Gastroenterology System Review Flashcards
what does pyrosis mean?
heart burn
what is a positive murphy’s sign?
Palpate the RUQ of the abdomen and if the patient has inspiratory arrest (stops breathing) due to pain then the test is positive.
what is the gold standard diagnostic test for ruling out acute cholecystitis?
US of the abdomen
is left or right sided colon cancer more common?
left-sided colon cancer is more likely
fecal occult blood test (gFOBT) are done how frequently ?
annually or yearly
need 3 specimens
FIT (stool) tests are done how frequently?
yearly or annually
FIT DNA (Cologuard) tests are recommended how frequently?
every 1-3 years
Colonoscopy is recommended how often?
every 10 years
Flexible sigmoidoscopy is recommended how often?
every 5 years
what tests measure the integrity of the liver?
ALT/AST
AST is twice the amount of ALP in what ?
Non-alcoholic fatty liver disease
ALT is much higher than the AST in what?
Viral hepatitis
IgM means what?
acute onset, antibodies to be produced the MINUTE there is an acute infection
IgG means what?
means gone, produced when immune, and infection is GONE
a positive anti-HAV IgM means what?
you are IMMUNE
a positive anti-HAV IgM means what?
you have an acute infection
what is this marker and what does it mean: HBsAg
Hepatitis B Surface Antigen, it means infected currently or in the past
what is this marker and what does it mean: anti-HBs
Hepatitis B Surface Antibody, it means you are immune (either from the vaccine or recovery from the disease)
what is this marker and what does it mean: anti-HBc
Total hepatitis B CORE antibody, this indicates current or previous infection
what is this marker and what does it mean: IgM anti-HBc
Igm antibody to hepatitis B core antigen, acute hepatitis B (less than 6 months of infection)
when you see “core” what should you think?
think infection which could be previous or current
what is the screening test for hepatitis C?
Hepatitis C virus antibody test (HCV antibody)
what is the confirmatory test for hepatitis C?
HCV RNA–this tests for presence of virus (if exposure within the last 6 months or exposure is unknown)
If the HCV antibody test is positive, what is the next step the clinician should do?
Order a HCV-RNA test to confirm presence of virus
Hepatobiliary iminodiacetic acid (HIDA) is an imaging that rules out what?
rules out cholecystitis
How do you conduct a psoas/iliopsoas?
With patient supine, have patient raise right leg against the pressure of the professional’s hand resistance OR with the patient on the left side extend the right leg from the hip.
a positive sign elicits pain.
a positive psoas/iliopsoas sign is means what? what is it associated with?
a positive finding suggests peritoneal irritation.
Associated with acute appendicitis
how do you conduct a obturator sign?
With the patient supine, get their right leg bent at night degrees and rotate the leg to the left and right.
A positive test elicits pain with movement or flexion the hip.
how do you conduct a rovsing’s sign?
With the patient in a supine position, apply deep palpation to the LLQ of their abdomen.
A positive test results in referred pain felt to their RLQ.
This is a sign of peritonitis
where is McBurney’s point?
Area located between the superior iliac crest and the umbilicus in the RLQ.
Tenderness or pain is a sign of possible acute appendicitis
What is the Markle test? what is another name for it?
Heel jar test
Tell the patient to patient to raise their heels and then drop them suddenly. An alternative is to ask the patient to jump in place.
Positive if pain is elicited or if patient refuses to perform because of pain.
what is rebound tenderness?
patient will complain of worsening abdominal pain when hand is released after palpating of the abdomen compared to when the pain felt during deep palpation. suspect acute or surgical abdomen. Refer to ED.
what is the carnett’s test?
an abdominal manuever that is used to determine if abdominal pain is from inside the abdomen or if it is located on the abdominal wall.
Instruct the patient while supine, to cross their arms over their chest. Instruct patient to lift up shoulders from the table so that the abdominal muscles tighten–if pain is on the abdominal wall, it will increase pain, if not the source is from inside the abdomen because the pain improves.
What is classic symptoms of acute pancreatitis?
Severe mid-epigastric pain that radiates to midback.
what is cullen’s sign?
It is edema and bruising of the subcutaneous tissue around the umbilicus
what is grey turner’s sign?
bruising or bluish discoloration of the flank area that may indicate retroperitoneal hemorrhage
what some antibiotics are used for the treatment of H.pylori?
Triple therapy
Clarithromycin (BIaxin)
Amoxicillin
Flagyl
standard PPI
Quadruple therapy
Bismuth Subsalicylate
Flagyl
Tetracycline (doxycycline)
standard PPI
A “left shift’ is common among what gastrointestinal disorder?
Diverticulitis
what is the treatment for diverticulitis?
Augmentin PO two-three times a day
OR
Ciprofloxacin + Metronidazole
what do positive cullen’s and grey turner’s signs mean?
possible hemorrhagic pancreatitis
what is the screening test for hepatitis B ?
Hepatitis B surface antigen (HbsAg)
hep A is transmitted how?
fecal and oral route from contaminated food or drink, households, sex.
hep B is transmitted how?
horizontal transmission via sexual activity (semen, vaginal secretions, saliva), blood, blood products, organs. vertical transmission occurs from mother to infant.
hep C is transmitted how?
transmitted sharing needles, blood transfusions before 1992, mother to infant (vertical transmission), needle-stick injuries.
GGT elevation is associated with what?
possible alcholism
GGT elevation is associated with what?
possible alcoholism
Hepatitis B “e” antigen (HBeAg) means what?
marker for activley replicating hepatitis virus; highly infectious
“E” indicates chronic hepatitis actively
