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Clinical Skills > SM02 Mini2 > Flashcards

SM02 Mini2 Flashcards

1
Q

stigmata

A

specific diagnostic signs of a dz

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2
Q

spider angioma

A

stigma of liver dz

found on skin of face, neck, arms, & upper trunk (area of superior vena cava)

swollen blood vessel just below surface of skin often w/spiderweb appearance

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3
Q

ascites

A

accumulation of fluid in peritoneal cavity

causes abdominal swelling

often caused by liver dz

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4
Q

cholecystitis

A

inflammation of the gallbladder

often secondary to cholelithiasis

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5
Q

acute abdomen

A

condition of severe abdominal pain caused by acute dz or injury to internal organs

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6
Q

perinotitis

A

inflammation of peritoneum

typically caused by bacterial infection via blood or organ rupture

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7
Q

McBurney’s point

A

1/3 distance from ASIS (anterior superior iliac spine) to umbilicus on the R lower abdomen

most commonly corresponds to base of appendix

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8
Q

rebound tenderness

A

pain that occurs or worsens after removal of pressure

reliable sign of peritoneal inflammation

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9
Q

pyelonephritis

A

inflammation of kidney & renal pelvis

usually caused by bacterial infection

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10
Q

most common causes of acute abdominal pain

A

acute appendicitis

nonspecific abdominal pain

urological origin

intestinal obstruction

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11
Q

what is the most likely diagnosis when pain worsens w/jolting movements?

A

peritonitis

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12
Q

important considerations of abdominal pain

A
  • age
  • onset: time & mode
  • pain: location, radiation, severity
  • duration: acute or chronic
  • associated symptoms: nausea, emesis (color/quality/frequency), loss of appetite
  • bowel movements: quality, color, frequency
  • menstrual hx
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13
Q

vomiting w/parethesias, blurred vision, dysphagia, & muscle weakness is likely caused by?

A

food-borne toxins (food poisoning)

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14
Q

most acute diarrhea is caused by?

A

infectious origin

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15
Q

constipation is most commonly found in what patients?

A

elderly

opoid drug users

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16
Q

what qualifies constipation as chronic?

A

presence of symptoms for at least 12 weeks w/onset at least 6 months prior to diagnosis

  • must have 2 or more of:
    • hard lumpy stool
    • straining
    • sensation of incomplete evacuation
    • anorectal obstruction
    • loose stool are rare w/o laxative use
    • insuffficient criteria for IBS
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17
Q

differentiation of chronic constipation v. IBS-C

A

abdominal pain or discomfort 3+ days per month in pervious 3 months w/onset 6+ months prior to diagnosis

  • 2+ symptoms of:
    • improvement of pain or discomfort upon defecation
    • onset associated w/change in frequency of stool
    • onset associated w/change in form or appearance of stool
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18
Q

when is constipation an alarming symptom?

A
  • hematochezia
  • family hx of colon CA
  • IBD
  • anemia
  • positive fecal occult blood test
  • unexplained weight loss of 10+ lbs
  • refractory of treament
  • new-onset w/o evidence of potential primary cause
19
Q

abdominal exam prodecure

A

inspection

auscultation

percussion

palpation

20
Q

what causes increased peristaltic sounds?

A

irritation of bowl, usually by toxins

can be heard during early obstruction

usually distinguishes diarrheal illness from obstruction

21
Q

what causes abdominal rigidity?

A

reflex muscle spasm due to peritoneal irritation

may be unilateral & localized

hurts most upon movement

22
Q

how is abdominal wall v. viseral organ pain differentiated?

A

palpate the abdomen in area of tenderness while patient raises head off pillow or feet off table

this raises the abdominal wall away from the organs

if tenderness if unchanged, likely disorder of abdominal wall

23
Q

signs of acute appendicitis

A

shifting of pain form umbilicus to RLQ

abdominal movements are painful/doesn’t like to move torso

sudden onset of pain, loss of appetite, n/v/fever, in that order

hypoactive bowel sounds

severe tenderness w/rigidity

24
Q

physical exam tests for acute appendicitis

A

Psoas: + if retrocecal appendix (64%)

Rovsing

obturator: + if pelvis appendix (32%)

25
Q

fecolith

A

“stone” of feces

usually found in colon due to chronic constipation or megacolon

possible cause of appendicitis

26
Q

watery emesis is associated with?

A

appedicitis

27
Q

bilious emesis is associated with?

A

biliary obstruction

cholecystitis

28
Q

Psoas test

A

in supine position have pt lift R leg against pressure

+ if causes pain

indicative of retrocecal appendicitis

29
Q

obturator test

A

in supine position, bend pt’s R leg 90º at knee & hip, then internally rotate hip (move pt. foot toward you)

+ if pelvic appendicitis

30
Q

presentation of acute pancreatitis

A

sudden onset of unrelenting epigastric pain

radiate to back

due to acute peritoneal inflammation caused by pancreatic enzymes

n/v, fever, tachycardia, leukocytosis

31
Q

common causes of acute pancreatitis

A

cholelithiasis

alcoholism

32
Q

Grey-Turner sign

A

hemorrhagic pancretitis displaying flank ecchymosis

33
Q

Cullen sign

A

periumbilical ecchymosis

often associated with acute pancreatitis

34
Q

requirements for acute pancreatitis diagnosis

A
  • 2 or more of:
    • elevated amylase & lipase (3x+ normal)
    • typical epigastric pain
    • confirmatory findings on cross-sectional imaging (CT or MRI)
35
Q

cholelithiasis is most commonly caused by?

A

precipitation of cholesterol crystals due to increase cholesterol in bile or if bile salt & phospholipids decrease

36
Q

presentation of acute cholecystitis

A

RUQ pain, bilious emesis, bilious diarrhea, and fever

pain precipitates after fatty food intake

37
Q

what diagnostic test is best to confirm cholelithiasis or cholecystitis?

A

US

38
Q

most common causes of peptic ulcer dz

A

Helicobacter pylori infection

OR

NSAID use

rarely by gastrinoma

39
Q

presentation of peptic ulcer dz

A

burning epigastric pain

may also be described as sharp, dull, ache, “empty” or “hungry” feeling

occurs daily for weeks, resolve, and recur weeks to months later

pain occurs as gastric contents is emptied, thus worsens at night

not postprandial, no nausea or retrosternal pain, not associated w/belching or food intolerance

40
Q

signs of gastric perforation

A

rapid onset of mid-back pain

n/v

vomiting of bright red blood or coffee-grounds

tarry stool

41
Q

precipitating factors for diverticuli

A

low-fiber diet

high-amplitude contractions

constipation

weakness in colonic wall

42
Q

diverticular dz presentation

A

abd pain

fever

leukocytosis

anorexia

severe constipation

43
Q
A

Clinical Skills (7 decks)

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