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Urgent Care Guide > GI 1 > Flashcards

GI 1 Flashcards

1
Q

RUQ pain DD
5

A
  1. biliary colic -type of gallbladder pain caused by a gallstone blocking the cystic duct or common bile duct
  2. cholecystitis
  3. cholangitis -condition that causes inflammation of the bile ducts
  4. hepatitis
  5. renal colic - severe pain in the kidney area that’s usually caused by a kidney stone blocking the ureter
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2
Q

epigastric pain DD
6

A
  1. pancreatitis
  2. gastritis - condition that causes inflammation of the stomach lining
  3. peptic ulcer - sore in the lining of the stomach or duodenum, the first part of the small intestine
  4. biliary colic
  5. ACS
  6. dissection/AAA
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3
Q

LUQ pain DD
4

A
  1. splenic infarction or rupture
  2. gastritis
  3. peptic ulcer
  4. renal colic
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4
Q

RLQ pain DD
5

A
  1. appendicitis
  2. ectopic pregnancy
  3. ovarian torsion
  4. ovarian cyst
  5. PID
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5
Q

suprapubic pian DD
4

A
  1. cystitis - common inflammation of the bladder that’s usually caused by a bacterial infection, also known as a lower urinary tract infection (UTI)
  2. early appendicitis
  3. PID
  4. endometriosis
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6
Q

LLQ pain DD
5

A
  1. diverticulitis - can occur anywhere in colon but most common in sigmoid colon
  2. ectopic pregnancy
  3. ovarian torsion
  4. ovarian cyst
  5. PID
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7
Q

flank pain DD

A
  1. kidney stone
  2. pyelonephritis
  3. AAA
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8
Q

abd diffuse or variable pain DD
10

A
  1. SBO
  2. mesenteric ischemia
  3. IBS
  4. infectious colitis
  5. hernia
  6. AAA
  7. IBD
  8. C. difficile
  9. gastroenteritis - inflammation of the stomach and intestines that causes diarrhea and vomiting
  10. malignancy
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9
Q

abd pain - ask about the context of what in the history taking portion
3

A
  1. onset and duration
  2. association w/ meals
  3. hx of trauma
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10
Q

abd pain - when asking about sx include questions about
3

A
  1. description and severity - constant vs intermittent
  2. location and radiation
  3. associated s/sx - fever, NV, diarrhea/constipation, hematuria, dysuria, vaginal discharge
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11
Q

abd pain - hx questions include
5

A
  1. prior episodes of similar pain
  2. abd surgeries
  3. alcohol use
  4. travel
  5. recent abx and/or nsaid use
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12
Q

Peritonitis

A

a serious condition that occurs when the peritoneum, the tissue lining the abdomen, becomes inflamed or infected

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13
Q

abd pain - appears diaphoretic, think
3

A
  1. peritonitis
  2. MI
  3. AAA
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14
Q

abd pain - appears w/ scleral icterus or jaundice, think

A

hepatobiliary disease

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15
Q

peritoneal signs
2

A
  1. rigidity
  2. rebound tenderness
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16
Q

abd pain - consider EKG for pain where
2

A

epigastric
upper abd pain

17
Q

abd pain - consider what for img/testing
5

A
  1. ekg - epi, upper quadrants
  2. urine sample
  3. pregnancy test
  4. POC glucose
  5. abd x ray - dilated loops of bowel, foreign body, stool, free air
18
Q

abd pain - disposition if well appearing, benign exam, tolerating PO

A

d/c

19
Q

abd pain - if referring to ER, keep what

A

NPO, consider appropriate analgesia

20
Q

abd pain - when to refer to ER
4

A
  1. acute/surgical abd warranting advanced imaging
  2. intractable vomiting or coffee ground emesis
  3. jaundice, lethargy, dehydration
  4. special considerations - advanced age, pregnancy/ectopic pregnancy, ovarian torsion, significant comorbidities
21
Q

vomiting/diarrhea - hx taking, asking about
6

A
  1. recent travel
  2. sick contacts
  3. dietary hx
  4. hx of chronic GI disorders or eating disorders
  5. medications (abx, NSAIDs etc)
  6. substance use
22
Q

vomiting/diarrhea - may present w/
3

A
  1. abd pain
  2. fever
  3. blood in vomitus or diarrhea
23
Q

vomiting/diarrhea - PE findings might include
5

A
  1. fever
  2. tachycardia
  3. hypotension
  4. sx of dehydration
  5. tender abx
24
Q

vomiting/diarrhea - img/testing
2

A

none usually required
consider obstruction series

25
Q

vomiting/diarrhea - DD
9

A
  1. acute intestinal obstruction
  2. mesenteric ischemia - when blood flow to the intestines in reduced or blocked
  3. medication w/d syndromes
  4. metabolic causes - DKA, hyperthyroid
  5. pregnancy - hyperemesis gravidarum
  6. infectious diarrhea/food poisoning
  7. inflammatory diarrhea - diverticulitis, IBD
  8. IBS
  9. eating disorders
26
Q

vomiting/diarrhea - overall tx #1

A

rehydration

27
Q

tx for vomiting w/o evidence of systemic disease or dehydration - tx as outpatient
2

A
  1. ondansetron 4 mg ODT 1 tab PO/SL q4-6
  2. promethazine 25 mg PO q6h
28
Q

vomiting in pregnancy rx
4

A
  1. pyridoxine 25 mg PO w/ doxylamine 12.5 mg PO
  2. metoclopramide 5-10 mg PO q4-6h
  3. promethazine 12.5-25 mg PO/PR q4-6h
  4. ondansetron 4-8 mg q4-6h ODT (avoid prior to 10 weeks)
29
Q

diarrhea w/o evidence of systemic disease or dehydration - tx as OP, was it typically not recommended

A

antimotility agents and abx

30
Q

vomiting/diarrhea - when to refer to ER
4

A
  1. dehydration
  2. intractable vomiting
  3. VS abnormalities
  4. concerning abd pain

Urgent Care Guide (38 decks)

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