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Patho > GI/Abdomen > Flashcards

GI/Abdomen Flashcards

1
Q

Organs in the RUQ

A 
ascending and transverse colon
duodenum
gallbladder
liver
pylorus
right adrenal gland
right kidney
right ureter
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2
Q

Organs in the RLQ

A 
appendix
ascending colon and cecum
right kidney 
right ovary and tube
right ureter
right spermatic cord
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3
Q

Organs in the LUQ

A 
right adrenal gland
left kidney
left ureter
pancreas
spleen 
stomach
transverse descending colon
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4
Q

Organs in the LLQ

A 
left kidney
left ovary and tube
left ureter
left spermatic cord
descending and sigmoid colon
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5
Q

At what age (on average) have most people lost 50% of their taste buds?

A

60

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6
Q

diseases associated with abnormal vasculature on inspection of abdomen

A 
malnutrition
liver disease
portal hypertension 
venous fluids building up
pregnancy
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7
Q

outie

A

protuberant

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8
Q

innie

A

recessed

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9
Q

blue striae

A

Cushing’s or steroid use

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10
Q

how long should you listen for 1 bowel sound

A

5-15 seconds, then for 5 minutes to say there are no bowel sounds

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11
Q

Tests for ascites

A

shifting dullness/ fluid wave test- use percussion to find tympany when pt lies on their side… fluid will go to the dependent area

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12
Q

Test for cholecystitis

A

Murphy’s sign- pt breathes in with pressure on the right side, breath catches with pain and wincing

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13
Q

Rebound tenderness

A

test for appendicitis-pain upon release of deep pressure

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14
Q

Roving’s sign

A

also called referred rebound tenderness- LLQ is palpated deeply and pain is felt in the RLQ upon release

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15
Q

Psoas sign

A

extension of the R leg with light pressure causes pain

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16
Q

Obturator sign

A

pain on internal rotation of the right thigh

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17
Q

visceral pain

A

poorly defined and localized, intermittent

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18
Q

parietal pain

A

severe and steady; generally localized and almost always some form of peritonitis

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19
Q

referred pain

A

pain felt somewhere where there’s no pathology

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20
Q

F’s of abdominal distention

A 
Fecal
fat
feces
fibroids
flatus (gas in or around intestines)
fluid 
fatal tumor
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21
Q

diastasis recti

A

bowel protruding through a tear in the rectus abdominus muscles

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22
Q

incisional hernea

A

bowel protruding through a tear in the incision

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23
Q

umbilical hernia

A

bowel protruding through a ring around the umbilicus

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24
Q

enlarged liver

A

anything over 12 cm

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25
Q

enlarged nodular liver

A

cancer, cirrhosis, syphilis

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26
Q

liver higher than normal

A

a mass or ascites

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27
Q

enlarged spleen

A

greater than 7 cm

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28
Q

enlarged kidney

A

cysts, tumor, inflammation

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29
Q

dysphagia

A

difficulty swallowing; could be anything from a dry mouth to disease

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30
Q

achalasia

A

difficulty with speech

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31
Q

esophageal diverticulum and the problem with it

A

“out-pouching”; hernia
problem is that the esophagus is not expandable or flexible so outpouching causes breaks and bleeding– it is an emergency

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32
Q

GERD

A

the persistent reflux of gastric contents into the espophagus; lower esophageal sphincter is weak/ incompetent

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33
Q

reflux disorder

A

a temporary situation of acid coming into esophagus and going away

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34
Q

treatments for acid reflux and GERD

A

antacids, PPIs, H2-receptor antagonists

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35
Q

Barrett esophagus

A

damage to the lower esophagus; can lead to adenocarcinoma

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36
Q

acute gastritis

A

abdominal pain and diarrhea;

most often caused by h. pylori and NSAIDS

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37
Q

chronic gastritis

A

insidious, slow onset, chronic;
most common reason is autoimmune disease;
can get chronic from not treating acute

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38
Q

Peptic ulcer disease

A

erosion of the stomach ining

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39
Q

Zollinger-Ellison syndrome

A

tumors in the pancrease and somethinges upper edge of duodenum; tumors increase the acid in the stomach which creates multiple gastric ulcers

40
Q

hallmark sign of a stress ulcer besides abdominal pain

A

pain before or after eating and blood mixing with food (coffee-ground emesis), and melena (dark, sticky, black stool)

41
Q

Who gets stress ulcers?

