GI Flashcards
With this maneuver, deep palpation of the LLQ of abdomen results in referred RLQ Pain.
Rovsing
A positive Rovsing could indicate?
Peritonitis
This is the heel jar test?
Markle
Rebound tenderness/worsening abdominal pain when the hand is released.
Blumberg
A positive blumberg could indicate?
acute or surgical abdomen- refer to the ED
This is the area located between the superior iliac creast and umbilicus in the RLQ.
McBurney’s point
A positive McBurney’s point may indicate?
possible acute appendicitis
This maneuver you press deeply on the RUQ during inspirations and is positive with a midinspiratory arrest.
Murphy’s sign
A positive Murphy’s sign indicates?
Cholecystitis
After eliciting a positive Murphy’s sign we order what?
An abdominal US to check for gallstones; if negative US then order a HIDA scan.
What test do we conduct if suspected appendicitis?
CT scan
This test the patient raises the leg against pressure or with patient on left side will extend right leg from hip. It will be positive with RLQ pain.
Psoas/Iliopsoas
A positive psoas/iliopsoas indicates?
peritoneal irritation
This sign is positive if inward rotation of the hip causes RLQ pain?
Obturator sign
This has a positive Murphys, pain that can radiate to the back or scapula, and typically in women over 40 that are overweight (female, fat, forty).
Cholecystitis
This condition also has pain that may radiate to the back, is common in males that smoke, and may have a familial tendency.
AAA
How do we diagnose an AAA?
US
Labs for pancreas and normal lab values:
Amylase (30-110)
Lipase (0-160)
What signs are seen with critically low calcium?
Chvosteks and Trousseaus
This sign is when you tap on patient’s face and one side scrunches up?
Chvostek’s
This sign is when you inflate the BP cuff the arm will draw up?
Trousseaus
If you have a Chvosteks or Trousseaus sign what is the patient at risk of?
Seizures
What signs are seen with necrotizing pancreatitis or an abdominal bleed?
Cullen’s and/or Turner’s
*Refer to the ED
First line treatment of GERD?
PPI
What are patients at risk of with long term PPI use?
Osteoporosis, B12 deficiency, and c. diff
First line treatment of PUD?
H2 blocker
What HTN med do we avoid in patients with GERD?
CCB
Diagnosis of GERD is done by?
EGD
Who should we order US for?
Above the umbilicus issues, cholecystitis/gallstones, kidney stones, AAA
When do we start screening for colon cancer?
CDC age 50 and up
ACS age 45 and up
Sooner with personal or family history of colorectal cancer
2 types of IBD?
- Crohn’s disease- any part of the GI tract
2. Ulcerative colitis- colon/rectum
Normal ESR
(0-22) men
(0-29) women
Normal CRP
less than 3 (always at least less than 10)
What do we treat travelers diarrhea with?
Cipro
What do we treat c. diff with?
PO Vanco
