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MDTs > GI > Flashcards

GI Flashcards

1
Q

small volume profuse watery diarrhea, BLOODY,
More than 3 bowel moments every days
Less than 2 weeks in duration

-Fever > 38.5 C
-(LLQ) Abdominal cramps
-Tenesmus
-Fecal urgency
-symptoms of dehydration

A

Acute INFLAMMATORY Infectious Diarrhea

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2
Q

Large volume watery diarrhea, NON BLOODY, More than 3 bowel moments every days
Less than 2 weeks in duration

-nausea
-vomiting
-cramps

A

Acute NON-INFLAMMATORY Infectious Diarrhea

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3
Q

Diarrhea present for greater than 4 weeks

A

Chronic Diarrhea

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4
Q

-Most commonly seen in ALCOHOLICS and LONG TERM NSAIDs USE, and critically ill patients

-Often asymptomatic
-Epigastic pain
-Nausea and vomitting
-Hematemesis
-Upper GI bleeding with “coffee grounds” emesis or bloody aspiration on NG Tube
-May present as dyspepsia, bloating, and postprandial fullness/discomfort

A

Gastritis

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5
Q

CAUSED BY:
-Diminishing intake of fiber and fluid _Systemic disease
-Medication
-Structural abnormalities
-Slow colonic transit
-Irritable Bowel Syndrome
-Hirschsprung disease
infrequent stool

S/S
-excessive straining
-sense of incomplete evacuation
-need for digital manipulation

_Most common digestive complaint in the United States

A

Constipation

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6
Q

Painless, bleeding, prolapse, and mucoid discharge

Not visible or palpable (may protrude through the anus with gentle straining)

Prolapsed hemorrhoids are visible purple nodules covered by mucosa

Bright red blood streaks visible on toilet paper/stool or bright red blood that drips into the toilet

PRIMARY LOCATIONS:
-Right anterior and posterior
-Left lateral

A

Internal Hemorrhoids

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7
Q

-Visible bluish perianal nodule

-PAINFUL

-Tender to palpation

A

External Hemorrhoids

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8
Q

Linear or rocket shaped ulcer that is usually less than 5mm in length

Severe, tearing pain during

defecation followed by throbbing discomfort that may lead to constipation

_Bright red blood on stool or toilet paper

A

anal fissure

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9
Q

_Dull, aching, or throbbing pain that becomes worse immediately before defecation, is lessened after defecation, but persist between bowel movements

_Aggravated by straining, coughing, or sneezing

_Pain and tenderness interfere with walking or sitting

A

Anorectal Abscess

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10
Q

-Nonhealing” anorectal abscess following drainage

-Chronic purulent drainage and a pustule-like lesion in the erianal or buttock area

-Intermittent rectal pain during defecation and sitting

-Intermittent and malodorous perianal drainage and pruritus

A

Anorectal fistula

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11
Q

caused by ingrown hair

Occur in the midline of the gluteal crease

Recurrent infection at the base of the spine

swelling
pain
persistent discharge
tender mass

A

Pilonidal Disease

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12
Q

_Lower abdominal cramps and fecal urgency

_ Periods of symptomatic flare ups and remissions

bloody diarrhea

anemia

_More common in non smoker and and former smoker

A

Inflammatory Bowel Disease
(Ulcerative Colitis)

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13
Q

_NON bloody diarrhea
_NON bloody diarrhea
_Weight loss and malaise
_General sense of well-being “poor”

A

Crohn’s Disease

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14
Q

-Chronic (more than 3 months) abdominal pain that occurs in association with altered bowel habits

Late teens to early 20’s

NORMAL physical exam

-Abdominal discomfort abdominal region) is relieved immediately after defecation

-Bloating or feeling abdominal

Dx CRITERIA (PAIN + 2/3):
1. Relieved with defecation
2. Associated with change in frequency of stool
3. Associated with change in form (appearance) of stool

NORMAL physical exam (no fevers, rashes, or bloody stool)

A

Irritable Bowel Syndrome (IBS)

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15
Q

mid line pain occurs 30-60 minutes after meals and upon bending over or reclining

-Reports relief from taking antacids or baking soda
-Complain of regurgitation
-Dysphagia
-Dyspepsia
-cough
-chest pain
-belching
-hoarseness

A

Gastroesophageal Reflux Disease (GERD)

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16
Q

Severe retrosternal chest pain

Odynophagia and dysphagia often beginning several hours to one month after taking a pill

History of taking pills without water or supine

A

Pill Induced Esophagitis

17
Q

Odynophagia or pain on swallowing

LOCALIZED pain to a discrete retrosternal area swallowing

White mucosal plaque like lesions are noted on the endoscopy

Is most common in HIV infected patients and in patients with hematologic malignancies

