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GI Flashcards

1
Q

Abdominal Pain alarm symptoms

A
  1. Nausea/vomiting
  2. Fever
  3. Acholic stools/tea-colored urine
  4. Black stools
  5. Bloody stools
  6. Hematemesis
  7. Constipation
  8. Pain before vomiting
  9. Migration of periumbilical pain to RLQ
  10. RLQ pain
  11. RUQ pain
  12. Jaundice
  13. Neurological deficit, focal
  14. Pain, abrupt onset
  15. Tearing pain
  16. Migratory pain
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2
Q

RUQ pain differential diagnosis

A
  1. Biliary (biliary colic, cholecystitis, cholangitis)
  2. Hepatic (hepatitis, hepatic abscess, hepatic congestion)
  3. Pancreatitis
  4. Perforated duodenal ulcer
  5. Retrocecal appendicitis
  6. Myocardial infarction.
  7. Dissecting aneurysm
  8. Pulmonary embolism
  9. Right lower lobe pneumonia/ pleural effusion
  10. Renal (pyelonephritis/ renal colic)
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3
Q

What is Charcot’s triad?

A
  1. RUQ pain
  2. Jaundice
  3. Fever
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4
Q

LUQ pain differential diagnosis.

A
  1. GI (Gastritis/peptic ulcer disease/ pancreatitis)
  2. Cardiac (MI/ pericarditis/ dissecting aneurysm)
  3. Pulmonary (PE/ LLL pneumonia/pleural effusion)
  4. Splenic rupture/abscess
  5. Renal: pyelonephritis/ renal colic
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5
Q

RLQ pain differential diagnosis

A
  1. Appendicitis
  2. Chron’s Dz
  3. Cecal diverticulitis
  4. Inguinal hernia
  5. Aortic aneurysm
  6. Ureter calculi
  7. Ectopic pregnancy
  8. Ovarian cyst or tumor
  9. Pelvic inflammatory Dz
  10. Mittelschmerz
  11. Endometriosis
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6
Q

LLQ Pain differential diagnosis

A
  1. Sigmoid diverticulitis
  2. Aortic aneurysm
  3. Ureter calculi
  4. ectopic pregnancy
  5. Ovarian cyst or tumor
  6. Ovarian torsion
  7. Pelvic inflammatory dz
  8. Mittelschmerz
  9. Endometriosis
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7
Q

Flank pain differential diagnosis.

A
  1. Nephrolithasis
  2. Pyelonephritis
  3. Muscular strain
  4. Renal infarct (w/ afib)
  5. Splenic infarct (w/ endocarditis)
  6. AAA
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8
Q

Diffuse abdominal pain differential diagnosis.

A
  1. Gastroenteritis
  2. Pancreaetitis
  3. Early appendicitis
  4. Bowel obstruction
  5. Volvulus
  6. Perforated bowel
  7. Peritonitis
  8. Inflammatory bowel dz
  9. Inflammatory bowel syndrome
  10. Mesenteric ischemia
  11. Aortic aneurysm
  12. Aortic dissection
  13. Sickle cell crisis
  14. DKA
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9
Q

Associate quality of pain with causes

A
  1. Burning: GERD
  2. Gnawing: peptic ulcer disease
  3. Tearing: dissection
  4. Colicky: biliary colic/bowel obstruction
  5. Crampy: distension of a hollow tube (bowel, bile duct, ureter)
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10
Q

Associate radiation with cause

A
  1. Back: pancreatitis, duodenal ulcer, gastric ulcer, aortic dissection, kidney stone.
  2. Right shoulder: gall bladder
  3. Left shoulder: spleen
  4. Left arm/neck: MI
  5. Groin: kidney stone
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11
Q

6 Dysuria alarm symptoms

A
  1. Fever
  2. Nausea
  3. Vomiting
  4. Flank pain
  5. Ulcerations
  6. Pelvic pain w/ vaginal discharge
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12
Q

7 Constipation alarm symptoms

A
  1. Unintentional weight loss
  2. Hematochezia/ melena
  3. Significant abdominal pain
  4. Change in stool caliber (narrow like pencil, flat like ribbon)
  5. Nausea/vomiting
  6. Fever
  7. Back pain, saddle anesthesia/ leg weakness/ difficulty urinating
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13
Q

7 diarrhea alarm symptoms

A
  1. Weight loss > 5 lbs
  2. Fever
  3. Bloody stools (dysentery)
  4. Awakening from sleep
  5. Family history of colon cancer, IBD, multiple endocrine neoplasia, celiac sprue
  6. Age > 50 with change in symptoms
  7. Immunocompromised host
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14
Q

6 dyspepsia alarm symptoms

A
  1. Weight loss
  2. Bleeding
  3. Anemia
  4. Dysphagia
  5. Age >45
  6. Male
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15
Q

7 dysphagia alarm symptoms

A
  1. weight loss
  2. progressive symptoms
  3. symptoms worse with solids than liquids
  4. blood in stools
  5. otalgia (ear pain) with dysphagia
  6. hoarseness (dysphonia) or pain with speaking and dysphagia
  7. dysarthria
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16
Q

