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Health Assessment II > GI/GU > Flashcards

GI/GU Flashcards

1
Q

Alimentary Tract

A

30 feet long
Includes the mouth and ends at the rectum.
Includes the pharynx, esophagus, stomach, small and large intestine.

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2
Q

Accessory organs

A 
Gall bladder
Liver
Appendix
Pancreas
Biliary Duct System
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3
Q

If questioning liver or splenic enlargement auscultate for?

A

Friction rub (sandpaper)

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4
Q

Ballottement

A

Lightly tapping fingers in a line accross the abdomen or up and down the abdomen

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5
Q

Splenic Percussion

A

Just posterior to the mid axillary line in the area of the 10th rib. Shouldn’t be felt unless 3x the normal size.

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6
Q

Rebound tenderness

A

If pain increases after your release your hand, + rebound tenderness

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7
Q

What could a tender liver on palpation mean?

A

Inflammation
Hepatitis
Cholecystitis

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8
Q

What could an inflamed spleen mean?

A

Viral illness

DO NOT palpate if suspected splenic injury

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9
Q

When should you be able to palpate the kidneys?

A

Postpartum women and pediatrics.

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10
Q

Where are the kidneys palpated?

A

4 cm above the right iliac crest.

5 cm above the left iliac crest.

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11
Q

When should you do a rectal exam?

A

Any patient with abdominal pain.

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12
Q

What diet decreases the risk of colon cancer?

A

Low fiber and high fat

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13
Q

Risk factors for colon cancer

A 
Inflammatory bowel disease
Adenomatous polyps/adenomas
Personal history or certain types of cancer (uterine, ovarian)
Race- high incidence in black women
Physical inactivity and obesity
Smoking
Diets high in processed meat
Increased age
Men>Women
First-degree relative
African American
Excessive ETOH
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14
Q

Preventing colon cancer

A

NSAIDs and ASA
Fruits and vegetables, diets low in red meat
Surveillance
Weight loss

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15
Q

Screening tests for colon cancer

A 
FOBT
Colonoscopy
Sigmoidoscopy
Double contrast barium enema 
CT Colonography
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16
Q

When should colonoscopies be done?

A

Age 50 and up unless you have a first degree relative , then check 10 years before that

Age 50-75 FOBT annually, sigmoidoscopy every 5 years, with FOBT every 3 years, screening colo every 10 years.

Age 76-85 No routine screening

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17
Q

What causes sudden severe abdominal pain?

A

Acute perforation, inflammation, torsion of abdominal organ, ruptured fallopian tube, perforated gastric ulcer, peritonitis or acute pancreatitis

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18
Q

Nausea without vomitting

A

Hepatocellular disease, pregnancy, metastatic disease

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19
Q

Causes of dry skin

A 
Chronic renal or hepatic diseases
Lymphoma
Hodgkin's disease
Malignancies
DRY SKIN
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20
Q

Shifting dullness

A

Ascites test

Percuss the border of tympany and dullness with the patient supine, then have them roll onto their side. Percuss and mark the borders again.

Normal- the borders remain consistent.

Ascites- dullness shifts to the dependent side, tympany at the top.

21
Q

Fluid wave

A

Ascites test

If easily palpable means there is ascites.

Press hand edges down the midline and tap on one side with fingertips while feeling the opposite side.

22
Q

Rovsing’s sign

A

Pain in the RLQ during left sided pressure.

+ for pain indicates appendicitis

23
Q

Psoas sign

A

Ask patient to raise their thigh against your hand while pressing on the knee. This contracts psoas muscle. If this increases their pain it indicates an inflamed appendix.

24
Q

Obturator sign

A

Flex patients right thigh at the hip. With the knee bent rotate the leg internally. This stretches the internal obturator muscle. If + for pain in the right hypogastric area this is indicates inflamed appendix.

25
Q

Murphy’s sign

A

When patient has RUQ pain/tenderness. Hook the left thumb of the right hand under the costal margin. As patient to take a deep breathe. Note the degree of tenderness. A sharp increase in tenderness with inspiratory effort is a + sign for acute cholecystitis.

