ICM GI Flashcards

Describe the clinical presentation, PE findings, differential diagnosis and "next best test" for the following disease conditions: PUD, pancreatitis, cholecystitis, diverticulitis, peritonitis, hepatitis, and colon cancer Describe the conditions associated with the following PE findings: 1) Murphy’s sign 2) McBurney’s point tenderness 3) Gray-Turners 4) Cullens 5) Spider angiomas Describe the conditions associated with the following PE findings: 6) Ascites- Fluid wave 7) Signs of peritonit

1
Q

gradual diffues periumbilical pain early, RLQ localized late

A

appy

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2
Q

rapid onset RUQ pain, localized and radiating to scapula

A

cholecystitis

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3
Q

rapid severe, boring, epigastric pain radiating to back

A

pancreatitis

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4
Q

gradulal onset LLQ ache pain localized

A

diverculitis

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5
Q

sudden epigastric burning pain localized early, diffuse late

A

perforated peptic ulcer

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6
Q

gradual periumbilical pain, diffuse and cramy

A

small bowel obstruction

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7
Q

sudden periumbilical diffuse agonizing pain

A

mesenteric ischemia, infarction

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8
Q

sudden abdominal, flank, back pain. Diffuse and tearing radiating to back

A

ruptured AAA

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9
Q

gradual periumbilical pain diffuse and spasmodic

A

gastroenterites

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10
Q

female, LQ or pelvic, localized and achy, radiate to upper thigh

A

PID

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11
Q

female sudden, LQ or pelvic pain localized with ligh-headedness

A

ruptured ectopic pregnancy

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12
Q

patient is still ans anxious indicates

A

peritonitis

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13
Q

pt is leaning forward

A

reteoperitneal inflammation

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14
Q

cullen sign

A

ecchymosis on front

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15
Q

cullen sign indicates

A

hemoperitoneum

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16
Q

grey-turner’s sign

A

ecchymosis on back

17
Q

grey-turner’s sign indicates

A

retroperitneal bleeding (think hemorragic pancreatitis)

18
Q

spider angiomas indicates

A

cirrhosis

19
Q

hyperactive bowel sounds

A

early obstruction

20
Q

succssion splash

A

obstruced colon or stomach

21
Q

rebound pain shows

A

peritonitis

22
Q

RUQ masses

A

enlarged gallblader
enlarged liver
liver cancer

23
Q

LUQ masses

A

enlarged spleen
pancreatic pseudocyst
gastric cancer

24
Q

lower abdomen masses

A

distened bladder
preg
GYN issues
hernia
aneurysm
colorectal cancer

25
Q

elevated AST/ALT

A

hepatitis

26
Q

elevated bilirubin and alkaline phosphatease

A

biliary tract injury

27
Q

what to look for in acute abdominal series exray

A

bowel gass
free air
masses
stones
calcifications
pneumonia

28
Q

what to look for on CT

A

causes of bowel obstuction
masses
abcesses
pancreatitis
aneurysms
trauma
kidney stones

29
Q

what ultrasound can show

A

gallstones, pancreatic issues, pelvic abnormalities

30
Q

when to order EGD

A

suspected PUD, gastritis, upper GI bleeding

31
Q

when to order ERCP

A

jaundice,( can show CBD stone, tumor) pancreatic cancer

32
Q

traube’s space

A

LUQ

33
Q

dullness to percussion over traube’s space

A

splenomegaly

34
Q

murphy’s sign

A

gallbladder issue

35
Q

pain an mcburney’s space

A

appy