Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dermatology > Gastrointestinal problems > Flashcards

Gastrointestinal problems Flashcards

You may prefer our related Brainscape-certified flashcards:
Dermatology Board Prep flashcards
1
Q

Abdominal pain

A

visceral=in organs, dull and pain poorly localized

Parietal pain-sharp and well localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RUQ

A 
chest cavity
liver
gallbladder
stomach
bowel
right kidney
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

LUQ

A

pancreas
left kidney
spleen
heart and chest cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

RLQ

A 
Appendix
bowel
right ureter
perlvis
ovary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

LLQ

A

bowel-diverticulitis
ureter
pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Appendicitis

A

Good oral history/OLDCARTS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Get consult when:BWAD

A

blood in stool
weight loss
anemia
dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Appeddicitis

A

obstruction of appendix with feces, inflammation, or stricture
occurs in all age groups-more common in males 10-30
higher mortality in complications of children and those over 55
leading cause of surgery in abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Appedicitis-S/S

A

Acute onset of periumbilcal or epi-gastric pain
Anorexia, n/v
Shifting of pain to right lower quadrant
McBurneys point after several hours
aggravated by coughing/walking
pain may be in testicles, spasm, contipation more so than diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

appendicitis-after 24 hours

A

if perforates may have sudden cessation of pain, abdominal rigidity, high fever, vominting, dehydration, decreased bowel sounds, shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

appendicitis- physicla findings before perforation

A

fever
abdominal rigidity, point and rebound tenderness in RLQ, decreased bowel sounds, +psoas and obturator signs
rectal exam-tenderness in right perirectal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Psoas-

A

pain when lifting right leg against pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Obturator sign

A

positive when hip and knee is flexed and rotate right leg into the inside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Appendicitis labs

A

CBC with diff-leukocytosis with increased band cells (shift to the left)
C-reactive protein (normal after 24 hours would mean NO appendicitis)
Urinalysis
HCG-ectopic
abdominal ultrasound- if uncertain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Appedicitis

A

Mayy reveal mass when doing rectal exam and it will be tender, refer to surgeon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nausea and Vomiting

A

Caused by: GI, PUD, CNS (motion sickness)
systemic-pregnancy, food poisoning
Iatrogenic-meds, bulemia
NO lab if no systemic S/S and duration is <24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

N/V

A

No solids for 4 hours, clear liquids gradually increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

N/V-medications

A 
Phergen-generalized n/v
bismuth subsalicylate-pepto bismal-n/v
Transdermal scope-motion sickness
Benzamides-due to reflux, diabetes
phenothiazines-sever nausea & vomiting
Chemo-5-HT (serotonin rec antagonists
dopamine, cannabinoids,benzodiazepines, and antihistaines and anticholinergic agents for motion sickness and migraines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

N/V during pregnancy

A

Reglan- Class B
zofran-Class B
Complimentary-ginger, B6
Consult if persists over 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Constipation

A

Medications that cause constipation are anticholinergics, calcium channel blockers, diuretics, antacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Constipation

A

2 of the following for 3 months and 6 months previous to that
fewer than 3 movements per week, hard lumpy stools, sensation of straining, feeling of incomplete evacuation, obstruction,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Constipation

A

caused by hypothyroidism, DM, slow transit, pelvic floor dysfuntion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Constipation lab studies

A 
urnialysis
stool occult for blood
TSH
CBC and differential
Chemistry profile
stool culture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Constipation

A 
lifestyle changes
bulk forming laxatives
stool softners
osmotic laxatives
stimulant laxatives
chloride channel activators
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

IBS

A

Functional disturbance of intestinal motility
diarrhea or constipation
influenced by emotional factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

IBS- relieved abdominal discomfort by pasage of stool or associated with diarrhe, constipation, or mucus in stool

A

young adulthood, no blood in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

IBS

A

3x per month for 3 months begining 6 mos prior to dx
dx of exclusion
abdomen - mild abdominal tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ROME III Diagnositc criteria

A 
must have two or more of the following: improvement with defecation, onset associated with change in frequency (less than 3 BMs per week or more than 3 per day) onset associated with change in appearance (lumpy hard or loose and watery)
One or more on 25% of the time
Abnormal stool
abnormal passage
stool form
bloating or distention
mucous in stool
loose stools    
Must be present for 6 mos prior to dx at least e days per mo for 3 mos.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Constipation or Diarrhea will affect the education