26
Q

McBurney’s sign

A

2 inches from the anterior superior spinous process of the ilium on a line drawn from that process to the umbilicus. Press down on this point, if having pain indicates appendicitis.

27
Q

Diagnostic tests for abdominal pain

A

Labs- cbc, urinalysis, pregnancy test, amylase/lipase,
ECG
Radiologic studies- plain films, ultrasound, CT

28
Q

General treatment principles for abdominal pain

A

Volume repletion
Pain relief
Antibiotics

Surgical consult, serial evaluation, discharge

29
Q

Functions of the Genitourinary System

A

Reproduction process
Removing and filtering waste products
Maintaining volume states and fluid composition
Assisting in the regulation of acid-base balance
Regulating BP
Producing erythropoietin and vitamin D

30
Q

How often should men do a self-screening?

A

Once a month in the shower

31
Q

HPV vaccine

A

Age 11-21 for males. Can prevent genital warts, anal cancer, and penile cancer. Reduce HPV transmission to female sex partners and lower risk of oropharyngeal cancers.

32
Q

Instructions for Safe Sexual Practices

A

Using a new condom with each sex act
Apply before any contact occurs
Add only water-based lubricants
Immediately withdraw if condom breaks and hold the condom while withdrawing

33
Q

When should men seek clinical attention for genital concerns?

A

Painless lump, swelling, enlargement in either tsticle, pain or discomfort in a testicle, feeling of heaviness or a sudden fluid collection in the scrotum or a dull machine in the lower abdomen or groin.

34
Q

Diagnostic Testing for Genitourinary Disorders

A 
Blood Test
Urinalysis- culture and sensitivity
24 hour urine collection for protein and creatinine
Spot urine specimen for sodium and urine osmolality
Renal ultrasound
IV pyelography
Fractional excretion of NA+ level
GFR
PSA prostate-antigen test
35
Q

Newborn urine

A

Should occur during the first 24 hours after birth
Usually colorless and odorless
Persistant diaper rash can be a sign of a UTI
Determine if there was use of sex hormones or birth control pills during pregnancy

36
Q

GU considerations for the peds patient

A

UTIs do not occur until 2-6 years old unless abnormal structure of the kidneys
Sign of UTI- toilet trained child having accidents
Increase incidence in adolescents can indicate sexual activity

37
Q

Peyronie disease

A

Palpable, non tender hard plaques found just beneath the skin usually along the dorsum of the penis. Crooked, painful erections.

38
Q

Hydrocele

A

Non tender fluid filled mass within the tunica vaginalis. Trasilluminates and the examining fingers can palpate above the mass within the scrotum.

39
Q

Hypospadias

A

Congenital displacement of the urethral meatus to the inferior surface of the penis.

40
Q

Scrotal edema

A

Pitting edema may make the scrotal skin taut as seen in CHF or renal disease.

41
Q

Scrotal hernia

A

Indirect inguinal hernia that comes through the external inguinal ring so the examining fingers cannot get above within the scrotum

42
Q

Cryptochordism

A

Testis atrophied outside the scrotum in the inguinal canal, abdomen, or near the pubic

43
Q

Small Testes

A

Kleinfelter syndrome-Testes <2cm

Cirrhosis, myotonic dystrophy, use of estrogens and hypopituitarism

44
Q

Acute orchitis

A

inflamed, painful, tender, and swollen testes

45
Q

Spermatocele and cyst of the epididymis

A

A painless moveable cystic mass above the testis. Both illuminate

46
Q

Varicocele of the spermatic cord

A

Gravity mediated varicose veins of the spermatic cord, usually found on the left.

47
Q

Acute epididymitis

A

Inflamed epididymis, swollen, tender. Can be caused by neisseria gonorrhea, chlamydia, e. coli, Pseudomonas, trauma, an autoimmune disease.

48
Q

Torsion of the spermatic cord

A

twisting of the testicle. The cremasteric reflex is almost always absent on the affected side. Surgical emergency, obstructed circulation.

Health Assessment II (8 decks)

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