GI

Question 1

With this maneuver, deep palpation of the LLQ of abdomen results in referred RLQ Pain.

Answer 1

Rovsing

Question 2

A positive Rovsing could indicate?

Answer 2

Peritonitis

Question 3

This is the heel jar test?

Answer 3

Markle

Question 4

Rebound tenderness/worsening abdominal pain when the hand is released.

Answer 4

Blumberg

Question 5

A positive blumberg could indicate?

Answer 5

acute or surgical abdomen- refer to the ED

Question 6

This is the area located between the superior iliac creast and umbilicus in the RLQ.

Answer 6

McBurney’s point

Question 7

A positive McBurney’s point may indicate?

Answer 7

possible acute appendicitis

Question 8

This maneuver you press deeply on the RUQ during inspirations and is positive with a midinspiratory arrest.

Answer 8

Murphy’s sign

Question 9

A positive Murphy’s sign indicates?

Answer 9

Cholecystitis

Question 10

After eliciting a positive Murphy’s sign we order what?

Answer 10

An abdominal US to check for gallstones; if negative US then order a HIDA scan.

Question 11

What test do we conduct if suspected appendicitis?

Answer 11

CT scan

Question 12

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.

Answer 12

Psoas/Iliopsoas

Question 13

A positive psoas/iliopsoas indicates?

Answer 13

peritoneal irritation

Question 14

This sign is positive if inward rotation of the hip causes RLQ pain?

Answer 14

Obturator sign

Question 15

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).

Answer 15

Cholecystitis

Question 16

This condition also has pain that may radiate to the back, is common in males that smoke, and may have a familial tendency.

Answer 16

AAA

Question 17

How do we diagnose an AAA?

Answer 17

US

Question 18

Labs for pancreas and normal lab values:

Answer 18

Amylase (30-110)

Lipase (0-160)

Question 19

What signs are seen with critically low calcium?

Answer 19

Chvosteks and Trousseaus

Question 20

This sign is when you tap on patient’s face and one side scrunches up?

Answer 20

Chvostek’s

Question 21

This sign is when you inflate the BP cuff the arm will draw up?

Answer 21

Trousseaus

Question 22

If you have a Chvosteks or Trousseaus sign what is the patient at risk of?

Answer 22

Seizures

Question 23

What signs are seen with necrotizing pancreatitis or an abdominal bleed?

Answer 23

Cullen’s and/or Turner’s

*Refer to the ED

Question 24

First line treatment of GERD?

Answer 24

PPI

Question 25

What are patients at risk of with long term PPI use?

Answer 25

Osteoporosis, B12 deficiency, and c. diff

Question 26

First line treatment of PUD?

Answer 26

H2 blocker

Question 27

What HTN med do we avoid in patients with GERD?

Answer 27

CCB

Question 28

Diagnosis of GERD is done by?

Answer 28

EGD

Question 29

Who should we order US for?

Answer 29

Above the umbilicus issues, cholecystitis/gallstones, kidney stones, AAA

Question 30

When do we start screening for colon cancer?

Answer 30

CDC age 50 and up
ACS age 45 and up
Sooner with personal or family history of colorectal cancer

Question 31

2 types of IBD?

Answer 31

1. Crohn’s disease- any part of the GI tract

2. Ulcerative colitis- colon/rectum

Question 32

Normal ESR

Answer 32

(0-22) men

(0-29) women

Question 33

Normal CRP

Answer 33

less than 3 (always at least less than 10)

Question 34

What do we treat travelers diarrhea with?

Answer 34

Cipro

Question 35

What do we treat c. diff with?

Answer 35

PO Vanco