Presentations/ GI weeks

Question 1

Kidney stones (urolithiasis)-

Answer 1

solid piece of material passes into the urinary tract

Question 2

If stone does get blocked in the ureter then there could be

Answer 2

Blood in the urine
Vomiting
Painful urination

Question 3

Form due to a high concentration of a certain minerals

Answer 3

Calcium
Uric acid- Gout
Struvite
Cystine

Question 4

Genetics and Environmental factors for kidney stones

Answer 4

High urine calcium levels
Obesity
Calcium supplements
Dehydration
Gout
Hyperthyroidism

Question 5

When is a radiograph not needed to kidney stone diagonsis?

Answer 5

H/o renal stones
Under 50 years old
Unconcerning S/S

Question 6

When do men usually have their first stone?

Answer 6

between 30-40

Question 7

When do women usually have their first stone?

Answer 7

between 35-55

Question 8

Percentage of kidney stone patients who are male?

Answer 8

65-80%

Question 9

Treatment of small stone

Answer 9

small less than 5mm

typically pass within four weeks of initial symptoms and need no management

Question 10

Treatment of larger stone:

Answer 10

greater then 5mm

will pass about half the time without further management

Question 11

Hallmark findings of kidney stone patients:

Answer 11

sudden, sharp, severe pain originating deep in the lumbar area and radiates around the side and down toward the testicle in the male 
Nausea and vomiting
Palpable flank mass
Hematuria
Fever and chills
Urge to urinate frequently
Abdominal muscle spasms

Question 12

Which dermatomes are usually sensitive in kidney stone patients?

Answer 12

T10-L1

Question 13

Pyelonephritis

Answer 13

inflammation of the renal parenchyma

Question 14

Chronic Glomerulonephritis

Answer 14

inflammation of the glomeruli of both kidneys

Question 15

Common types of infection:

Answer 15

pyelonephritis

chronic glomerulonephritis

Question 16

Less common types of infection:

Answer 16

Renal papillary necrosis

Renal tuberculosis

Question 17

People at risk for kidney infection:

Answer 17

Age over 60
Hx of diabetes or HTN
Hx of kidney disease, heart attack, or stroke
Hx of kidney stones or UTI
African, Hispanic, Pacific Island, or Native American descent
Exposure to chemicals (e.g. paint, glue, degreasing solvents, cleaning solvents), drugs, or environmental conditions
Low birth weight
Pharmacologically immunocompromised (e.g.. renal transplantation, AIDS)
Stress Incontinence
Those who engage in anal sex
Structural or congenital abnormalities that obstruct urinary flow (e.g. prostatic hypertrophy or malignancy)
Patient’s who have or have had an indwelling urinary catheter or have experienced urinary tract obstruction

Question 18

Hallmark finding in kidney infection patients:

Answer 18

Unilateral costovertebral tenderness
Ipsilateral shoulder pain
Flank pain (in rare cases this can be bilateral) 
Haematuria, polyuria, pyuria, or bacteriuria
Offensive smelling urine 
Dysuria, nocturia and urgency 
Tachycardia and tachypnoea 
Fever and chills
Systemic ill health, rigor and chills 
Anorexia and nausea

Question 19

Endometriosis:

Answer 19

An estrogen-dependent disorder defined by the presence of endometrial tissue (lining of the
uterus) outside of the normal uterus area

Question 20

Regurgitation Theory:

Answer 20

Most common theory explaining this disorder is which is also called, retrograde menses, which means the blood goes up into the body, rather than down and out
through the vagina

Question 21

Metaplastic Theory:

Answer 21

Endometrial tissue arises from endometrial differentiation of coelomic epithelium. During development of the embryo there is no differentiation between reproductive
cell types

Question 22

Vascular/lymphatic Dissemination Theory:

Answer 22

endometrial cells somehow work their way into the

vascular/lymphatic system

Question 23

4 Most common areas for endometriosis

to occur:

Answer 23

Surface of the ovaries
Endometrioma: in the ovaries
Peritoneum over the uterus
Fallopian tubes

Question 24

Incidence of endometriosis may be higher in:

Answer 24

women who have infertility issues (15-70%)
women younger than 20 with chronic pelvic pain (44-73%)
women during reproductive age

Question 25

Risk factors for endometriosis:

Answer 25

starting period early
regular periods with shorter cycles (less than 27 days)
longer duration of period (greater than 7 days)
heavier flow
increased menstrual pain
first degree relative with condition
it is a risk factor for ovarian and breast cancer

Question 26

Endometriosis signs and symptoms:

Answer 26

Chronic pelvic pain
Dysmenorrhea- painful menstruation
Dyspareunia- difficult or painful intercourse
Low back pain
Dyschezia- excessive straining with stools
Menorrhagia- abnormally heavy bleeding at menstruation
Metrorhagia- abnormal bleeding from the uterus
Cylical bowel and bladder symptoms
Infertility

Question 27

Differential diagnosis for endometriosis:

Answer 27

pelvic inflammatory disease
ovarian cysts
recurrent UTI
irritable bowel disease

Question 28

PT for endometriosis:

Answer 28

Postural Exercises
Breathing Exercises
Soft Tissue Mobilization and Massage
Stretching
Pelvic Floor Musculature Strengthening

Question 29

Carcinoma

Answer 29

tissue of origin is epithelial

Question 30

ADENOCARCINOMA

Answer 30

MALIGNANCY IN GLANDULAR TISSUE

Question 31

Tumors of the large intestine / colon are described as:

Answer 31

polyps that protrude into the lumen of the gut
Can be sessile (raised mucosal nodules) or pedunculated (attached by a stalk)
Histopathologic appearance: hyperplastic or adenomatous
Neoplastic potential: benign or malignant

Question 32

Risk factors for colon cancer:

Answer 32

genetic
environmental exposure to toxins
lifestyle: obesity, diabetes 2, excess alcohol use
african american men

Question 33

Hallmark findings in colon cancer:

Answer 33

Changes in bowel habits
Constipation
Uncomfortable bowel movements
Changes in stool: narrower (pencil thin)
Feeling of incomplete emptying
Abdominal discomfort
Bleeding
Constant fatigue
Unexplained weight loss
Iron deficiency/anemia

Question 34

Early stages of colon cancer:

Answer 34

Rectal bleeding, hemorrhoids
Pain in abdominals, pelvic, back, or sacrum
Pain in back that radiates down legs
Changes in bowel patterns

Question 35

Advanced stages of colon cancer:

Answer 35

Constipation progresses to obstipation
Diarrhea accompanied by a lot of mucous
Nausea, vomiting
Abdominal distention
Weight loss
Fatigue, dyspnea, fever

Question 36

Differential diagnosis for colon cancer:

Answer 36

Crohns disease
UC
rectal bleeding