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Part 2/3 boards > General Diagnosis 5 > Flashcards

General Diagnosis 5 Flashcards

1
Q

direct/conjugated bilirubin

A

water soluble

increases with duct obstruction (gallstones), hepatic disease, pancreatic cancer

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2
Q

what might increased bilirubin in the blood lead to?

A

bilirubin in urine (urobilinogen(=)

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3
Q

indirect/unconjugated bilirubin

A

not water soluble

increases with hemolytic disease, drugs, spleen disorders

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4
Q

indirect/unconjugated bilirubin can be seen in what anemia?

A

hemolytic anemia

increase in reticulocyte count (coomb’s test)

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5
Q

gallbladder pain referral

A

to right shoulder or tip of right scapula (viscerosomatic)

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6
Q

cholecystitis

A

most commonly seen in overweight females

MC cause is cholelithiasis

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7
Q

s/s of cholecystitis

A

right upper quadrant pain
nausea
vomiting
precipitated by eating a large fatty meal

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8
Q

murphy’s sign

A

inspiratory arrest sign
breath in, push up on liver
they will stop breathing because it hurts
refer to gastroenterologist

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9
Q

porcelain gallbladder

A

calcification that can become malignant due to chronic inflammation

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10
Q

pancreatitis

A

epigastric pain going straight through the T10-12 area like a knife

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11
Q

chronic pancreatitis

A

seen with alcoholism

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12
Q

acute pancreatitis

A

911 emergency

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13
Q

grey turner sign

A

pancreatitis

bleeding into flank

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14
Q

cullen’s sign

A

periumbilial eccymosis caused by intraperitoneal hemorrhage or seen with a ruptured ectopic pregnancy
pancreatitis

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15
Q

lab tests for pancreatitis

A

increased amylase and lipase

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16
Q

pancreatic cancer

A

usually at head of pancreas

presents with dark urine, clay colored stools and jaundice

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17
Q

what position is usually most comfortable for pancreatic cancer?

A

flexed/fetal position

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18
Q

s/s of diabetes mellitus

A

polydypsia
polyphagia
polyuria

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19
Q

labs for diabetes mellitus

A

glucose tolerance test
fasting plasma glucose
HgA1C

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20
Q

insulin dependant type 1

A

juvenile
under 30
usually thin

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21
Q

non-insulin dependant type 2

A 
adult
over 40
usually obese
hyperinsulinemia
insulin resistance
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22
Q

diabetes insipidus

A

condition of posterior pituitary gland in which there is insufficient ADH
may have polydipsia, polyuria
NOT polyphagia

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23
Q

hiatal hernia

A

protrusion of the stomach above the diaphragm
presents with palpable tenderness in LUQ, reflux esophagitis, dyspepsia (indigestion)
made worse after eating a large meal or when lying down

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24
Q

reflux esophagitis

A

upward reflux of acid contents of the stomach into the esophagus
caused by sliding hiatal hernia
worse when lying down, after eating a big meal, valsalva, bearing down

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25
Q

barrett’s esophagus

A

destruction of esophagus due to reflux esophagitis

precursor to esophageal cancer)

26
Q

tests for reflux esophagitis

A

xray or upper GI series

27
Q

peptic ulcers

A

includes gastric and duodenal ulcers
caused by H. pylori
burning pinpoint epigastric pain
coffee ground emesis

28
Q

gastric ulcer

A

has no consistent pain pattern

29
Q

duodenal ulcer

A

most common type of peptic ulcer
pain occurs 2 hours after eating
black/tarry stool

30
Q

what test do you do if you suspect duodenal ulcer?

A

guiac test: occult blood in stool

31
Q

pyloric stenosis

A

projectile vomiting in the newborn

32
Q

gastric carcinoma

A

most common on the lesser curvature

virchow’s node

33
Q

virchow’s node

A

left supraclavicular lymph node involvement

34
Q

mono of caused by? s/s

A

HHV-4
seen in young adults
fever, headache, fatigue, lymphadenopathy in cervical region, splenomegaly

35
Q

labs for mono

A

atypical lymphocytes in blood (downey cells)
monospot
heterophile agglutination
paul bunnell

36
Q

osteopetrosis

A

bone marrow becomes sclerotic, thus RBCs are not made properly
liver and spleen become enlarged

37
Q

referral of pain for small intestine

A

periumbilical

38
Q

regional ileitis

A

AKA chron’s disease

nonspecific inflammatory disorder that affects distal ileum and colon

39
Q

s/s of regional ileitis

A

RLQ pain
chronic diarrhea
cobblestone appearance on sigmoidoscopy
leads to malabsorption of B12

40
Q

what else can cause regional ileitis

A

non-tropical sprue/celiac sprue (gluten allergy) can cause chron’s

41
Q

ulcerative colitis

A

most common at the colon and rectum
presents with bloody diarrhea
diagnosed with sigmoidoscopy

42
Q

irritable bowel syndrome

A

AKA spastic colon
variable degrees of diarrhea in response to stress
more common in females
abdominal pain and gas relieved by bowel movements

43
Q

appendicitis

A

dull periumbilical or epigastric pain that radiates to lower right quadrant (mcburney’s point)

44
Q

s/s of appendicitis

A 
fever
nausea
vomiting
anorexia
increased WBC
45
Q

tests for appendicitis

A 
rebound tenderness
rovsing's sign
psoas sign
obturator sign
CT scan
46
Q

diverticulitis

A

consequence of inadequate fiber in diet
chronic constipation which causes small outpouchings within colon that become infected
LLQ pain

47
Q

meckel’s

A

outpouching of ileum

48
Q

zenker’s

A

outpouching of esophagus

49
Q

cushing’s disease

A

inceased production of adrenal cortex hormone (hyperadrenalism, hypercortisolism)

50
Q

s/s of cushing’s disease

A 
moon face
buffalo hump
pendulous abdomen with purple striae
hirsutism
weakness
HTN
increased cortisol
decreased bone density
more prominent in spine
51
Q

addison’s disease

A

decreased aldosterone
hypoadrenalism
hypocortisolism

52
Q

s/s of addison’s disease

A 
increased ACTH causes melanin deposition
thin person
decreased blood pressure
weakness
fatigue
lethargy
nausea
vomiting
hair loss
53
Q

pheochromocytoma

A

tumor of adrenal medulla
increased catecholamine production (epinephrine, norepinephrine)
may be similar to hyperthyroidism but this produces extreme HTN

54
Q

nephrolithiasis

A

made of cacium
flank pain (writhing)
may radiate/travel to groin

55
Q

murphy’s test

A

kidney punch

56
Q

labs for nephrolithiasis

A

increased BUN
increased uric acid
creatinine clearance
KUB study

57
Q

hydronephrosis can cause

A

staghorn calculi

58
Q

acute glomerulonephritis

A

nephritic syndrome
caused by group A hemolytic strep (ASO titer)
RBC casts in urine with small amount of protein

59
Q

nephrotic syndrome

A

HTN
edema
massive proteinuria
in pregnant women is called pre-exlampsia

60
Q

pyelonephritis

A

starts as an LUTI
ecoli
WBC/fatty casts in urine

61
Q

pylycystic kidney disease

A

inherited disorder characterized by many bilateral renal cysts that increase renal size but reduce functioning renal tissue

Part 2/3 boards (16 decks)

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