gi facts Flashcards
what problem
starts abruptly reaching max intensity within 60 minutes and is a constant pain lasting up to 6 hours
located right hypochondrial but can also be felt in the epigastric or left sided occasioanlyl being retrosternal pain
associated with nausea and vomiting and may radiate to the back along the subcostal margin
no guarding or rebound,, no fever
slight sinus tachy
biliary colic
r hyochondrial pain that can also be epigastric and left sided.
The pain radiates to tip of shoulder blade and is onstant lasting over 12 hours.
It is assoicated with N and V and a distended abdomen is noted. Guarding and positive murphys sign( breathe in with hand on right costal margin) with slight fever.
tahcycardia
anoxeria
normal bowel habit
acute cholecystitis
rare sign associated with acute cholecystitis
Boas sign
what is boas sign
area of hyperaesthesia at the site of radiation of the pain to the back - typically below the scapula
upper abdo pain radiating to back. can go to shoulder too.
sudden onset and relived by sitting forward. history og gall bladder disease and alcohol abuse.
N and V
mild jaundice, dimished bowel sounds, may develp basal creps , fever an dhypotension
acute pancreatitis
grey turners sign and cullen ( umbilical) and shock
mx of acute pancreatitis
fluid resus
monitor uirne output
analgesia
nutrioon - enteral andnill by mouht
surgery if stones
intially central abdo discomfort potential colickly
shifts to RIF over hours
becomes more intense and constant
associated with N&V, anoxeria and constipation
shallow breathing and tachycardia, fever, halistosis, furred tongue and flsuhed
tender, guarding ,rigidity and tenderness on percussion , pain on voluntary cough
acute appendicitis
what are special signs in acute appendiciits
rovsing sing - LIF fooa press greater pain on right
obturator sign - RIF pain with internal rotation of the flexed right jp with a retrocaecal appendix
psoas sign - RIF pain with hyperextnesion of right hip with retrocaecal appednix
varying bowel frequency assciated with diarrhoea and blood in the stool. lots of mucus too.
abdo pain in LIF associated with fever , WL, pallor and abdo tenderness.
had fialure to thrive as kid
UC
abdo pain - RIF
WL, diarrhoea, lassitude( lack of energy) , anoxeria, malaise and fever
mouth ulcers and abcesses. can hvae rectal bleeding.
Crohns
hx of vascular disease or DM
can follow aortic aneurysm surgery
cramping left sided abdo pain
dark red rectal bleeding occuring multiple times each day without faces.
ischaemic colitis
recent abx use and in hospital
had diarrhoea and fever with abdo cramps associated with nausea, malaise and anoxeria.
pseudomonas colitis
RF for cancer of the colon
low fibre diet
familial polyposis coli
UC
adenomatous ppolyps
gardner syndrome
most sigmoid and rectal
sx of cancer of colon
tiredness, anxoeria, WL, abdo pain, change in bowel habit, rectal bleeding, passing mucus, tenesmus, bowel obstruction
pallor, mass, blood and mucus on PR , cachexia, jaundice, hepatomegaly, ascites
LIF pain episodic
alternating diarrhoea and constipation
systemically unwell with pyrexia and tenderness
rectal bleeding and a little bit of bowel obstruction
rigiidy and rebound with lcoalised abescess or generalised periotnitis
diverticular disease
perforation - paracolic abscess and peritonities
fistula - bladder - cystitis and pneumaturia and if vaginal faceulent discharge
colicky pain, intermittent waves
central abdo
n&v
abdo distention and constipation ( late feature)
dehydrated
scars - potntial for adhesions
distension and peristalsis
hernias
no tendernesss, no fever
borborygmi - rumbling or gurglign noise made by movment of fluid or gas in the intestines. - possibe ileus later
empty rectum
small bowel obstruction
crampy lower abdo pain
gradual onset
abdo distension
n&v
sudden onset makes it into an acute event
constipation
change in bowel habit
rectal bleeding
WL and tiredness
distended abdo
borborygmi
no tenderness
rectum os usually empty
a mass
large bowel obstrution
lump in groin or scrotum
increases in size when cough or strain
reduces when relaxed or supine
may cause pain or discomfort
frequently painless
abdo pain may indicate intestinal obstruction
groin hernia
direct - protrudes throguh abdo wall
indirect - follow path of inguinal canal going into scrotum
reduced indirect - controlle dby pressure over internal inguinal ring
above and lateral to pubic tubercle- direct
above and medial - indirect
below and lateral is femoral
when thinkng abotu abdo pain or hernias what should you do
examine both lying and standing and assess effect of cough
due to hidden hernias
incarcerated hernias are no longer reduceable but vascular supply may still be intact
Rome 3 criteria
12 weeks consecutive in preceedign 12 months of abdo discomfort or pain having 2/3 features
relieved by defaecation
assoicated with change of freq of stool
change of consistency of stool
3 stools per day or more
or less than 3 a week
hard or lupy, loose or watery
straining
urgency
incomplete empty
passing mucus
abdo fullness
IBS
red flag sx for people with IBS
over 50
WL
occult blood
FH of ca colon
anaemia
tiredness and maliasie WL
diarrhoea and steatorrhoae
distention and pain wth flatulence
n adn v
skin rashes
neuropathy
peripheral oedema and reduced fertility
gluten enteropathy - coealiac disease
child 6-12 was healthy now developed diarrhoea, steatorrhoea, distenstion and struggling to thrive. Irritable and anoxeric struggling to put on weight.
hypotonia, rickets, osteomalacia, pimentation, glossitis,purpura, tetna, spinal cord degeneration and peripherla neuropathy wth psychosis
coealic