8 acute GI bleed alarm symptoms

A
  1. Ongoing hematemesis, bright red blood per nasogastric tube with hematochezia, or unstable vital signs
  2. Ongoing hematemesis or bright red blood from nasogastric tube with melena.
  3. Ongoing, brisk hematochezia with no blood from nasogastric lavage
  4. Weight loss
  5. Acute onset of lower abdominal or midabdominal pain followed by bleeding
  6. Prior aortic repair
  7. SOB, chest pain, light headedness
  8. upper gastric intestinal bleed that begins in hospitalized patient
17
Q

8 jaundice alarm symptoms

A
  1. fever
  2. ruq pain
  3. Confusion or altered mental status
  4. mucosal or cutaneous bleeding
  5. back pain
  6. pregnancy
  7. dark urine
  8. involuntary weight loss
18
Q

13 nausea/vomiting alarm symptoms

A
  1. large-volume hematemesis
  2. history of head trauma
  3. headache
  4. neck stiffness
  5. altered mental status
  6. RLQ pain
  7. Migration of periumbilical pain to RLQ
  8. Abdominal pain before vomiting
  9. Abdominal pain that worsens with jolting movements, such as going down stairs
  10. Upper abdominal pain, steady lasting more than 30 minutes
  11. Acute chest pain
  12. Postural symptoms, lethargy, unable to retain oral liquids for > 8 hours in child (12 for adult)
  13. Parasthesias, blurred vision, dysphagia, muscle weakness
19
Q

9 anorectal pain alarm symptoms.

A
  1. Weight loss
  2. chronic anemia
  3. blood in stool
  4. dark blood or blood mixed with stool
  5. fevers
  6. abdominal pain
  7. gradual increase in pain over days
  8. Loss of sensation or muscle weakness
  9. change in bowel habits in patients older than 50 years.
20
Q

Dysphagia differential diagnosis

A
  1. Esophageal spasticity (intermittent)
  2. Scleroderma
  3. Achalasia
  4. Neuro dysfunction
  5. Food impaction
  6. Esophageal stricture
  7. Eosinophilic esophagitis
  8. Esophageal webs and rings
  9. Esophageal carcinoma
21
Q

Dyspepsia differential diagnosis

A
  1. Functional dyspepsia (most common, 50% of cases)
  2. GERD
  3. Esophagitis
  4. Food intolerance
  5. Dudoenal/ gastric ulcer
  6. Gastric/ esophageal cancer
22
Q

Nausea differential diagnosis

A
  1. GI infection/toxins
  2. Associated with visceral pain: infection, ischemia, hepatic/biliary disorder, renal colic, obstruction/dysmotility, post-operative, MI.
  3. Medications: Chemotherapy, antibiotics, narcotics
  4. Vestibular: motion sickness, vertigo, Meniere’s, labrynthitis
  5. CNS: head trauma, increasing intracranial pressure, CVA, migraine, infections.
  6. Metabolic issues: DKA, uremia, endocrine issue, pregnancy
23
Q

GI bleed differential diagnosis

A 
UPPER GI:
1. Mucosal abnormality
2. Peptic ulcers
3. Esophageal inflammation
4. Esophageal varices
5. Vascular dilation (veins/capillaries)
6. Mallory-Weiss tear
LOWER GI
1. Diverticulitis
2. Andiodysplasia, vascular ectasia
3. Colorectal cancer
4. s/p polypectomy
5. Colitis (ischemic, infectious, Chron's dz, Ulcerative colitis)
6. Anorectal causes (hemorrhoids/fissures)
7. Meckel's diverticulum
8. NSAID induced ulcer
24
Q

Jaundice differential diagnosis

A 
UNCONJUGATED
1. Hemolysis (excess bilirubin)
2. Sepsis (impaired conjugation)
3. Gilberts syndrome (impaired conjugated)
CONJUGATED
1. Cirrhosis
2. Alcohol abuse
3. Viral hepatitis
4. non-alcoholic fatty liver disease (NAFLD)
5. Meds/toxins
6. Infiltrative Dz (i.e. Wilson's, hemochromatosis)
7. Gallstones
8. Pancreatic or Hepatic cancer
25
Q

Constipation differential diagnosis

A
  1. Colonic myopathy
  2. Neuropathy
  3. Dyssynergic defecation
  4. Irritable bowel syndrome
  5. Anorectal obstruction
  6. Metabolic/endocrine cause
  7. Myogenic disorder
  8. Psychosocial
    MEDICATIONS
  9. analgesics
  10. anticholinergics (antihistamines, antidepressants, antipsychotics)
  11. Cation-containing agents (iron supplements, aluminum, barium)
  12. Neurally active agents (opiates, hypertensives, calcium channel blockers)
26
Q

Diarrhea differential diagnosis

A
  1. Functional
  2. Infectious
  3. Inflammatory bowel disease
  4. Malabsorption
  5. Laxative use
  6. Medications
  7. Post-op
  8. Malignancy
27
Q

Anorectal pain differential diagnosis

A
  1. anal fissure
  2. Thromboid external hemorrhoid
  3. Perianal abscess
  4. Thrombosed/ prolapsed internal hemorrhoid
  5. Defecatory dysfunction
  6. Fistula
  7. Proctitis
  8. Fecal impaction
  9. Malignancy

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