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PCM FINAL 2014 > GI Exam 12.1 - Stasio > Flashcards

GI Exam 12.1 - Stasio Flashcards

1
Q

colic pain

A

visceral pain

coming and going**

stretching and compressing of organs - hollow organs

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2
Q

parietal pain

A

constant

peritoneum inflammation

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3
Q

gallbladder

A

right shoulder

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4
Q

left shoulder

A

spleen

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5
Q

back

A

pancreas or aorta

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6
Q

epigastrium pain

A

MI
peptic ulcer
acute cholecystitis
perforated esophagus

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7
Q

inferior wall MI

A

abdominal epigastric pain**

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8
Q

RLQ pain

A

appendicitis

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9
Q

LLQ pain

A

sigmoid diverticulitis

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10
Q

melena

A

black tarry stools
-50-60mL of blood in stomach

generally above ligament of treitz

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11
Q

hematochezia

A

bright red - no digestion

-usually at level of colon or lower

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12
Q

blood in bowel

A

cathartic - makes you go to bathroom

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13
Q

blood mixed with stool

A

colon

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14
Q

blood outside of stool

A

anus

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15
Q

DDx for bleeding

A 
congeintal
inflammatory/immune
mechanical/trauma
neoplasm
infection
metabolic/toxic
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16
Q

intussesception

A

currant jelly stool

bowel telescopes on itself

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17
Q

darker urine

A

jaundice

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18
Q

acholic feces

A

jaundice
-malodorous gray to light colored stools

bc blockage of bilirubin release

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19
Q

unconjugated hyperbilirubinemia

A

hemolysis, RBC defect, ineffective erythropoiesis, deficient hepatic uptake, deficient hepatic conjugation

unconjugated produced at rate exceeding rate at which liver conjugation can occur

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20
Q

conjugated hyperbilirubinemia

A

impaired excretion

also - serum alkaline phosphatase is elevated out of proportion of AST/ALT

obstruction

intrahepatic cholestasis - hepatocellular disease, drugs, sepsis

extrahepatic cholestasis - gallstones, biliary carcinoma, sclerosing cholangitis

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21
Q

painless jaundice

A

pancreatic cancer until proven otherwise**

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22
Q

pruritis

A

itchy skin

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23
Q

ascites

A

peritoneal fluid in abdomen

often portal HTN - cirrhotic liver

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24
Q

four signs of ascites

A

bulging flanks
tympany at top of abdomen
fluid wave
shifting dullness

25
DDx for ascites
cirrhosis - alcoholic malignancy CHF
26
hepatojugular reflex
press liver - JVP goes up
27
fluid wave
ascites also shifting dullness
28
exposure of abdomen
xiphoid to pubis **
29
portal HTN
caput medusa esophageal varices hemorrhoids
30
best place to listen
RLQ over cecum
31
normal bowel sounds
high pitched tinkles every 3-5 seconds
32
absent bowel sounds
no peristalsis - bad
33
no bowel sounds
ileus
34
borborygmi
increased hyperactive low pitched rumbling
35
at umbilicus
aorta splits to iliac arteries then splits to femoral artery
36
percussion of abdomen
tympany liver should be dull
37
liver percussion
resonant lung dull liver tympany bowels
38
deep palpation
organ size, masses, aorta, deep pain
39
rebound tenderness
peritoneal inflammation
40
rovsings sign
referred rebound tenderness
41
DDx for peritonitis
infection, pancreatic ascites, PID, ectopic pregnancy, fitz-hugh-curtis syndrome
42
fitz hugh curtis syndrome
disseminated gonorrhea or chlamydia out of uterus and causes generalized hepatitis and peritonitis
43
ilver function test
enzymes - ALT, AST, alkaline phos bilirubin, albumin, PT
44
function of liver
bilirubin, albumin, PT
45
liver inflammation, tissue damage, obstruction
ALT, AST, ALP (alk phos)
46
anasarca
generalized edema
47
AST and ALT larger elevation than alk phos
hepatic
48
alk phos elevated larger than AST/ALT
extra-hepatic
49
lloyds sign
CVA tenderness
50
DDx for lloyds sign
nephrolithiasis pyelonephritis renal cell carcinoma
51
condyloma accuminata
anal warts with HPV
52
condyloma lata
anal warts with syphilis
53
procidentia
complete rectal prolapse
54
appendicitis
anorexia - don't want to eat
55
obturator sign
figure 4 with leg
56
acute cholecystitis
CT scan
57
most common cause of pacreatitis
alcohol use
58
turners sign
?
59
other test
? look at PPT

PCM FINAL 2014 (2 decks)

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