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Nurp 500: Health Assessment > Week 10-GI > Flashcards

Week 10-GI Flashcards

1
Q

When voiding is inconvenient, brain can inhibit what?

A

Detrusor muscle

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2
Q

Odynophagia is:

A

Painful swallowing

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3
Q

Type of pain that is gnawing, burning, cramping, or aching:

A

Visceral pain

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4
Q

This occurs when hollow organs contract forcefully or are distended or stretched, or when the capsules of solid organs are stretched; can also happen with ischemia

A

Visceral pain

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5
Q

This type of pain is a steady, aching, more severe than visceral type of pain that occurs from inflammation of the parietal peritoneum (peritonitis); it is aggravated by coughing or moving, patients prefer to lie still

A

Parietal pain

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6
Q

This type of pain that is felt at more distant sites which are innervated at approximately the same spinal levels as the disordered structures.

A

Referred pain

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7
Q

Visceral pain in the RUQ suggests:

A

Liver distention against its capsule (hepatitis)

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8
Q

Visceral periumbilical pain suggests ____ then becomes ______ in the RLQ from inflammation of the parietal peritoneum

A

Early appendicitis from distention of the Inflamed appendix

Parietal pain

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9
Q

Referred pain to the ___ from pancreatic or duodenal origin.

A

Back

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10
Q

Referred pain from the Biliary tree to the :

A

Right scapular region or the right posterior thorax

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11
Q

Referred pain from pleurisy or inferior wall myocardial infarction to the ____.

A

Epigastric area

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12
Q

Sensitivity of pain increases or decreases in older adults?

A

Decreased

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13
Q

Colicky acute upper abdominal pain:

A

Renal stone

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14
Q

Sudden knife-like epigastric pain:

A

Pancreatitis

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15
Q

Epigastric pain:

A

GERD, pancreatitis, and perforated ulcers

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16
Q

RUQ/upper abdominal pain:

A

Cholecystitis and cholangitis

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17
Q

Pain precipitated by exertion consider:

A

CAD

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18
Q

Chronic, recurrent upper abdominal pain:

A

Dyspepsia

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19
Q

Negative feeling that is not painful:

A

Discomfort

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20
Q

3 month history of nonspecific upper abdominal discomfort or nausea not attributable to structural abnormalities or PUD.

A

Functional (non-ulcer) dyspepsia

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21
Q

Dysphagia, odynophagia, recurrent vomiting, evidence of GI bleed, early satiety, weight loss, anemia, rial factors for GI cancer, palpable mass, painless jaundice are all

A

Alarm symptoms in chronic upper abdominal discomfort/pain

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22
Q

Postprandial fullness, early satiety, epigastric pain/burning are symptoms of:

A

Dyspepsia

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23
Q

RLQ pain that migrates from periumbilical area plus abdominal wall rigidity is suspicious for:

A

Appendicitis

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24
Q

RLQ pain in women consider:

A

PID, ruptured ovarian cysts, ectopic pregnancy

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25
Q

LLQ pain plus palpable mass:

A

Diverticulitis

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26
Q

Diffuse abdominal pain, distention, hyperactive high-pitched bowel sounds and tenderness on palpation:

A

Small or large bowel obstruction

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27
Q

Pain, absent bowel sounds, rigidity, percussion tenderness, and guarding:

A

Peritonitis

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28
Q

Change in bowel habits with mass:

A

Colon cancer

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29
Q

Pain for 12 weeks in preceding 12 months, relief with defecation, change in frequency of bowel movements, change in form of stool:

A

IBS

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30
Q

Nocturnal diarrhea is usually:

A

Pathologic

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31
Q

Grey or light colored stools are called __ and are caused by ___?

A

Acholic stools

Obstructive jaundice

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32
Q

Acholic Stools with itchy skin consider:

A

Hepatitis A, B, C, alcoholic, toxic liver damage from meds/toxins, gallbladder disease or surgery

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33
Q

Melena is___

A

Black, tarry stool less than 100 ml blood from upper GI bleed

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34
Q

Red or maroon colored stool greater than 100 ml of blood with lower GI bleed:

A

Hematochezia

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35
Q

Feeling as if one cannot evacuate all the stool present:

A

Tenesmus

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36
Q

Suprapubic pain indicates:

A

Bladder disorder

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37
Q

Dysuria in women presents as:

A

Internal urethral discomfort or external across inflamed urethra

38
Q

Dysuria in men presents as:

A

Proximal to glans penis, prostatic pain- in the Perineum and across the rectum

39
Q

Increase in urine volume in 24 hour period (>3L)

A

Polyuria

40
Q

Polyuria causes:

A

Psychogenic polydipsia, poorly controlled diabetes, decreased secretion of ADH of central DI

41
Q

Increased abdominal pressure causes bladder pressure to exceed urethral resistance (usually poor sphincter tone or poor support of bladder).

A

Stress incontinence

42
Q

Urgency is followed by involuntary leakage due to uncontrolled detrusor contractions that overcome urethral resistance.

A

Urge incontinence

43
Q

Neurological disorder or anatomic obstruction from pelvic organs or the prostrate limit bladder emptying until the bladder becomes over distended.

A

Overflow incontinence

44
Q

Combined incontinence is:

A

Stress and urge

45
Q

Functional incontinence is caused by:

A

Impaired cognition, MSK problems, immobility

46
Q

Screen all patients for alcohol abuse T/F?