A

Abdominal pain must be present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

IBS

A

Usually unremarkable exam . mild abdominal tenderness, normal or mild hyperactive bowel sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

IBS labs

A 
CBC, sed rate, blood chemistry, TSG
Stool occult
Fecal leukocytes
Pts > 50 colonoscopy
Pts <50 sigmoidoscopy
Rule out lactose intolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How to rule out lactose intolerance

A

Intolerance with a two week lactose free dite OR drink a quart ofmilk and check for symptoms/hydrogen breath testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

IBS-constipation Tx

A

High fiber diet
bulking agents
drug therapy for sever symptoms-1/3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

IBS-diarrhea

A

Antispasmodics-Bentyl or Hyoscomine
Immodium
Anti-depressants SSRIs
Behavioral therapy, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

IBS constipation

A

Miralax, therapy, SSRIs, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

IBS education

A

Sit on toilet after breakfast every morning for 20 minutes
Meds and lifestyle
Watch for blood, fever, unintentional weight loss and then refer

37
Q

Regular Diarrhea

A

No labs if under 48 hours and no s/s
Stop all soldis for 12-24 hours, rehydrate
kaopectate of pepto bismol for symtomatic relief, Donnatol for cracmping

38
Q

Infectious diarrhea

A

Most is viral
Antibiotics if fecal leukocytes, occult blood, fever with watery diarrhea or symptoms > a week (salmonella, campy, shigella)
Give Cipro 500 mg every 12 hours orally 1-3 days in adults.

39
Q

No antimotility drugs if fecal leukocytes or blood in stools

A

none

40
Q

C-difficile

A

Metronidazole 500 mg 3x/day for 10-14 days or vancomycin

41
Q

Travelers Diarrhea

A

Antibiotics if fecal leukocytes, occult blood, fever with watery diarrhea or symptoms great than 1 week (usually salmonella, shigella, campylobactor

Cipro

42
Q

No antimotility drugs if fecal leukocytes or blood in stools

A

Slows the bug from excreting form the body.

43
Q

Diarrhea over 2 weeks consider giardia

A

Tx with flagyl

44
Q

Dyspepsia and heartburn

A

disturbed digestion GERD

45
Q

GERD

A

Daily presence of heartburn, 10% in normal adults, is a defect in esophageal motility

46
Q

GERD

A

retrosternal aching or burning occurring 30-60 minutes after eating and associated with large meals and aggravated by lying down-can mimic angina with heavy chest and pressure daiating down to the neck or jaw or shoulders-regurgitation of food particles, nonturnal aspiration can cause pneumonia or bronchospasm

47
Q

GERD-physical findings

A

epigastric tenderness, stool for occult blood have them do at home. Dysphagia with weight loss, loss of dental enamal from acid

48
Q

GERD labs

A

Usually dx by history
Endoscopy indicated if
>50 with sudden onset
does not respond to therapy
alarm symptoms (bleeding, anemia, dysphagia, odynophagia
long standing symptoms at risk for barretts esophagus

49
Q

GERD Management

A

lifestyle modification
PPI x 8 weeks and if no response then endoscopy
Follow up 2-4 weeks
Treat with antacids first then PPI’s

50
Q

GERD differentials

A

Angina
PUD
gastritis
heart attack

51
Q

GERD

A 
Decrease meal size
smoking cessation
reduce alcohol consumption
reduce carbonated drinks
redeuce fat
weight loss
52
Q

GERD labs

A

if indicated CBC and stool occult. Usually only after meds dont work

53
Q

Barretts esophagus can lead to caner

A

If PPI’s don’t work refer

54
Q

Causes of negative blood in melena

A

iron, pepto, licorice

55
Q

Jaundice

A

elevated aspartate aminotransferase (AST) and alamine aminotransferase (ALT) are indicate hepatocyte damage

56
Q

jaundice

A

ALT is usually higher in viral hepatitis

In alcoholic hepatitis the AST may be higher

57
Q

AST ratio with ALT over 2

A

indicates cirrohsis and alcohol problem

58
Q

Alkaline phosphatase is found in the liver (alp-1 and the bone alp-2)

A

Elevated in a teen means bone growth. Could be fetal bone growth

59
Q

elevated alkaline phosphatase

A

cirrohsis or cholecstasis, obstructive liver disease

60
Q

gamma glutamyl transferase (GTT)

A

May determine the cause of elevated ALP

61
Q

ALP and GTT are elevated in disease of the bile ducts

A

and in some liver diseases

62
Q

Only ALP will be elevated in bone disease

A

If GTT is normal and a high ALP it is most likely bone disease

63
Q

ALP is up in bone disease

A

Got that !!