A

people who are stressed and burn patients (bc their body is constantly in fight or flight)

42
Q

survival rate of stomach cancer

A

25%

43
Q

IBS

A

recurring abdominal pain, diarrhea, flatulence; often from gluten intolerance or lactose intolerance

44
Q

hallmark sign of IBS

A

abdominal pain that is relieved with bowel movements; pts are more well than sick

45
Q

Crohn’s disease

A

inflammation that can occur anywhere and everywhere in the GI tract, from lips to anus; some classify as autoimmune, others don’t;causes permament changes in the lining of the gut and development of “skip lesions”: ulcer, strip of well tissue, ulcer, well, etc…

46
Q

ulcerative colitis

A

inflammation in the rectum and colon; similar to symptoms of Crohn’s but without the skip lesions; high rate of cancer development

47
Q

infections entercolitis

A

viral: rotovirus
bacterial: c.diff, e.coli

48
Q

diverticular diseases

A

outpouching in the intestines

49
Q

diverticulosis

A

the state of having outpouching in the diverticula, but it doesn’t bother you; well-developed countries have it the most

50
Q

diverticulitis

A

when one of the outpouches becomes an abscess and is spilling into the peritoneum; acute lower-quadrant pain and fever

51
Q

entercolitis

A

water is pulled into the bowel and it causes osmotic diarrhea and vomiting

52
Q

diarrhea causes loss of which electrolyte

A

salt (Na+)

53
Q

noninflammatory diarrhea

A

large volume; rarely have blood; from e.coli, staph, etc, and the toxins from these bugs cause the diarrhea

54
Q

inflammatory diarrhea

A

small volume, fever, and blood in stools; caused by shigella, salmonella, etc.. actual organism is invading the tissues (not just toxins from the organism)

55
Q

secretory diarrhea

A

if the bile doesn’t get absorbed, it causes loss of electrolytes; pt could stop eating and they’ll still have diarrhea no matter what
-cholera

56
Q

osmotic diarrhea

A

explosive

57
Q

constipation

A

decreased water in stool or a neuro issue

58
Q

slow-transit constipation

A

infrequent bowel movements bc of innervation of the gut;
hershbrung’s disease- child with big belly- congenital absence of ganglion in the gut, so they can’t sense expansion in the gut

59
Q

disorders of defecation

A 
spinal chord injury
parkinsons
MS
hypothyroidism
anything obstructive
drugs
60
Q

mechanical obstruction

A

severe, colicky pain
borborygmus heard before obstruction
audible, high-pitched peristalsis
awareness of intestinal movements

61
Q

paralytic obstruction

A 
continuous pain (dif from colicky)
silent abdomen
62
Q

compartment syndrome

A

result of obstruction; causes ischemia and necrosis- part of that organ system gets cut off from the blood supply;
any pressure from inflammation can cause compartment syndrome

63
Q

peritonitis symptoms and signs

A

muscles of the abdominal wall tighten to protect inflammed bowel;
board-like abdomen
guarding reflex

64
Q

peritonitis patho

A

pain and SNS cause the bowel to freezy in position

diaphragm and accessory breathing muscle movements decrease–> shallow breathing and vomiting

65
Q

malabsorbtion syndrome

A

diarrhea and weightloss despite eating a lot of food
statarhea (fat in the stool bc its not being digested
bleeding bc of vitamin K deficiency

66
Q

celiac disease

A

tcell immune reaction to gluten
causes intense inflammation of the intestine and loss of villi, which does not allow for absorption
Affected share the MHCII allele

67
Q

colorectal adenomas: tubular, villous, tubulovillus

A

tubular- peduncated, not too bad
villous- caulifower-like, very bad
tubulovillus- mix between both

68
Q

how often should someone over 50 get screened for colon cancer?

