GI - GASTRO Flashcards
1
Q
Sxs:
- RUQ pain, fever, jaundice
- Right subscapular pain
- Radiates to or through back
- Pain comes and goes, worse after eating fatty meal
- N/V
- Indigestion or bloating sensation
A
Cholelithiasis
2
Q
Sxs:
- Epigastric pain
- No guarding/rebound tenderness
- Bowel sounds variable
- N +/- V
- Hiccups
- Anorexia
A
Gastritis
3
Q
Sxs:
- Epigastric pain (gnawing or burning)
- RUQ pain
- Pain worse with eating
- Nausea/anorexia
A
PUD - Gastric Ulcers
4
Q
Sxs:
- Heartburn
- Regurgitation of digested food
- Chest pain
- Persistent/non-productive cough
- Bronchospasm
- Aspiration
A
GERD
5
Q
Sxs:
- LLQ pain that increases with bowel movement
- Left sided pain worse after eating
- Diarrhea or constipation
- Fever/chills, anorexia
- N/V possible
- Rebound tenderness, guarding
A
Diverticulitis
6
Q
Sxs:
- Crampy abdominal pain relieved by gas/stool
- Change in bowel habits
- N/V/heartburn
A
IBS
7
Q
Sxs:
- Fever, elevated WBC
- Tachycardic
- RUQ pain
- Right subscap pain
- Positive Murphy’s sign
A
Cholecystitis
8
Q
Sxs:
- Epigastric pain (gnawing or burning)
- RUQ pain
- Pain decreased with meals then increases 2-3 hours post-prandial
A
PUD - Duodenal Ulcers
9
Q
Sxs:
- Periumbilical pain migrates to RLQ
- Anorexia/N/V
- Fever, tachycardia
- Rebound tendernes, guarding
- Psoas sign
- Obturator sign
- Rovsing’s sign
A
Appendicitis
10
Q
Sxs:
- Vomit
- Obstipation
- Distention
- Crampy
- Abdominal pain
A
Bowel obstruction
11
Q
Sxs:
- Bloody diarrhea
- LLQ pain
A
Ulcerative colitis
12
Q
Sxs:
- RLQ pain
- Fistulas common
- Gall/renal stones common
- Cobble stone appearance
- Skip leasions
A
Crohn’s dz
13
Q
Most common type of gallstones
A
Cholesterol
14
Q
Risk Factors for Cholelithiasis
A
fair, fat, female, forty, flatulence, fertile
15
Q
Charcot’s Triad
A
- RUQ pain
- Fever
- Jaundice
16
Q
Murphy’s Sign
A
pushing into the RUQ under the rib cage to check for pain/tenderness in gallbladder area
17
Q
Gold standard test for cholelithiasis
A
ultrasound
18
Q
Diagnostic Tests and Findings for Cholecystitis
A
- leukocytosis and elevated CRP
- radiographic signs: thickening of GB wall, sonographic Murphy’s sign, pericholecystic fluid
19
Q
Causes of Gastritis
A
- H. pylori
- NSAIDs
- stress-related mucosal changes
- atrophy
20
Q
Risk Factors for GERD
A
- obesity/pregnancy
- alcohol, smoking, caffeine
21
Q
What is first line “test” for GERD? What other tests might be done?
A
- trial treatment
- then barium swallow or perhaps endoscopy
22
Q
Risk Factors for PUD
A
- H pylori
- NSAID use
- smoking
- FHx
- meds: bisphosphonates, corticosteroids, chemo drugs
23
Q
Common Causes of PUD
A
- H pylori
- NSAIDs
- stress
- Zollinger Ellison syndrome
24
Q
Risk Factors for NSAID Induced Ulcers
A
- age 60+
- Hx PUD/GI bleed
- toxic NSAID use
- corticosteroid, bisphosphonate, SSRI, anticoagulant, antiplatelet use
- immunocompromised
25
Tests for PUD
- CBC
- FOBT
- H pylori testing
- endoscopy for pts 55+, with alarm sxs or those w/ ulcers that don't respond to tx
26
H pylori Testing
- endoscopy is gold standard, but invasive
- urea breath test
- IgG serology
- stool antigen
- may get a false negative if using abx/bismuth/PPI
27
Diverticulitis Sx Triad
- LLQ pain/tenderness
- fever
- leukocytosis
28
Tests and Results for Diverticulitis
- CBC: low Hgb, leukocytosis
- positive UA and blood culture
- elevated ESR
- CT or flex sig is diagnostic
- colonoscopy after recovery from acute sxs
29
Risk Factors for IBS
- genetics
- young
- women - menstruation
- stress with exacerbations
- previous gastroenteritis
30
Rome 3 Criteria
-abdominal pain 3 d/mo x3 months with 2 or more of:
relieved by stool evacuation
change in stool form
change in stool frequency
31
Labs and Imaging for IBS
- CBC, FOBT usually normal
| - abdominal US
32
Most common cause of acute surgical abdomen
appy
33
Tests for Appy
- elevated WBC
- US for pg women and children
- CT with oral contrast is test of choice
34
Define acute diarrhea.
less than 14 days duration
35
Define chronic diarrhea and list common causes.
- decrease in fecal consistency >4 weeks
| - IBS, IBD, malabsorptive syndromes, chronic infxs, idiopathic
36
Psoas Sign
RLQ pain with flexing of the right thigh up toward chest
37
Obturator Sign
pt on side; flexion at hip and internal rotation of thigh; if RLQ painful, positive test
38
Rovsing Sign
deep palpation of LLQ elicits referred pain in RLQ
39
McBurney's Point
point over the appendix that is 1/3 of the way from the ASIS to the belly button
40
Causes of Constipation
- low fiber and water intake
| - meds: opioids, anticholinergics
41
What presents with a tinkling sound when the abdomen is auscultated?
bowel obstruction
42
Tests and Results for Bowel Obstruction
- abd XR: air/fluid levels, distended bowel loops
| - CBC: elevated WBC, moderate increase in Hct
