GI SM

Question 1

What is Rovsing?

Answer 1

appendicitis

palpate LLQ and hurts on RLQ - Reverse side

Question 2

What is Markle?

Answer 2

appendicitis

pain RLQ when hoping on one foot

Question 3

What is Blumberg?

Answer 3

appendicitis

rebound tenderness

Question 4

What is Mcburney’s point?

Answer 4

appendicitis

2/3rd distance of belly button and anterior iliac crest

Question 5

What is Obturator?

Answer 5

appendicitis

internal rotation of Right hip at 90 degrees causes pain if positive

Question 6

What is Psoas?

Answer 6

appendicitis

raising leg against resistance

Question 7

What diagnostic tool is BEST for appendicitis?

Answer 7

CT scan is better option

ultrasound is ok

Question 8

What is a Murphy’s sign? Diagnostic tool?

Answer 8

cholecystitis
pain with inspiration when palpating RUQ

ultrasound - gallstones?

Question 9

When is a HIDA scan ordered?

Answer 9

cholecystitis WITH NO gallstones on ultrasound

DO NOT perform with gallstones = dislodgement, pancreatic duct

Question 10

What is Cullen’s sign?

Answer 10

internal bleed, Cullen, Center = belly button
necrotizing pancreatitis, pregnancy
REFER!

Question 11

What is Turner’s sign?

Answer 11

internal bleed, Turner, Turn the patient over = flank
necrotizing pancreatitis, pregnancy
REFER!

Question 12

What two labs are specific to pancreas?

Answer 12

amylase and lipase

Question 13

What is Chvostek’s sign?

Answer 13

parathyroid - hypocalcemia = seizure

tapping on the face = twitching/scrunch

Question 14

What is Trousseau’s sign?

Answer 14

parathyroid - hypocalcemia = seizure

inflate BP cuff and hand draws up/fists

Question 15

A patient with elevated calcium, but asymptomatic indicates?

Answer 15

redraw labs

may indicate possible malignancy

Question 16

What PPIs are appropriate for GERD treatment?

Answer 16

Omeprazole

Pantoprazole

Question 17

What is first line for GERD?

Answer 17

H2 or PPI - depends on patient and symptoms/causes

Question 18

What are 3 complications of PPIs?

Answer 18

Osteoporosis
B12 deficiency anemia
C.diff

Question 19

What is associated with barrett’s esophagus?

Answer 19

esophageal cancer

Question 20

what blood pressure medication should be avoided with GERD?

Answer 20

calcium channel blockers

Question 21

A patient taking tums now presents with tarry stools.

Answer 21

GI bleed

Question 22

A patient not improving on PPIs or H2 blockers with GERD, what should be done?

Answer 22

H. pylori testing

EGD

Question 23

What is triple therapy for H. Pylori?

Answer 23

CAP - more resistance
Clarithryomycin
Amoxicillin
PPI

Question 24

What is quadruple therapy for H. pylori?

Answer 24

Tetracycline + Flagyl + PPI + bismuth salt

Question 25

When is an ultrasound utlized?

Answer 25

kidney stones cholecystitis AAA

Question 26

How will an AAA present?

Answer 26

a pulsating mass in the abdomin

Question 27

When should patients start getting a colonoscopy?

Answer 27

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

Question 28

What are signs and symptoms of colorectal cancer?

Answer 28

thin pencil stools

Question 29

Where are the most polyps?

Answer 29

descending colon

Question 30

Distinguish IBS vs IBD

Answer 30

irritable is not inflammatory, no elevation of inflammation markers

Question 31

RLQ

Answer 31

appendicitis

Question 32

Ulcerative colitis

Answer 32

colon specifically | bloody stools with mucus

Question 33

Crohn's disease

Answer 33

mouth to anus | can't empty bowels, urgency for BM, d/c

Question 34

LLQ

Answer 34

diverticulitis

Question 35

What is the current recommended antibiotic for C. diff?

Answer 35

Vancomycin

Question 36

Celiac disease

Answer 36

gluten - wheat, rye, barley | treat: remove from diet