A

every ten years unless they’re at risk

69
Q

what stage are you in if you’re already bleeding when you come in for colon cancer screeding

A

2 or 3

70
Q

occult blood test

A

Guaiac

71
Q

frank hematemesis

A

hemorrhage that is above the stomach;

can see the blood bright red in the emesis

72
Q

what type of hemorrhage is seen with coffee ground vomitus

A

its into the stomach with partial digestion; vomit is blood mixed with food

73
Q

what type of hemorrage is seen with melena

A

it is into the intestines with large volumes of blood; stools are dark and tarry

74
Q

hemorrage seen with red blood coating the stools

A

in the rectum

bright red bleeding in stools

75
Q

hepatitis A

A

self-limited

fever, malaise, abdominal pain

76
Q

Hepatitis B

A

very bad
oral and sexual contact
highly contagious and often results in cirrhosis and liver failure

77
Q

Hepatitis B- Associated Delta Virus (hepatitis D)

A

causes the same symptoms as hepatitis A but worse bc they have 2 viruses

78
Q

Hepatitis C

A

bad, “criminal”
very unstable so we can’t get a vaccine
IV drug abuse, needle sticks
usually leads to cirrhosis, cancer, or liver failure

79
Q

Hepatitis E

A

fecal-oral transmission

sympt similar to A if you’re not pregnant; if pregnant, it could be fatal

80
Q

Fatty liver

A

alcoholic liver disease;

liver cells contain fat deposits; the liver is enlarged

81
Q

alcoholic hepatitis

A

rapid onset of liver inflammation and liver failure
rapid onset of jaundice
50% mortality

82
Q

Cirrhosis

A

long-term effects of any type of liver problem;
liver border would feel lumpy;
scar tissue block blood flow through liver, the blood back up into the organs before the liver causing portal hypertension

83
Q

portal hypertension

A

veins from the stomach, intestines, spleen, pancrease merge into the portal vein

84
Q

caput medusa

A

spider veins around the umbilicus

85
Q

biggest toxin that causes encephalopathy

A

ammonia

86
Q

how much function do you have to lose to establish liver failure

A

80%

87
Q

treatment of liver failure

A

transplant

88
Q

what hormones cause endocrine disorders like fluid retention, hypokalemia, and disordered sexual functions

A

decreased aldosterone, which helps us get rid of water; if we don’t have it we get water and salt retention

89
Q

oliguria

A

less than 500 ml urine in 24hrs or less than 30 an hour

should be 0.5 ml/kg/hr

90
Q

hepatorenal syndrome

A

azotemia- increased BUN
increased plasma creatinine
oliguria

91
Q

hepatic encephalopathy

A
  • asterixis- when asked to hyperextend wrist and you push on it, hand at wrist will flap
  • confusion, coma, convulsions
92
Q

cholelithiasis

A

gallstones

93
Q

choledocholithiasis

A

stones in the common bile duct

94
Q

cholangitis

A

inflammation of the common bie duct
surgical emergency
ERCP- endoscopic procedure with an XRay

95
Q

autodigestion of the pancreas

A
  • activated enzymes begin to digest the pancreas cells- start eating itself
  • starts with trypsin
  • severe pain in the LUQ that radiates to the back and down the flanks
  • can see cullen’s sign
  • pancreatic enzymes increased x3
  • hypocalcemia
  • distention
  • flank swelling
96
Q

cullen’s sign

A

superficial edema and bruising around umbilicus

97
Q

chronic pancreatitis and pancreatic cancer

A
  • digestive problems bc of inability to deliver enzymes to the duodenum
  • glucose control probs
  • signs of biliary obstruction
  • 4% 5-year survival rate

Patho (10 decks)

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