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GI Flashcards

1
Q

Parietal pain

A

sharp localized

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2
Q

colicky pain is usually felt with which problems?

A

intestinal obstruction, renal calculi

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3
Q

where does pancreatitis radiate?

A

to the back

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4
Q

where does renal calculi radiate?

A

to the groin

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5
Q

when does mesenteric ischemia begin?

A

within one hour of eating

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6
Q

How can a person relieve pancreatitis pain without medical intervention?

A

sit up and lean foreward

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7
Q

What is a normal AAA size?

A

2cm

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8
Q

How big does a AAA get for it to be considered dilated?

A

> 3cm

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9
Q

How big can a AAA get for it to be at risk for rupture?

A

> or equal to 5cm

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10
Q

what test do you do in order to diagnose a AAA?

A

CT test

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11
Q

How often do you do ultrasounds for a stable AAA >4cm?

A

q2 years

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12
Q

How often do you do ultrasounds for a AAA > or equal to 5cm?

A

q6months

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13
Q

When should you refer a AAA to a thoracic surgeon?

A

> 5.5cm

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14
Q

which in office tests should you do for appendicitis?

A

psoas sign, mcBurneys point, Rovsing sign, orbturator sign

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15
Q

what kind of lab work should you do for appendicitis?

A

CBC and CRP

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16
Q

Rosvings sign

A

pain in right lower quadrant when the left lower quadrant is palpated (appendicitis)

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17
Q

Orbturator sign

A

rotate hip inwardly while knee slightly bent (appendicitis)

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18
Q

Psoas sign

A

Lift leg while your hand is on the thigh, create resistance (appendicitis)

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19
Q

Murphys sign

A

palpate under rib cage while patient takes a deep breath, will elicit pain if gallbladder

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20
Q

McBurneys point

A

pain felt at umbilicus when RLQ pushed

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21
Q

2 main causes for a bowel obstruction

A 
#1 Adhesions from surgery
#2 Groin hernia incarceration
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22
Q

patient s/s of bowel obstruction

A

crampy, periumbilical or diffuse pain, unable to have BM or flatus, N/V sensation of fullness

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23
Q

physical findings of bowel obstruction

A

distention, tympany, absent, high pitched or tinkling bowel sounds

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24
Q

WBC greater than what suggests bowel necrosis or abscess or peritonitis?