A

Candida Esophagitis

18
Q

Esophageal irritation from chronic GERD

Localized substernal chest pain

heartburn

Dysphasia

A

Esophageal Stricture

19
Q

_Gradual onset of dysphagia with solid foods and some liquid

can be present for months

substernal chest pain and discomfort/fullness

Lifting neck or throwing shoulders back to enhance gastric emptying

Regurgitation

A

Esophageal Spasm

20
Q

Gnawing, dull, aching or “hunger like” epigastic pain

Nausea and anorexia (gastric ulcers)

_Relief of pain with food or antacids and a recurrence of pain 2-4 hours later

TWO MAJOR CAUSES:
1. NSAIDs
2. H. Pylori

A

Peptic Ulcer Disease

21
Q

Acute abdominal pain and fever

Left lower quadrant tenderness with palpable mass

Constipation or loose stool

Nausea and vomiting

A

Diverticulitis

22
Q

HEMATEMESIS
_Bright red blood (indicates a bleed at or proximal to the LES
_“Coffee ground” emesis (indicates a bleed in the stomach or proximal duodenum)

MELENA
_“Tar colored” black stool (iron in hemoglobin + gastric acid)

HEMATOCHEZIA:
_Massive upper GI bleed > 1000ml

A

Upper GI Bleed

23
Q

HEMATOCHEZIA (bright red blood per rectum)

Large volumes of bright red blood suggest colonic source

Maroon stool = right colon or small intestine

Melena = source proximal to ligament of treitz

A

Lower GI Bleeding

24
Q

Heavy ALCOHOL user

S/S of upper GI bleed (hematemesis w/ or w/o melena)

History of retching, vomiting, or straning

A

Mallory Wiess Tear

25
Q

Hartman’s Sign (crunching sound heard on auscultation)

_Possible crepitus with palpation over the chest

A

Boerhaave Syndrome

26
Q

Periumbilical abdominal pain that progresses to more localized right lower quadrant pain

Tender McBurneys point

Nausea and anorexia

fever
rosving sign
rebound tenderness
obturator sign
Psoas Sign

A

Appendicitis

27
Q

Acute onset of intermittent sharp RUQ pain

Pain precipitated by meals

No fever

A

Biliary Colic

28
Q

Sudden onset of RUQ pain after eating a meal high in fat

Murphy’s sign

6 F’s: (Fat, Fertile, 40, Female, fever, flatulence)

Symptoms greater than 6 hours

A

Cholecystitis

29
Q

Sudden onset of RUQ pain after eating a meal high in fat

Murphy’s sign

6 F’s: (Fat, Fertile, 40, Female, fever, flatulence)

A

Choleodocholithiasis

30
Q

Charcot’s Triad:
RUQ pain
Fever
Jaundice

A

Cholangitis

31
Q

Abrupt onset epigastric abdominal pain

Steady, ‘boring’, severe abdominal pain that is made worse with walking and lying supine

Pain radiates to the back

Relief with sitting upright and leaning forward

Grey Turner and Cullen’s sign

Mild jaundice

Nausea and vomiting

Weakness, fever, and anxiety

MOST COMMON CAUSE:
alchol
gallstones

A

Pancreatitis

32
Q

Lower anterior abdominal mass

Abdominal contents herniate DIRECTLY through Hasselbach’s triangle

Caused by muscular weakness

A

Direct Inguinal Hernia

33
Q

Scrotal mass

Abdominal contents herniate through the inguinal canal

Caused by a patent processus vaginalis

Frequently incarcerate and strangulate

A

Indirect Inguinal Hernia

34
Q

“Out-y belly button”

Typically congenital

Usually resolve by 5 years old

Rarely incarcerate

A

Umbilical Hernia

35
Q

Mechanical
-Crampy, intermittent abdominal pain _Unable to find comfortable position -Abdominal distention
-Vomiting
-Possible diarrhea
-Tympanic abdomen on percussion _Constipation and bloating
-Active HIGH PITCHED bowel sounds with occasional “rushes”

Paralytic Ileus:
-Less intense abdominal pain that is more constant
-Constipation
-Diminished bowel sounds

A

Small Bowel Obstruction

36
Q

Constant aching diffuse lower

abdominal pain

Bloating and distention

Constipation and inability to pass flatus

Possible feculent vomitus

A

Large Bowel Obstruction

37
Q

Very ill appearing

Unstable vitals: (fever, tachycardia, hypotension)

Typically DO NOT WANT to move _Board-like abdomen

May have absent bowel sounds

Percussion: absence of dullness over the liver suggest free air/ perforation)

A

Secondary Peritonitis

38
Q

Patient may have no pain

Little external evidence of injury

Seat belt sign

A

Blunt Abdominal Trauma

39
Q

Hypovolemic shock syndrome

S/S of peritonitis

A

Penetrating Abdominal Trauma

MDTs (12 decks)

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