A

True

47
Q

HAV is spread by:

A

Fecal/ oral transmission prevented with hand washing and bleach

48
Q

HAV does or does not become chronic?

A

Does not

49
Q

HBV is transmitted:

A

Sexual, percutaneous, mucosal transmission

50
Q

HBV can or cannot become chronic?

A

Can

51
Q

HCV transmission:

A

Percutaneous, blood or organ transplant before 1992, clotting factors before 1987, hemodialysis, healthcare workers with needle stick injury, birth to HSV positive mother.

52
Q

Chronic Illness occurs in what present of those infected with HCV?

A

75%

53
Q

Risk factors for colorectal cancer:

A

Increasing age, personal history, polyps, long-standing IBD, family hx. Weak- male, AA, tobacco use, excessive alcohol use, red meat consumption, obesity

54
Q

When to start screening for colorectal cancer?

A

Adults 50-75

55
Q

How to screen for colorectal cancer?

A
  1. ) high sensitivity FOBT annually
  2. ) sigmoidoscopy every 5 years with FOBT q3yrs
  3. ) screening colonoscopy every 10 years
56
Q

Normal bowel sounds:

A

Clicks and gurgles, 5-34 per minute

57
Q

Rumbling bowel sounds:

A

Borborygmi

58
Q

These bowel sounds suggest vascular occlusive diagnosis:

A

Bruits

59
Q

If patient has HTN where should one auscultate in the abdominal?

A

Epigastrum and CVAs for renal artery stenosis

Aorta, iliac arteries and femoral arteries

60
Q

These bowel sounds are found over the liver and spleen and are present in hepatoma, gonococcal infection around the liver, splenic infarction, and pancreatic carcinoma.

A

Friction rubs

61
Q

These bowel sounds are a soft humming with both systolic and diastolic component and indicate collateral circulation between the portal and systemic venous systems (hepatic cirrhosis)

A

Venous hums

62
Q

Tympanic areas with percussion in the abdomen indicate:

A

Air/gas

63
Q

Dull areas with percussion of the abdomen indicate:

A

Mass or enlarged organ

64
Q

On inspiration, liver is palpable about __ below the right costal margin.

A

3cm

65
Q

If dullness is present over spleen this indicates:

A

Splenomegaly in 80% of patients

66
Q

This is when you percuss the lowest interspace- should be tympanic and should remain tympanic even with deep breath.

A

Splenic percussion sign

67
Q

Left hand behind and press forward, right hand below costal margin, press toward spleen:

A

Palapation for splenic edge

68
Q

CVA tenderness indicates:

A

Pyelonephritis/MSK

69
Q

Enlarged kidney caused by:

A

Hydronephrosis, cysts, tumors, polycystic kidney dz(bilateral)

70
Q

Aortic span should not be over:

A

3cm in adults of 50

71
Q

Ultrasound of the aorta is recommended for:

A

Men over 65 who have ever smoked

72
Q

Protuberant abdomen with bulging flanks:

A

Ascites, happens commonly with cirrhosis

73
Q

How to test for shifting dullness in abdomen?

A

Supine and then on side, without ascites border should stay the same

74
Q

How to test for a fluid wave in the abdomen?

A

Have someone push midline, tap on one flank sharply and feel opposite flank for an impulse

75
Q

Tests for appendicitis:

A 
Mcburney point
Rovsing sign
Psoas sign 
Obturator sign 
Rectal exam and pelvic in women
76
Q

When you press deeply into LLQ and assess for withdrawal pain?

A

Rovsing sign

77
Q

When you raise thigh against resistance or turn to left side and extend the right leg at the hip?

A

Psoas sign

78
Q

When you flex right thigh at hip and internally rotate hip?

A

Obturator

79
Q

When the patient exhales and the examiner places hand below costal margin on the right side at the mid-clavicular line and then the patient inspires. If the patient stops breathing in and winces with a catch in breath this is a:

A

Positive Murphy’s sign

80
Q

A positive Murphy’s sign indicates:

A

Acute cholecystitis due to an inflamed gallbladder being palpated as it descends on inspiration

81
Q

Ventral hernia:

A

Diastasis recti: 2-3 cm gap in rectus muscles

82
Q

These are detectable by a few weeks of age and disappear by 1 year, nearly all by 5:

A

Umbilical hernias

83
Q

A midline ridge that resolves during early childhood:

A

Diastasis recti

84
Q

These are generally easily palpated in newborns/infants?

A

Spleen and liver

85
Q

In peds a silent, tympanic, distended and tender abdomen suggests:

A

Peritonitis

86
Q

Abnormal palpation findings in peds:

A

Hydronephrosis (enlarged kidney)
Deep palpation in RUQ olive size firm pyloric mass (May have visible peristaltic waves followed by projectile vomiting)- pyloric stenosis

87
Q

Patient with peritonitis May present with:

A

Guarding, rigidity, rebound tenderness

88
Q

This is voluntary contraction of the abdominal wall often with grimace:

A

Guarding

89
Q

Involuntary reflex contraction of the ab wall from peritoneal inflammation:

A

Rigidity

90
Q

Kidney pain is an example of what type of pain?

A

Visceral

91
Q

Appendicitis typically presents with pain in what area?

A

Periumbilical migrating to RLQ

Nurp 500: Health Assessment (11 decks)

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