DDx, conditions, etc. Flashcards

1
Q

Prolonged exposure of esophagus to gastric acid due to impaired esophageal motility or lower esophageal sphincter.

A

GERD

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2
Q

Describe the location and quality of GERD pain.

A

Burning chest/epigastric pain

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3
Q

Describe the provocative/palliative factors affecting GERD.

A

physical activity, lying down, alcohol, fatty meals, chocolate make worse BUT antacids and avoiding Ca Channel blockers make better.

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4
Q

Associated symptoms of GERD

A

chronic cough, SOB, hoarseness, halitosis, sore throat

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5
Q

Describe the location and quality of pain associated with a peptic ulcer.

A

gnawing, burning, boring, aching or hunger like epigastric pain/discomfort that may radiate to the back

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6
Q

Patient complains of pain that wakes her at night and is intermittent over a few weeks.. even disappears for months

A

Duodenal ulcer should be considered.

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7
Q

Describe the location and quality of pain associated with acute appendicitis.

A

Initially mild, poorly localized periumbilical pain that becomes more steady, severe and moves to RLQ

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8
Q

Associated symptoms for acute appendicitis

A

anorexia, nausea/vomiting, low fever

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9
Q

Gallbladder inflammation due to cystic or common bile duct obstruction (gallstone)

A

acute cholecystitis

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10
Q

Pt. complains of steady, aching RUQ pain than radiates to the rt. scapular area.

A

Acute cholecystitis

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11
Q

A steady epigastric pain that radiates to the back… it seems to get better when leaning forward with trunk flexed.. Which organ will you focus on?

A

Pancreas.. Acute/chronic pancreatitis? cancer?

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12
Q

Pt. complains of steatorrhea and DM… Part of Ddx should include:

A

chronic pancreatitis

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13
Q

A cramping LLQ pain comes on gradually, but becomes steady… Pt. has fever, constipation, and brief initial diarrhea. What you think?

A

Acute diverticulitis

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14
Q

Cramping, paroxysmal pain… Obstipation and possible vomiting… What you think?

A

Bowel obstruction… location of pain and composition of vomit may help decide between SBO and colon..

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15
Q

Three reasons for a bowel lumen obstruction?

A

adhesions, hernias, cancer, diverticulitis

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16
Q

When might you consider mesenteric ischemia as part of your Ddx?

A

abrupt periumbilical cramping pain at first that becomes diffuse and persistent.. older pt. possibly prone to thrombi or emboli

17
Q

What causes oropharyngeal dysphagia?

A

motor disorders affecting the pharyngeal muscles (stroke, bulbar palsy, neuromuscular conditions)

18
Q

AS with oropharyngeal dysphagia:

A

aspiration, regurgitation into nose with attempts to swallow

19
Q

Various reasons for esophageal dysphagia:

A

mucosal rings, esophageal stricture, or cancer causing a mechanical narrowing

20
Q

P/P factors associated with esophageal dysphagia

A

Solid foods provocate… regurgitation of the bolus relieves

21
Q

Uncoordinated spasms of esophagus that fail to propel food to stomach… shows a characteristic corkscrew barium swallow x-ray… What is condition and possible triggers?

A

DES (diffuse esophageal spasm). Uncontrolled gastroesophageal reflux, really hot/cold beverages

22
Q

Provide 3 life activities/habits that suggest constipation

A

ignoring defecation reflex, false expectations, low-fiber diet

23
Q

Functional change in frequency/form of BM w/o known pathology…possible change in intestinal bacteria.. What’s the problem?

A

Irritable Bowel Syndrome

24
Q

3 reasons for a mechanical obstruction resulting in constipation

A

narrowed lumen from adenocarcinoma, fecal impaction, diverticulitis, volvulus, intussusception, hernia..

25
Q

Acute diarrhea can be secretory or inflammatory infection. Give possible causative agents.

A

S.aureus, B. cereus, C. perfringens, cholerae, cryptosporidium, Giardia, rotavirus

26
Q

List several causative agents of inflammatory infection resulting in acute diarrhea

A

Salmonella, Shigella, Yersinia, Campylobacter, E. coli, C. difficile

27
Q

Name several drugs that can induce diarrhea

A

Mg containing antacids, antibiotics, antineoplastic agents, laxatives

28
Q

Causes of chronic diarrhea include:

A

IBS, cancer, ulcerative colitis, Crohn’s, malabsorption syndrome, lactose intolerance

29
Q

What are several causes for melena

A

Gastritis, GERD, peptic ulcer, esophageal/gastric varices, reflux esophagitis Mallory-Weiss tear

30
Q

Black stools but a negative occult test and asymptomatic.. reason?

A

ingestion of iron, bismuth salts, licorice, chocolate cookies

31
Q

Causes for hematochezia

A

cancer, adenomatous polyps, diverticula, inflammatory conditions, hemorrhoids, fissures, proctitis