascites
  • Jaundice, Icterus, pruritis
  • Tender enlarged liver +/-mass
A

HCC

93
Q
  • associated with illnesses where the body is in a hypermetabolic state, i.e. trauma, sepsis, burns
  • progressive muscle loss
  • organ dysfunction
A

Kwashiorkor-like deficiency

94
Q
  • results from chronic diseases like heart failure, cancer, COPD, AIDS
  • organ dysfunction
  • Progressive muscle wasting in setting of early weight loss to severe cachexia
  • Temporal wasting
A

Marasmus-like deficiency

95
Q
  • Weight loss leading to body weight 15% below expected
  • In female patients, amenorrhea is almost always present
  • Constipation
  • Cold intolerance
  • Bradycardia
  • Hypotension
  • Loss of body fat
  • Dry and scaly skin
A

anorexia

96
Q
  • Body weight fluctuations but generally within 20% of normal body weight
  • Commonly describe family and psychological issues
  • Impulsive or antisocial behavior may be present
  • Menstruation is typically preserved
  • Gastric dilatation, pancreatitis after binges
  • Poor dentition, esophagitis secondary to vomiting
  • Electrolyte abnormalities, dehydration secondary to diuretics and cathartics
  • Constipation
A

Bulimia Nervosa

97
Q
  • Fatigue
  • Tachycardia
  • Palpitations
  • Dyspnea on exertion
  • Skin and mucosal changes
  • Smooth tongue
  • Brittle nails
  • Spooning of nails
  • Cheilosis
  • Many patients develop pica, a craving for specific foods
A

iron-deficient

98
Q
  • Anorexia
  • Muscle cramps
  • Paresthesias
  • Irritability
  • Cardiovascular dysfunction – wet beriberi
  • Neurological dysfunction – dry beriberi
A

Thiamine deficient

99
Q

Wet beriberi

A
  • Marked peripheral vasodilation caused high output heart failure
  • Dyspnea, tachycardia, cardiomegaly, edema
100
Q

Dry beriberi

A

Peripheral nerve involvement causing motor and sensory neuropathy, 
paresthesias and loss of reflexes

101
Q
  • megaloblastic anemia
  • Glossitis occurs and vague GI symptoms occur
  • Paresthesias
  • Balance difficulty
  • Cerebral dysfunction: dementia 

  • low B12
A

B12 deficiency

102
Q
  • GI symptoms

  • Swollen, painful tongue
  • Neurologic symptoms such as cognitive impairment, dementia, depression
  • low folic acid
  • megaloblastic anemia
A

folic acid deficiency

103
Q

osteomalacia

A

Vitamin D deficiency

104
Q
  • Asymptomatic
  • Epigastric pain
    o Gastric – while eating
    o Duodenal – hours after eating or middle of the night
  • Early satiety
  • Nausea +/- vomiting
  • Belching, bloating, distention
  • Chest pain/heartburn
  • GI bleed– hematemesis, melena
  • Guaic + stools
  • Perforation – sudden onset of pain +/- peritoneal signs
A

PUD

105
Q
  • Epigastric pain
  • Burning sensation
  • Gnawing Sensation
  • Nausea +/- vomiting
  • +/- Hematemesis (BR or coffee ground)
A

gastritis

106
Q
  • retrosternal pain
  • heart burn
  • odynophagia
  • dysphagia
    WATER BRUSH
  • globus densation
  • food impaction
    LARYNGITIS
  • chronic cough
  • hematemesis
  • abdominal pain
  • weight loss
A

GERD

107
Q

odynophagia
Immunocompromised ptn
Thrush

A

candida esophagitis

108
Q
  • retrosternal pain
  • heart burn
  • odynophagia
  • dysphagia
  • water bursh
  • globus densation
  • food impaction
  • laryngitis
  • chronic cough
  • hematemesis
  • abdominal pain
  • weight loss
A

esophagitis

109
Q
  • Hematemesis
  • melena
  • hematochezia
  • Pale, hypotensive, lightheaded, syncope, orthostatic, tachycardic
  • Liver disease/Cirrhosis signs : jaundice, pruritus, ascites, encephalopathy/MS changes, muscle cramps, anorexia, spontaneous bleeding/easy bruising, abdominal pain, nausea/vomiting
A

esophageal varicies

110
Q
  • repeated episodes of retching and vomiting
  • severe chest pain lower thorax and upper abdomen radiating to the back or left shoulder.
  • Swallowing aggravates the pain
  • Shortness of breath
  • Mackler triad
  • Neck pain, upper chest pain, epigastric pain
  • rales (pleural effusion)
A

Boerhaave syndrome

111
Q

Hematemesis 85%
o Vomit/retch then hematemesis classic- blood streaked vomit
Melena
Hematochezia
Syncope/Assoc GI hemorrhagic hypovolemia
Guaic stool positive

A

Mallory Weiss tear

112
Q

halitosis
regurgitation of undigested food
gurgling in throat

A

Zenker diverticulum

113
Q
  • Dysphagia*- intermittent, non-progressive, solids only
  • Odynophagia
  • Heartburn
  • Food impaction
  • Chest pain
  • Chronic cough, asthma
A

Schatzki ring

114
Q
  • Dysphagia*- slow onset, solid to liquid
  • Odynophagia
  • Heartburn
  • Food impaction
  • Chest pain
  • Chronic cough, asthma
A

esophageal strictures

115
Q 
dysphagia
- progressive solid to liquid
- regurg at night and supine
- long duration of sx
Chest pain
- sudden, squeezing in the retrosternal
exacerbated by food and stress
A

dysmotility disorder

116
Q
  • Dysphagia*- Progression from solid food to liquids; Rapid
  • Weight loss >50%
  • Regurgitate food- Epigastric pain/retrosternal pain/bone pain from mets
  • Chronic cough
  • Hoarseness/dysphonia
  • Virschow node- lymph node in left supraclavicular fossa
  • Cachectic
A

esophageal carcinoma

117
Q
  • Insidious presentation
  • Indigestion
  • Nausea/Vomiting
  • Dysphagia
  • Early satiety/Anorexia
  • Weight loss
  • Melena/Hematemesis
  • Local spread to omenta, pancreas, diaphragm, mesocolon, transverse colon, duodenum
  • GOO- gastric outlet obstruction
  • SBO
  • Palpable enlarged stomach
  • Hematogenous spread liver
  • Sister Mary Joseph Node- periumbilical lymph node
  • Virchow Node- supraclavicular node
  • Hepatomegaly
A

gastric cancer

Clin Med 2 (25 decks)

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