GI SM Flashcards
What is Rovsing?
appendicitis
palpate LLQ and hurts on RLQ - Reverse side
What is Markle?
appendicitis
pain RLQ when hoping on one foot
What is Blumberg?
appendicitis
rebound tenderness
What is Mcburney’s point?
appendicitis
2/3rd distance of belly button and anterior iliac crest
What is Obturator?
appendicitis
internal rotation of Right hip at 90 degrees causes pain if positive
What is Psoas?
appendicitis
raising leg against resistance
What diagnostic tool is BEST for appendicitis?
CT scan is better option
ultrasound is ok
What is a Murphy’s sign? Diagnostic tool?
cholecystitis
pain with inspiration when palpating RUQ
ultrasound - gallstones?
When is a HIDA scan ordered?
cholecystitis WITH NO gallstones on ultrasound
DO NOT perform with gallstones = dislodgement, pancreatic duct
What is Cullen’s sign?
internal bleed, Cullen, Center = belly button
necrotizing pancreatitis, pregnancy
REFER!
What is Turner’s sign?
internal bleed, Turner, Turn the patient over = flank
necrotizing pancreatitis, pregnancy
REFER!
What two labs are specific to pancreas?
amylase and lipase
What is Chvostek’s sign?
parathyroid - hypocalcemia = seizure
tapping on the face = twitching/scrunch
What is Trousseau’s sign?
parathyroid - hypocalcemia = seizure
inflate BP cuff and hand draws up/fists
A patient with elevated calcium, but asymptomatic indicates?
redraw labs
may indicate possible malignancy
What PPIs are appropriate for GERD treatment?
Omeprazole
Pantoprazole
What is first line for GERD?
H2 or PPI - depends on patient and symptoms/causes
What are 3 complications of PPIs?
Osteoporosis
B12 deficiency anemia
C.diff
What is associated with barrett’s esophagus?
esophageal cancer
what blood pressure medication should be avoided with GERD?
calcium channel blockers
A patient taking tums now presents with tarry stools.
GI bleed
A patient not improving on PPIs or H2 blockers with GERD, what should be done?
H. pylori testing
EGD
What is triple therapy for H. Pylori?
CAP - more resistance
Clarithryomycin
Amoxicillin
PPI
What is quadruple therapy for H. pylori?
Tetracycline + Flagyl + PPI + bismuth salt
When is an ultrasound utlized?
kidney stones
cholecystitis
AAA
How will an AAA present?
a pulsating mass in the abdomin
When should patients start getting a colonoscopy?
age 50 for CDC and ACA is 45
every 10 years with annual occult blood testing
earlier if family hx, inflammatory bowel disease, personal history of colorectal cancer, abdominal radiation
What are signs and symptoms of colorectal cancer?
thin pencil stools
Where are the most polyps?
descending colon
Distinguish IBS vs IBD
irritable is not inflammatory, no elevation of inflammation markers
RLQ
appendicitis
Ulcerative colitis
colon specifically
bloody stools with mucus
Crohn’s disease
mouth to anus
can’t empty bowels, urgency for BM, d/c
LLQ
diverticulitis
What is the current recommended antibiotic for C. diff?
Vancomycin
Celiac disease
gluten - wheat, rye, barley
treat: remove from diet
