GI, renal, etc. Flashcards
what are the symptoms of GERD?
heartburn - 30 min after eating
dysphagia
sour taste (from acids regurgitating)
hoarse voice
atypical pain of head and neck
what positions help sx of GERD?
L sidelying and recliner/propped up
where can GERD refer pain?
L shoulder
is supine a good position to be in for GERD?
no…this straightens the esophagus which causes increased reflux
where will the appendix refer pain?
RLQ
where will kidneys cause pain? what will you see in urine with kidney probs?
flank, mid back and R shoulder, blood in urine
if you have a liver issue, how will your pee and poop look?
dark urine, clay colored poop
why do you see dark urine with liver issues?
it does not metabolize bilirubin so there’s build up
when will you see palmar erythema?
liver issues
where do peptic ulcers refer pain?
RUQ
what organs refer pain to L shoulder?
heart, diaphragm, spleen, tail of pancreas, L kidney
what organs refer pain to R shoulder?
gallbladder, liver, head of pancreas, R kidney
what conditions referpain to LLQ?
diverticulitis, ulcerative collitis, IBS
what refers pain to RLQ?
AC: Appendix, Crohn’s
what refers p! to RUQ?
R kidney, peptic ulcers
gallbladder pathology, liver head of pancreas
good luck hot pack
what refers pain to LUQ?
L kidney, tail of pancreas, spleen pathology
what is the special test for spleen rupture?
Kehr’s, pt is supine and you raise legs, positive if p! in L shoulder
a hiatal hernia causes ___ shoulder pain
L
what’s cholecystitis?
blockage or impaction of gallstones in the cystic duct resulting in inflammation of the gallbladder
pain increases with ingestion of fatty foods
where does cholecystitis refer pain?
RUQ (R scapula)
whats the special test for cholecystitis?
Murphy’s sign: palpate near R subcostal margin, have pt take deep breath, positive test if pain is elicited during inspiration
what’s the murphy’s punch sign testing?
kidney infection
for duodenal ulcers, pain increases with _______ of food
absence
for peptic ulcers, pain increases with ______ of food
prescence
what are two characteristics of peptic ulcers?
melena (dark tarry stool) and coffee ground emesis (vom)
you’ll see melena more commonly in duodenal ulcers
what are sx of ulcerative collitis? where does it refer pain?
diarrhea with mucus and pus, rectal pain, bleeding, weight loss
LLQ
what are the sx of Crohn’s? where does it refer pain?
pain relief with farting, abdominal pain, weight loss, joint arthritis, reactive arthritis
RLQ
causes of IBS? where does it refer pain?
emotional stress, anx, high fat, lactose foods
LLQ
symptoms of IBS?
pain relieved by pooping
sharp cramps in morning or after eating
nausea, vom, foul breath
ribbon like stools
LLQ pain
for what condition does ingestion of fatty food increase pain?
cholecystitis
s/s of appendicitis?
pain in RLQ, anorexia, nausea, vom, elevated temp
what are the special tests for appendicitis?
tender at McBurney’s point (RLQ pinch an inch)
Rovsing’s sign for pain migration (Palpate LLQ, pain in RLQ)
Blumberg’s sign for rebound tenderness (pain when released)
hop test: pain on RLE
markel heel drop, pain in RLQ
obturator - pain with stretch into IR
PSOAS - pain with stretch into extension
what condition mimics TOS and causes pain on the top of ipsilateral shoulder, with pain at night?
pancoast tumor (upper lung tumor)
where could the diaphragm refer pain?
LUQ/L shoulder
increase in urea production, increase in BUN and creatinine, and decreased urine output are all associated with what?
kidney dysfunction
