GI, renal, etc.

Question 1

what are the symptoms of GERD?

Answer 1

heartburn - 30 min after eating
dysphagia
sour taste (from acids regurgitating)
hoarse voice
atypical pain of head and neck

Question 2

what positions help sx of GERD?

Answer 2

L sidelying and recliner/propped up

Question 3

where can GERD refer pain?

Answer 3

L shoulder

Question 4

is supine a good position to be in for GERD?

Answer 4

no…this straightens the esophagus which causes increased reflux

Question 5

where will the appendix refer pain?

Answer 5

RLQ

Question 6

where will kidneys cause pain? what will you see in urine with kidney probs?

Answer 6

flank, mid back and R shoulder, blood in urine

Question 7

if you have a liver issue, how will your pee and poop look?

Answer 7

dark urine, clay colored poop

Question 8

why do you see dark urine with liver issues?

Answer 8

it does not metabolize bilirubin so there’s build up

Question 9

when will you see palmar erythema?

Answer 9

liver issues

Question 10

where do peptic ulcers refer pain?

Answer 10

RUQ

Question 11

what organs refer pain to L shoulder?

Answer 11

heart, diaphragm, spleen, tail of pancreas, L kidney

Question 12

what organs refer pain to R shoulder?

Answer 12

gallbladder, liver, head of pancreas, R kidney

Question 13

what conditions referpain to LLQ?

Answer 13

diverticulitis, ulcerative collitis, IBS

Question 14

what refers pain to RLQ?

Answer 14

AC: Appendix, Crohn’s

Question 15

what refers p! to RUQ?

Answer 15

R kidney, peptic ulcers

gallbladder pathology, liver head of pancreas

good luck hot pack

Question 16

what refers pain to LUQ?

Answer 16

L kidney, tail of pancreas, spleen pathology

Question 17

what is the special test for spleen rupture?

Answer 17

Kehr’s, pt is supine and you raise legs, positive if p! in L shoulder

Question 18

a hiatal hernia causes ___ shoulder pain

Answer 18

L

Question 19

what’s cholecystitis?

Answer 19

blockage or impaction of gallstones in the cystic duct resulting in inflammation of the gallbladder

pain increases with ingestion of fatty foods

Question 20

where does cholecystitis refer pain?

Answer 20

RUQ (R scapula)

Question 21

whats the special test for cholecystitis?

Answer 21

Murphy’s sign: palpate near R subcostal margin, have pt take deep breath, positive test if pain is elicited during inspiration

Question 22

what’s the murphy’s punch sign testing?

Answer 22

kidney infection

Question 23

for duodenal ulcers, pain increases with _______ of food

Answer 23

absence

Question 24

for peptic ulcers, pain increases with ______ of food

Answer 24

prescence

Question 25

what are two characteristics of peptic ulcers?

Answer 25

melena (dark tarry stool) and coffee ground emesis (vom)

you’ll see melena more commonly in duodenal ulcers

Question 26

what are sx of ulcerative collitis? where does it refer pain?

Answer 26

diarrhea with mucus and pus, rectal pain, bleeding, weight loss

LLQ

Question 27

what are the sx of Crohn’s? where does it refer pain?

Answer 27

pain relief with farting, abdominal pain, weight loss, joint arthritis, reactive arthritis

RLQ

Question 28

causes of IBS? where does it refer pain?

Answer 28

emotional stress, anx, high fat, lactose foods

LLQ

Question 29

symptoms of IBS?

Answer 29

pain relieved by pooping
sharp cramps in morning or after eating
nausea, vom, foul breath
ribbon like stools

LLQ pain

Question 30

for what condition does ingestion of fatty food increase pain?

Answer 30

cholecystitis

Question 31

s/s of appendicitis?

Answer 31

pain in RLQ, anorexia, nausea, vom, elevated temp

Question 32

what are the special tests for appendicitis?

Answer 32

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

Question 33

what condition mimics TOS and causes pain on the top of ipsilateral shoulder, with pain at night?

Answer 33

pancoast tumor (upper lung tumor)

Question 34

where could the diaphragm refer pain?

Answer 34

LUQ/L shoulder

Question 35

increase in urea production, increase in BUN and creatinine, and decreased urine output are all associated with what?

Answer 35

kidney dysfunction