GI CIS/DSA Flashcards
Definitions: Acholic Anorexia Acute abdomen Borborygmi Cachexia
Acholic: acholic stools are white clay colored stools, which result from absence of secretion of bile into the GI tract
Anorexia: lack of appetite
Acute abdomen: any serious acute intraabdominal condition attended by pain, tenderness, and muscular rigidity and for which emergency surgery must be considered
Borborygmi: a rumbling noise caused by propulsion of gas through the intestines
Cachexia: a profound and marked state of constitutional disorder; general ill health and malnutrition
Definitions: Cholestasis Coffee ground emesis Colic Courvoisiers Sign Cullen sign
Cholestasis: stoppage or suppression of bile flow, due to factors within (intrahepatic cholestasis) or outside the liver (extrahepatic cholestasis)
Coffee ground emesis: denotes blood congealed and separated within gastric contents that takes the form of coffee grounds when in contact with acidic environment
Colic: acute paroxysmal abdominal pain
Courvoisiers sign: Enlarged non-tender gallbladder secondary to pancreatic disease or cancer
Cullen sign: Ecchymosis around the umbillicus secondary to hemorrhage
Definitions: Curling ulcer Cushing ulcer Dyspepsia Dysphagia Dysplasia
Curling ulcer: stress ulcer is a peptic ulcer of the duodenum in a patient with extensive superficial burns
Cushing ulcer: stress ulcer is a peptic ulcer occuring from severe head injury or with other lesions of the central nervous system
Dyspepsia: postprandial epigastric discomfort
Dysphagia: difficulty swallowing
Dysplasia: abnormal tissue development, alteration in size, shape, and organization of cells
Definitions: Edentulous Esophagitis ERCP Eructation EUS
Edentulous: having no teeth
Esophagitis: inflammation of the esophagus
ERCP: Endoscopic retrograde cholangiopancreatography
Eructation: expulsion of swallowed air, aka buroing
EUS: Endoscopic ultrasound
Definitions: Flatus Gastritis Gastropathy GGT Grey turner sign Globus pharyngeus Gaurding Heel strike
Flatus: gas or air in the GI tract expelled through the anus
Gastritis: inflammation of the stomach with distinctive histologic and endoscopic features
Gastropathy: gastric conditions where there is epithelial or endothelial damage without inflammation
GGT: gamma glutamyl transferase, used to determine the cause of elevated alkaline phosphatase (ALP)
- both elevated = liver disease
- ALP elevated but not GGT = other (usually bone)
Grey turner sign: Flank ecchymosis secondary to hemorrhage
Globus pharyndeus: also known as globus hystericus which is a foreign body sensation lovalized in the neck that does not interfere with swallowing and sometimes is relieved by swallowing
-often occurs in the setting of anxiety or OCD, often attributed to GERD
Gaurding: protective response in muscle resulting from pain or fear of movement, voluntary versus involuntary
Heel strike: Patient supine, Doc strikes patients heel. pain upon striking could indicate appendicitis
Definitions: Hematemesis Hematochezia Icterus/jaundice Iliopsoas Muscle test KUB Xray
Hematemesis: Vomiting blood
Hematochezia: passage of bright red blood or marron stools
icterus/jaundice: yellowish staining of the integument, sclera, and deeper tissues
Iliopsoas muscle test: have the patient flex their hip against your resistance - increased abdominal pain is a positive test
-suggests irritation of the psoas muscle from inflammation of the appendix
KUB Xray: plain abdominal x-ray of the kidney Ureters and bladder
Definitions: LGIB Llyods punch/CVA tenderness McBurneys Point Melena Mittleschmerz
LGIB: Lower gastrointestinal bleeding
Llyods punch/CVA tenderness: gently tapping the area of the back overlying the kidney produces pain
-suggests an infecttion around the kidney or a renal stone
McBurneys Point: Rebound tenderness or pain 1/3 of the distance from the ASIS to the umbilicus that may suggest appendicitis or peritoneal irritation
Melena: dark colored stool consistent with broken down hemosiderin in bowel, typically malodorous sticky and thick like paste (Tarry)
Mittleschmerz: lower abdominal pain in the middle of the mestrual cycle, doesnt cause rebound tenderness
Definitions: MRCP Murphy sign Nausea Obstipation Obturator muscle test Odynophagia
MRCP: Magnetic resonance cholangiopancreatography
Murphy sign: Palpate deeply under right costal margin during inspiration and observe for pain and or sudden stop in inspiratory effort
-test for cholecystitis or cholelithiasis
Nausea: subjective sensation of impending urge to vomit
Obstipation: severe intractable constipation caused by intestinal obstruction
Obturatior muscle test: Flex the patients right thigh at the hip, with the knee bent and rotate the leg internally at the hip. Right hypogastric pain is a positive test
-this suggests irriation of the obturator muscle from an inflamed appendix
