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CPD II > GI test 2: Approach to pt with lower GI condition-diagnostics > Flashcards

GI test 2: Approach to pt with lower GI condition-diagnostics Flashcards

1
Q

Special test for peritonitis?

A

blumberg sign

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2
Q

Special tests for appendicitis?

A

McBurney’s point, Rovsing’s sign, rebound tenderness, psoas sign, obturator sign

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3
Q

Ascites tests?

A

fluid wave & shifting dullness

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4
Q

Cholecystitis test?

A

Murphy’s sign

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5
Q

Kidney inflammation test?

A

CVA tenderness

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6
Q

Other exams for lower GI sxs?

A

DRE, gynecological exam, male genitalia exam

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7
Q

2 things that can cause RUQ pain?

A

hepatitis, cholecystitis/cholelithiasis, cholangitis, biliary colic, Budd Chiari syndrome, pancreatitis, pneumonia/pleuris

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8
Q

2 things that can cause epigastric pain?

A

GERD, gastritis, PUD, pancreatitis, myocardial ischemia, pericarditis, ruptured aortic aneurysm

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9
Q

2 things that can cause LUQ pain?

A

spleen infarct, splenic rupture, gastritis, gastric ulcer, pancreatitis, hiatal hernia

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10
Q

2 things that can cause R flank pain?

A

kidney inflam, pyelonephritis

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11
Q

2 things that can cause periumbilical pain?

A

early appendicitis, gastroenteritis, bowel obstruction, peritonitis

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12
Q

2 things that can cause L flank pain?

A

kidney inflam, pyelonephritis

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13
Q

2 things that can cause RLQ pain?

A

appendicitis, IBD, cecal diverticulitis, inguinal hernia, nephrolithtiasis, female: ovarian cyst, salpingitis, endometriosis, ectopic pregnancy; male: testicular or epididymal inflam

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14
Q

2 things that can cause suprapubic pain?

A

cystitis, acute urinary retention, female: uterine cramps, cervicitis, endometriosis, PID; male: acute prostatitis

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15
Q

2 things that can cause LLQ pain?

A

diverticulitis, IBD, IBS, nephrolithiasis, same female & male conditions as RLQ

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16
Q

Things that can cause diffuse abd pain

A

early appendicitis, gastroenteritis, intestinal obstruction, mesenteric ischemia, peritonitis, IBS, abd wall hematoma, infections, metabolic d/o’s, thoracic d/o’s, toxic events

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17
Q

Clinical definition of diarrhea

A

> 200 g/day of stool weight or >3 BM a day

18
Q

4 types of diarrhea

A
  1. osmotic= too much water into bowels
  2. secretory= increase in active secretion or inhibition of absorption
  3. exudative= mucous, blood, protein from inflam
  4. motility= increase or decrease contact b/w GI contents & mucosal surface
19
Q

Causes of osmotic diarrhea?

A

maldigestion= pancreatic dz, celiac dz
osmotic laxatives
ions

20
Q

Causes of secretory diarrhea?

A 
enterotoxins
hormones
gastric hypersecretion
laxatives
bile salts
fatty acids
21
Q

Causes of exudative diarrhea?

A 
idiopathic (Crohn's, UC)
infectious
ischemic
vasculitis
radiation injury
22
Q

Causes of motility diarrhea?

A

increased motility= hyperthyroidism, postgastrectomy

decreased motility= DM, hypothyroid, scleroderma

23
Q

RED FLAGS WITH DIARRHEA & COMPLICATIONS

A

RED FLAGS: blood, pus in stool, fever, signs of dehydration, chronicity, unintended wt loss, failure to thrive in kids
COMPLICATIONS: dehydration, electrolyte imbalance

24
Q

What is constipation?

A

difficulty passing, infrequent stool, hardness of stool, incomplete feeling afterwards

25
Q

Two main categories of constipation?

A

acute (organic)

chronic (functional or organic)

26
Q

RED FLAGS WITH CONSTIPATION

A

abd distention, vomiting, blood in stool, wt loss, severe or worsening sxs

27
Q

What causes gas?

A

colonic bac fermenting nutrient, swallowed air

28
Q

What are the 3 types of gas?

A

belching
bloating/distention
flatus

29
Q

RED FLAGS WITH GAS

A

wt loss, blood in stool

30
Q

What are the two forms a GI bleed can present as?

A

gross or occult blood

31
Q

What is hematochezia?

A

gross blood suggesting lower GI bleed

32
Q

What are some causes of small bowel bleeding?

A

angioma, AV malformation, tumors, meckel’s diverticulum

33
Q

What are some causes of colon, anal bleeding?

A

anal fissure, colitis, carcinoma & polyps, diverticular dz, IBD, hemorrhoids

34
Q

What is dyschezia? What is happening to cause it?

A

difficulty stooling- feel urge but can’t go, often from incoordination of rectal muscles & sphincter

35
Q

Why do an O&P x 3?

A

to find protozoa, worms, worm eggs & other parasites
commonly detect parasites like giardia, cryptosporidium & worms like roundworms, hookworms, tapeworms, flukes & flatworms

36
Q

Why do a stool culture?

A

immunocompromised pt, severe inflam diarrhea, in those w/IBD to distinguish b/w a flare & infxn

37
Q

What will a fecal occult blood analysis tell you about?

A

detect upper GI bleed

38
Q

What will a fecal leukocyte analysis tell you?

A

help confirm or deny bac cause of diarrhea

39
Q

What is the point of a fecal lactoferrin test?

A

marker for fecal WBCs, help distinguish b/w inflam diarrhea (bac infxn, IBD) & non-inflam (viral, IBS)

40
Q

What is a fecal lysozyme test used for?

A

measure success of tx for IBD, N= absence of colonic inflam, suggests irritation only

41
Q

What is a comprehensive digestive stool analysis include?

A

markers for digestion, absorption, metabolism plus micro

42
Q

When is a salival secretory IgA test low? High?

A 
low= celiac, IBD, chronic infxn, chronic stress
high= acute GI infxn

CPD II (10 decks)

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