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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
Q

DDx for ascites

A

cirrhosis - alcoholic
malignancy
CHF

26
Q

hepatojugular reflex

A

press liver - JVP goes up

27
Q

fluid wave

A

ascites

also shifting dullness

28
Q

exposure of abdomen

A

xiphoid to pubis **

29
Q

portal HTN

A

caput medusa
esophageal varices
hemorrhoids

30
Q

best place to listen

A

RLQ over cecum

31
Q

normal bowel sounds

A

high pitched tinkles every 3-5 seconds

32
Q

absent bowel sounds

A

no peristalsis - bad

33
Q

no bowel sounds

A

ileus

34
Q

borborygmi

A

increased hyperactive low pitched rumbling

35
Q

at umbilicus

A

aorta splits to iliac arteries

then splits to femoral artery

36
Q

percussion of abdomen

A

tympany

liver should be dull

37
Q

liver percussion

A

resonant lung
dull liver
tympany bowels

38
Q

deep palpation

A

organ size, masses, aorta, deep pain

39
Q

rebound tenderness

A

peritoneal inflammation

40
Q

rovsings sign

A

referred rebound tenderness

41
Q

DDx for peritonitis

A

infection, pancreatic ascites, PID, ectopic pregnancy, fitz-hugh-curtis syndrome

42
Q

fitz hugh curtis syndrome

A

disseminated gonorrhea or chlamydia out of uterus and causes generalized hepatitis and peritonitis

43
Q

ilver function test

A

enzymes - ALT, AST, alkaline phos

bilirubin, albumin, PT

44
Q

function of liver

A

bilirubin, albumin, PT

45
Q

liver inflammation, tissue damage, obstruction

A

ALT, AST, ALP (alk phos)

46
Q

anasarca

A

generalized edema

47
Q

AST and ALT larger elevation than alk phos

A

hepatic

48
Q

alk phos elevated larger than AST/ALT

A

extra-hepatic

49
Q

lloyds sign

A

CVA tenderness

50
Q

DDx for lloyds sign

A

nephrolithiasis
pyelonephritis
renal cell carcinoma

51
Q

condyloma accuminata

A

anal warts with HPV

52
Q

condyloma lata

A

anal warts with syphilis

53
Q

procidentia

A

complete rectal prolapse

54
Q

appendicitis

A

anorexia - don’t want to eat

55
Q

obturator sign

A

figure 4 with leg

56
Q

acute cholecystitis

A

CT scan

57
Q

most common cause of pacreatitis

A

alcohol use

58
Q

turners sign

A

?

59
Q

other test

A

? look at PPT

PCM FINAL 2014 (2 decks)

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