Odynophagia: painful swallowing
Definitions: Pneumobilia Pneumomediastinum Pneumoperitoneum Psoas sign Pyrosis
Pneumobilia: abnormal presence of gas in the biliary system/bile ducts
Pneumomediastinum: abnormal presence of air or gas in the mediastinum, may interfere with respiration and circulation, may lead to pneumothorax or pneumopericardium, occur spontaneously or as a result of trauma or pathology or after diagnostic procedure
Pneumoperitoneum: abnormal presence of air in the peritoneal cavity
Psoas sign: associated with retrocecal appendix. Maifested by RLQ pain with passive right hip extension
Pyrosis: substernal burning sensation aka heartburn
Definitions: Rebound tenderness Regurgitation Reetching Rovsings sign Steatorrhea Tenesmus UGIB Ulcer Ureterolithiasis Virchows node Vomiting/emesis
Rebound tenderness: pain upon removal of pressure, rather than the application of pressure in the abdome. Tests for peritoneal inflammation/acute abdomen
Regurgitation: effortless reflux of liquid or gastric or esophageal food contents in the absence of N/V
Retching: peristalsis of stomach and esophagus conducted with a closed glottis
Rigidity: like it sounds, abdomen is hard, involuntary reflex contraction of abdominal wall
Rovsings sign: Pain in the RLQ during left-sided pressure- referred rebound tenderness seen in appendicitis
Steatorrhea: fatty greasy stools
Tenesmus ineffectual and painful straining at stool (or urination)
UGIB: upper gastrointestinal bleeding
Ulcer: local defect or excavation of the surface of an organ or tissue that is produced by the sloughing (shedding) of inflammed necrotic tissue
Ureterolithiasis: stone from kidney making its way through ureter to bladder, urine analysis will show hematuria
Virchows Node: Palpable mass, lymph node, in the left supraclavicular/sternoclavicular fossa
Vomiting emesis: Queasiness to retching, forceful ejection of upper gut contents from the mouth
what is a list of Red Flag symptoms and signs?
Dysphagia Odynophagia Hematemesis Melena Unintentional weight loss Persistent vomiting Constant/severe pain Unexplained iron deficiency anemia palpable mass Lymphadenopathy Family history of upper gastrointestinal cancer
Common disease found in the RUQ?
Cholecystitis Pyelonephritis Ureteric colic Hepatitis Pneumonia
Gall bladder!
Common diseases found in RLQ?
Appendicitis Ureteric colic Inguinal hernia IBD UTI Gynaecological Testicular torsion
Common diseases found in the LUQ
Gastric ulcer Pyelonephritis Ureteric colic Pneumonia PUD (peptic ulcer disease) Gastritis
common disease found in the LLQ
Diverticulitis Ureteric colic Inguinial hernia Gynaecological Testicular torsion
common diseases found in the epigastric region?
Peptic ulcer disease cholecystitis Pancreatitis Mycocardial infarction food poisoning Biliary tract disease
common diseases found in the Peri umbilical region
Small bowel obstruction
Large bowel obstruction
Appendicitis
Abdominal aortic aneursym
what is a differential diagnosis for a Upper GI bleed?
Peptic ulcer disease Erosice gastritis Arteriovenous malformations/angioectasias Mallory-weiss tear Esophageal varices
difference between visceral pain and parietal pain
Visceral pain:
- visceral pain fibers
- secondary to distention, stretching or contraction of hollow organs
- felt in midline at the level of the structure involved
- not localized
Parietal pain:
- somatic nerve fibers
- secondary to inflammation in the parietal peritoneum
- constant more severe
- localized
- aggrevated by movement or coughing
- alleviated by remaining still
what are important historical elements for Nausea and vomiting and what are the main big triggers for these?
Important historical findings:
- apperance
- blood
- coffee grounds
- food
- feculent
- how often
- projectile
main causes:
- visceral afferent stimulation
- vestibular disorders
- CNS disorders
- irritation of chemoreceptor trigger zone
Main causes of oropharyngeal dysphagia
Trouble initiating swallowing:
- Neurological disorders
- Muscular and rheumatologic disorders
- metabolic disorders
- infectious disease
- structural disorders
Main causes of esophageal dysphagia
Mechaincal obstruction:
- schatzu ring
- peptic structure
- esophageal cancer
- eosinophilic esophagitis
Motillity disorder:
- achalasia
- diffuse esophageal spasm
- scleroderma
- ineffective esophageal motillity
What is CBC and what is it if it has Diff?
CBC would contain:
- white blood count (WBC)
- Hemoglobin
- hematocrit
- Mean corpuscular volume (MCV)
- Mean corpuscular hemoglobin (MCH)
- Mean corpuscular hemoglobin concentration (MCHC)
- Red cell distribution width (RDW)
- Platelet count (RBC)
- Red cell count
with diff: includs all above and
- Percentage and absolute differential counts of
- PMN
- Lymph
- Baso
- Eos
- Mono
- Neut