A

> 20,000

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25
What will an xray show with a bowel obstruction?
air fluid levels, dilated loops of bowel, lack of gas in distal bowel and rectum
26
What is the treatment for a bowel obstruction?
fluid resuscitation, NGT, surgical consult
27
what kind of lab work/tests should you do to diagnose a bowel obstruction?
abdominal xray series or CT scan
28
your chances of getting diverticulitis increase q___years starting at age 40
10 years
29
Diverticulitis treatment
1. ) Cipro + flagyl 2. ) Bactrim + flagyl 3. ) Augmentin 4. ) Moxifloxacin
30
which antibiotic should you avoid with renal patients and the elderly?
Bactrim
31
with severe diverticulitis what test should you do to determine severity? and what other thing might you have to do?
CT scan and hospitalization
32
s/s of cholecystitis/Cholelithiasis (patient may not have all symptoms)
n/v, sudden sharp pain in URQ, fever, positive Murphy sign, jaundice, palpable gallbladder
33
a positive murphys sign helps to diagnose what problem?
cholecystitis/Cholelithiasis
34
what lab findings will show with cholecystitis/Cholelithiasis
elevated WBC, elevated bilirubin, elevated serum aminotransferase and alk phos.
35
A hepatobiliary (HIDA) scan is helpful for which problems
liver, gallbladder and bile ducts
36
which type of scan is used to evaluate the rate at which bile is released from the gallbladder?
HIDA scan
37
if radioactive tracer moves through the bile duct very slowly, what does this indicate?
there may be a blockage or obstruction or a problem with the liver function
38
If the radioactive tracer isnt seen in your gallbladder, this may indicate what?
acute inflammation (acute cholecystitis)
39
If the amount of radiotracer leaving the gallbladder is low after giving the medication CCK, what may this indicate?
chronic inflammation (chronic cholecystitis)
40
if the radioactive tracer is found in other areas outside the biliary system, what could this indicate?
a leak
41
Cholelithiasis
gallstones
42
cholecystitis
gallbladder
43
Treatment for acute Cholelithiasis
laparoscopic cholecystectomy
44
Treatment for cholecystitis
will subside on own (will come back),need to go on a low fat diet. Cipro and flagyl BID with low grade fever
45
first line treatment for GERD
antacids
46
antacids
maalox, mylanta, tums, gelusil
47
function of H2 receptors and PPIs
they block acid production
48
H2 receptors
cimetidine (tagament), famotideine (pepcid), ranitidine (zantac)
49
PPI
lansoprazole (prevacid), omeprazole (prilosec)
50
what kind of drugs put a patient at risk for pancreatitis
amiodarone, antivirals, diuretics, NSAIDS, antibiotics
51
risk factors for pancreatitis
alcohol, gallstones, severe hyperlipidemia, certain drugs
52
s/s of pancreatitis
epigastric pain, constant boring pain, radiates to back, severe, n/v, bloating
53
physical findings of pancreatitis
low grade fever, tachycardia, hypotension, respiratory symptoms such as pleural effusion, atelectasis, illeus
54
late physical finding of pancreatitis
peritonitis
55
cullens sign
bluish discoloration around the umbilicus
56
grey turner sign
bluish discoloration of the flanks
57
what lab are indicative of pancreatitis and what lab is not
lipase, level will be 2 times elevated, amylase is not specific..dont bother with it
58
what kinds of tests can you do for pancreatitis
RUQ ultrasound, CT scan (not necessary to diagnose pancreatitis, not useful in the early stages, helpful in evaluating complications)
59
what are the pros and cons of a CT scan for pancreatitis
not necessary to diagnose pancreatitis, not useful in the early stages, helpful in evaluating complications
60
Pancreatitis treatment
NPO, fluid resuscitation, maintain urine output of 100cc/hr, no antibiotics unless severe
61
antibiotics for pancreatitis treatment in severe cases
imipenem or cipro with flagyl
62
mild disease treatment for pancreatitis
discharge on liquid diet, follow up in 24-48 hours, all others admit
63
are gastric ulcers relieved by food or do they feel worse after eating?
worse after eating
64
which ulcers are associated with obstruction (bloating, N/V) which are caused by edema and scarring?
pyloric channel ulcers
65
are duodenal ulcers relieved by food or do they feel worse after eating?
relieved by food, hurts again 2-3 hours after meal
66
when do duodenal ulcers usually appear?
mid morning, usually awakens a patient at night
67
what do serologic assays show? but what are the negatives about this test?
antibodies to H.pylori BUT these tests can be positive for up to 3 years after treatment of an infection and antibody levels don't decline for up to 6-12 months after treatment these tests aren't used
68
why are PPIs good for use of H.pylori treatment?
they suppress H.pylori, they decrease acid production causing an increase in stomach pH which is a hostile environment for H.pylori
69
antibiotic treatment for H.pylori
PPI (Prilosec or prevacid) plus clarithromycin (Biaxin) plus amoxicillin (or flagyl if allergic to PCN) for 14 days
70
most common GI surgical emergency in elderly?
acute cholecystitis
71
a lack of free airon chest xray does or does not rule out perforation?
does not
72
what do you suspect if patient has biliary colic that lasts more than 6 hours?
early cholecystitis
73
what do you have to rule out in the elderly that have renal colic symptoms?
AAA
74
ovarian torsion s/s
tachycardia, decreased bowel sounds, fever, acute rigid abdomen, peritonitis
75
do ovarian torsions have an acute onset?
yes
76
when does a testicular torsion need to be repaired in order to salvage the testicle?
6 hours
77
treatment for testicular torsion
emergent urology consult, ultrasound with doppler
78
ovarian torsion treatment
GYN consult, IV fluids, NPO, pain medications, ultrasound

Role 2 (13 decks)

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