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PT Exam - 3 > GI System > Flashcards

GI System Flashcards

1
Q

what can GI tract issues mimic

A

MSK pain

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2
Q

pain can be referred to

A

sternum

shoulder/neck

scapula

mid-back

lower back

hip

pelvis

sacrum

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3
Q

signs and sxs

A

absolute signs

pain

most clinically significant sxs

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4
Q

absolute signs

A

nausea

vomiting

diarrhea

constipation

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5
Q

most clinically significant signs (1)

A

abdominal pain

dysphagia

odynophagia

GI bleeding

epigastic pain

sx affected by food

early satiety w/ weight loss

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6
Q

most clinically significant signs (2)

A

constipation/diarrhea

fecal incontinence

arthralgia

referred shoulder pain

psoas abscess

tenderness @ mcburnys point

neuropathy

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7
Q

epigastric pain

A

w/ radiation to back

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8
Q

tenderness @ mcburneys point

A

1/3 of the way b/w ASIS and umbilicus

appendix

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9
Q

sxs that dont warrant referral

A

abdominal pain

arthralgia

referred shoulder pain

psoas abscess

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10
Q

how is visceral pain usually described

A

deep aching

boring

gnawing

vague burning

deep grinding

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11
Q

when referred to somatic regions of low back, hip, shoulder…

A

sensation will be vague and poorly localized

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12
Q

liver, respiratory, diaphragm and pericardium

A

refer pain to the shoulder

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13
Q

gallbladder, stomach, pancreas and small intestine

A

refer pain to mid-back and scapular region

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14
Q

colon, appendix, pelvic viscera, sigmoid, rectum, ureters and testes

A

refer pain to pelvis, sacrum, flank and upper thigh

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15
Q

arthralgia

A

there is a relationship b/w “gut” inflammation and joint inflammation

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16
Q

what do many inflammatory GI conditions have

A

arthritic component affecting the joints

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17
Q

what is hypothesized about arthralgia

A

that an antigen crosses the guy mucosa

and enters the joint

which sets up and immune response

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18
Q

joint arthralgia associated w/ GI infection

A

usually asymmetric, migrating and oligoarticular

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19
Q

oligoarticular

A

affecting only 1-2 joints

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20
Q

what is arthralgia called when triggered by a microbial infection

A

reactive arthritis

21
Q

accompanying sxs of arthralgia

A

fever

malaise

skin rash or lesions

nail bed changes

iritis and conjunctivitis

22
Q

left shoulder pain

A

free floating air following laparoscopic surgery or blood in the abdominal cavity

23
Q

right shoulder

A

perforated and duodenal ulcers

leaking gastric juices from posterior wall of stomach irritate the diaphragm and refers pain to the r shoulder

24
Q

pancreatic cancer

A

head

tail

25
Q

head of pancreas

A

r shoulder pain and mid back

26
Q

tail of pancreas

A

L shoulder pain

27
Q

obturator and psoas abscess

A

no protective barrier form abdominal structures

so any infectious or inflammatory processes affecting the abdominal cavity can cause an abscess and cause lower abdominal pain

28
Q

clinical manifestations of obturator and psoas abscess

A

fever, night sweats

pain

may present w/ antalgic gait w/ leg in IR

29
Q

pain –> obturator and psoas abscess

A

lower abdomen, back and pelvis

referred to the hip, medial thigh, groin and knee

30
Q

may present w/ antalgic gait w/ leg in IR –> obturator and psoas abscess

A

causing a fxnal hip flexion contracture

31
Q

what can be used to assess the possibility of systemic origin of painful hip or thigh

A

4 tests

32
Q

4 tests

A

heel tap

hop test

iliopsoas muscle test

palpate iliopsoas

33
Q

heel tap

A

left pt’s leg and tap the heel

34
Q

if heel tap is positive

A

painful expression and reports of R-lower quadrant pain

35
Q

hop test

A

if willing and able

have the pt hop on one leg

36
Q

if hop test is positive

A

will clutch side and be unable to complete the movement

37
Q

iliopsoas muscle test

A

cant rule out but can R/I w/ 95% certainty

38
Q

positive iliopsoas MMT test

A

increased abdominal pain, flank pain or pelvic pain

39
Q

palpate iliopsoas

A

tightness may result in radiating pain to the lower back

40
Q

palpate iliopsoas –> inflammation and abscess

A

painful sxs in R/L lower quadrants

41
Q

NSAID can have a

A

delirious effect on the entire GI tract

42
Q

what do NSAIDs most commonly affect

A

gastroduodenal mucosa

43
Q

what can NSAIDs cause

A

erosion of the mucosa

ulceration w/ life threatening bleeding and perforation

44
Q

NSAIDs can..

A

be asymptomatic until advanced conditions

45
Q

most common side effects of NSAIDs

A

upset stomach and pain

indigestion

heart burn

46
Q

what should we look for w/ NSAID use

A

elevated BP and ankle/foot edema

d/t potent renal vasoconstrictor

47
Q

risk factors of NSAIDs

A

> 65 y/o

hx of peptic ulcer dz or GI dz

smoking and alc

oral corticosteroids and anticoagulants

renal complications w/ HTN or CHF

combined w/ SSRI

48
Q

combined w/ SSRI

A

celexa

zoloft

prozac

PT Exam - 3 (20 decks)

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