64
Q

Peptic Ulcer Disease

A

ulceration of the GI mucosa

bathesd by acid pepsi, stomach, and esophagus

65
Q

PUD

A

H. pylori

NSAID usage

66
Q

PUD aggravating factors

A

severe trauma, burns. shock
alcohol and nicotine use
presence of cirrohsis, chronic pancratitis
famiy hx

67
Q

PUD

A

80% are duodenal

68
Q

PUD s/s

A

intermittent epigastric pain
begins 1-3 hours after eating, awakens a person at night
pain relieved by food
They eat then feel better

69
Q

If its a gastric ulcer

A

people get skinny and don’t like to eat.

70
Q

PUD dx

A

pain-food-relief pattern

71
Q

PUD Dx

A

limited to epi tenderness
include rectal exam and testing for occult blood
CBC with diff-could be anemia
H. pylori testing

72
Q

H. Pylori testing

A

serum culture
breath test
fecal antigen test
serum culture will not tell if previous or now
Next two test can only be done if not PPI’s for a week previous

73
Q

PUD

A

Endoscopy in pt over 50. Do if two week PPI shows no improvement
to locate bleeding site in those with dx or suspected blood loss

74
Q

Management of PUD

A 
relieve symptoms
stop smoking
avoid nsaids
reduce stress
reduce alcohol and caffeine
75
Q

PUD medication

A

1st line PPIs most potent, but expensive

H2RA’s 4-6 weeks then nightly pm x 1yr

76
Q

H. Pylori

A

PPI twice daily 10-14 days
Clarithromycin 500 mg/twice a day
Amoxicillin 1000mg/twice/day

77
Q

PUD education

A

no evidence for bland diet
encourage avoidance of known gastric acid stimulants, coffe, soda
stress reduction
report lack of response, rectal bleeding, weight loss, increased weakness or dizziness

78
Q

PUD f/u

A

1-2 weeks to check on response to meds, GI bleeding, toxic side effects of meds

79
Q

Diverticulitis

A 
Inflammation of the diverticuli
occurs in 25% of population Increases after 45
MOre in women and low fiber diets
mostly in sigmoid colon
15% will develop complications
80
Q

Diverticulitis

A 
acute lower left quadrant pain-steady and severe or crampy and lasts for days
constipation more usual than diarrhea
pain increased with defecation
flatulence
N/v
low grade fever
81
Q

Diverticulitis findings

A 
mild fever, tachycardia
guarding
rebound tenderness
rigidity over LLQ
tender palable mass if abcess has formed
82
Q

Diverticulitis Dx labs

A 
CBC with slight leukocytes
urinalysis-wbc
Stool for occult blood
plain abdominal films
if no response to tx CT scan
colonoscopy after acute phase
83
Q

Diverticulitis Tx

A

clear liquids for 2-3 days
Metronidazole 500 bid AND
Cipro 500 mg BID 7-14 days of Bactrim or Augmentin
If moderate or severe will require hospitilization

84
Q

Diverticulitis

A

Should be better in 1-2 days or refer

85
Q

Diverticulitis

A

After acute phase, gradually increase fiber, avoid laxatives, use bulk forming agents
F/U in 24-48 hrs and again after antx therapy

86
Q

Acute pancreatitis

A

Severe abdominal pain, poorly localized, frequently radiates to the back
rebound tenderness

87
Q

Pancreatitis

A

Cullens and Grey turners can be seen in sever cases. rare but loooks like bluing in the flank area

88
Q

Pancreatitis- labs

A 
Serum amylase is the most common test Rises 6-12 hours after onset and then normal in 3-5 days.  A three fold serum lipase elevation is more diagnostic and is elevated in both alcoholic and non alcoholic pancreatitis
Chem 7, bun creatinine
tryipsynogin
C-reactive protein
TSH
89
Q

pancreatitis

A

abnormal CT scan is useful

Refer to gastroenterologist

Dermatology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions