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PBL exams > Rotation 1 > Flashcards

Rotation 1 Flashcards

1
Q

McBurney’s sign

A

pain w palpation of RLQ

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2
Q

Rovsing’s sign

A

palpation or rebound pressure of the LLQ results in pain in RLQ

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3
Q

Obturator sign

A

pain in RLQ when flexed right thigh is internally rotated when pt is supine

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4
Q

psoas sign

A

pt is supine and attempts to raise right leg against resistance

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5
Q

where does pain start and end for appendicitis

A

begins in epigastrium –> umbilicus –> RLQ

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6
Q

appendicit is unlikely if

A

pt is hungry

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7
Q

common blood test findings in appendicitis

A

leukocytosis

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8
Q

on which side of the abdomen is diverticulosis/diverticulitis MC

A

left side

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9
Q

test of choice for diverticulosis

A

colonoscopy

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10
Q

test of choice for diverticulitis

A

CT scan

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11
Q

what type of diverticulitis can mimic appendicitis

A

cecal diverticulitis

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12
Q

what remains causing meckel’s diverticulus

A

vitelline duct

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13
Q

what is the MC congenital anomaly of the GI tract

A

Meckel’s diverticulum

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14
Q

Rule of 2’s for Meckel’s diverticulum

A

2% of population
Within 2 ft from ileocecal valve
2% symptomatic
2 inches in length
2 types of ectopic tissue (gastric MC or pancreatic)
2 years MC age
2x mc in males

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15
Q

Familial adenomatous polyposis is due to

A

mutation in APC gene

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16
Q

what is familial adenomatous polyposis + tx

A

they get hella adenomatous polyps
prophylactic colostomy best chance for survival

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17
Q

in which syndrome is there hamartomatous polyps and mucocutaneous hyperpigmentation

A

Peutz-Jehgers

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18
Q

what is the MC cause of occult GI bleed

A

Colon CA

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19
Q

what is the MC cause of large bowel obstruction

A

colon CA

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20
Q

Common sx in proximal/right sided colon CA

A

chronic occult bleeding
diarrhea

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21
Q

common sx in distal/left sided colon CA

A

bowel obstruction
changes in stool diameter

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22
Q

what will you see on barium enema for colon CA

A

apple core lesion

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23
Q

what is the most commonly monitored tumor marker for colon CA

A

CEA (carinoembryonic antigen)

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24
Q

characteristics of Crohn’s disease

A

transmural inflammation that affects any part of the GI tract (anywhere from mouth to anus)

Can lead to fistulas, bowel strictures, perianal disease, abscesses

Skip areas of involvement

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25
Q

what is the most commonly involved segment involved in crohns disease and on what side is it located

A

terminal ileum (on the right side)

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26
Q

cardinal sx of crohns disease

A

crampy abdominal pain
chronic, persistent, but intermittent diarrhea

no gross blood

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27
Q

what will upper GI series show for crohns disease

A

string sign

28
Q

what will labs likely show for crohns disease

A

positive anti-saccharomyces cerevisiae antibodies
iron deficiency
b12 deficiency

29
Q

ulcerative colitis

A

chronic, intermittent inflammation of the colon limited to the mucosal and submucosal layers

usually involves the rectum and may extend proximally to the colon in a continuous, circumferential pattern

30
Q

who is less likely to develop ulcerative colitis

A

smokers
someone who had appendectomy

31
Q

sx of ulcerative colitis

A

hematochezia
diarrhea which may be associated w blood and/or mucus (bloody diarrhea main sx)
abdominal pain (LLQ)

32
Q

what will double contrast barium enema show for ulcerative colitis

A

stovepipe or lead pipe sign - cylindrical bowel or loss of haustral markings

33
Q

labs for ulcerative colitis

A

P-ANCA

34
Q

common signs for testicular torsion

A

negative prehn sign = no pain relief w elevation
negative cremasteric reflex on affected side = no elevation of the stifle after stroking inner thigh

35
Q

when should you do surgical exploration for testicular torsion

A

within 6 hours

36
Q

MC cause of epididymitis in 14-35 yo

A

chlamydia trachomatis (MC) and neisseria gonorrhoeae

37
Q

MC cause of epididymitis in > 35 yo

A

E coli

38
Q

sx of epididymitis

A

gradual onset (over a few hours to days) of localized testicular pain and swelling

39
Q

exam signs for epididymitis

A

positive prehn sign = pain relief w elevation of scrotum
positive cremasteric reflex = elevation of testicle after stroking inner thigh

40
Q

MC imaging for testicular torsion

A

testicular dopper ultrasound

41
Q

MC imaging for epididymitis

A

scrotal ultrasound

42
Q

in what population is multiple sclerosis more common

A

women in 20s-30s

43
Q

MC presenting sx in multiple sclerosis

A

sensory disturbances followed by weakness and visual disturbances (diplopia, optic neuritis)
trigeminal neuralgia

44
Q

what is uhthoff’s phenomenon and in what disease is it present

A

worsening of sx with heat
present in multiple sclerosis

45
Q

what type of signs, UMN or LMN signs will you see in multiple sclerosis

A

UMN - spasticity, hyperreflexia, upward babinski, rigidity

46
Q

what is Lhermitte’s sign and in what disease do you see this sign

A

neck flexion causing lightening-shock type pain radiating from spine down the leg
present in multiple sclerosis

47
Q

what is Marcus gunn pupil and in what disease do you see this

A

light from unaffected eye to affected eye –> pupil dilation
present in multiple sclerosis

48
Q

what is Charcot’s neurologic triad and in what disease do you see this

A

staccato speech, intentional tremor, nystagmus
present in multiple sclerosis

49
Q

will people with multiple sclerosis have bladder, bowel, or sexual dysfunction

A

yes

50
Q

MRI with gadolinium - MS

A

hyper intense white matter plaques (at least 2 areas)

51
Q

lumbar puncture if negative MRI- MS

A

increased IgG and oligoclonal bands

52
Q

acute exacerbation tx MS

A

IV high dose glucocorticoids
plasmapheresis if not responsive

53
Q

prevention of relapse and progression tx MS

A

beta interferon or Glatiramer

54
Q

what is myasthenia gravis

A

autoimmune peripheral nerve disorder of neuromuscular junction due to antibodies against acetylcholine receptor

55
Q

2 main clinical manifestations with myasthenia gravis

A

ocular weakness (pupils spared)
generalized weakness worsened w repeated use

56
Q

sensation and DTR in myasthenia gravis

A

usually preserved

57
Q

tx for myasthenic crisis or severe

A

IVIG or plasmapheresis

58
Q

long term tx myasthenia gravis

A

acetylcholinesterase inhibitors - Neostigmine or Pyridostigmine

59
Q

for what disease do patients usually have a thymectomy and chest CT/MRI to view enlargement of thymus

A

myasthenia gravis

60
Q

what do antibodies attack in Guillain barre

A

myelin sheath (Schwann cells)

61
Q

will people w Guillain barre have UMN or LMN signs

A

LMN - weakness, decreased DTR, flaccid paralysis

62
Q

sensation and DTRs in Guillain barre

A

decreased

63
Q

what is the MC presenting sx of ALS

A

asymmetric limb weakness

64
Q

what is usually spared in ALS

A

sensation
voluntary eye movement
sphincter function (bowel and bladder)
sexual function

65
Q

tx for ALS

A

Riluzone

PBL exams (1 decks)

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