GI 1 Flashcards
classic exam findings for acute appendicitis
low grade fever
RLQ pain w/ rebound and guarding
McBurney’s point
psoas and obturator signs are positive
acute cholecystitis classic presentation
overweight adult pt c/o severe RUQ or epigastric pain that occurs within 1 hour or more after eating a fatty meal
acute diverticulitis class s/sx
high fever
anorexia
NV
LLQ pain
signs of acute diverticulitis
3
positive Rosving’s sign
board like abd
CBC - leukocytosis w/ netrophilia and shift to the left
positive Cullen’s sign
blue discoloration around umbilicus - acute pancreatitis
Grey Turner’s sign
blue discoloration on the flanks - acute pancreatitis
crohn’s disease
IBD that can affect any part of GI tract; transmural inflammation and skip areas of involvement
IBD that can affect any part of GI tract; transmural inflammation and skip areas of involvement
Crohn’s disease
form of IBD that is limited to the colon/rectum
UC
blood diarrhea w/ mucus (hematochezia) is more common with what
UC than with CD
severe “squeezing” cramping pain located on the left side of the abd w/ bloating and gas that is exacerbated by food
UC
Zollinger-Ellison syndrome
gastrinoma located on the pancreas or stomach that secretes gastrin which increases acid production in the stomach that causes severe ulcers
gastrinoma located on the pancreas or stomach that secretes gastrin which increases acid production in the stomach that causes severe ulcers
Zollinger-Ellison syndrome
zollinger-ellison syndrome - screen by
serum fasting gastrin level
positive signs for appendicitis
psoas - raise leg while applying downward pressure
obturator - internal rotation of hip causes RLQ pain
rovsing’s sign
deep palpation LLQ causes referred pain to RLQ - appendicitis
mcburney’s point
RLQ pain - appendicitis
murphy’s maneuver
press deeply on RUQ during inspiration, pain is positive - suggests cholecystitis
hepatitis A - acute infection, patient is contagious
IgM antibody (IgM Anti-HAV)
positive IgG Anti-HAV
hep A virus - presence means lifelong immunity, no virus present, native hep A infection or vaccine
HBsAG positive
positive when the patient is infected currently or was infected in the past with hep B
serologic hallmark of hep B virus infection HBV
HBsAg
disappearance of HBsAg is followed by
the presence of hepatitis B surface antibody (anti-HBs) conferring antibodies and long term immunity from reinfection
IgM anti-HBc indicates
acute HBV infection - but may remain detectable up to 2 years after acute infection
patient is anti-HCV positive - do what
check HCV RNA and HCV antibody - if RNA is positive, infection is there, refer to GI
biomarkers of hepatic injury
AST
ALT
ALP
bilirubin
which liver biomarker points to issues with alcohol disorder
AST
ratio of what may indicated alcohol abuse AST ALT
2:1 or greater
GGT elevated on its own inidicated
alcoholism