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ChiroBoards3:GI/Abd
ChiroBoards3: GI and Abdomen
Question | Answer |
---|---|
Early intestinal obstruction = increased/decreased Bowel sounds? | increased |
late intestinal obstruction = increased/decreased Bowel sounds? | absent (adynamic/paralytic ileus) |
Vomiting up blood, aka | Hematesis |
coughin up blood, aka | Hemoptysis |
blood in stool, aka | hematochesia |
Non-specific liver markers = | Alk phosphatase (increase); SGOT/AST; LDH |
Classic liver markers = | GGT; SGPT/ALT |
Markers of MI = (3) | CPK; SGOT/AST; LDH |
BUN seen with two organ dysfunctioning = | Liver (low BUN from processing issue) ; Kidney (high BUN from clearance issue) |
Most common cause of liver destruction (cirrhosis) = | alcoholism |
All of these listed can be seen with this liver condition = portal hypertension, ascites, esophageal varices, Mallory Weiss syndrome, and PALMER RASH (due to bile salts). | Cirrhosis |
Coughing, tearing esophageal blood vessels, and hematemesis indicates what condition? | Mallory Weiss syndrome |
Thiamin deficiency without alcoholism = | Beri Beri |
Thiamine deficiency in the brain = | Wernicke Korsakoff Syndrome (leads to dementia) |
Liver may be tender and enlarged. BUT the edge remains soft and smooth = | Hapatitis |
From food through fecal/oral route, self limiting, not a carrier = which hepatitis? | A |
M/C hepatitis? | A |
Dirty needles and sexual contact; carrier for life = which hepatitis? | B |
M/C to become liver cancer | B |
Blood transfusions = which hepatitis? | C |
M/C site for metastatic disease = | liver |
How does the liver present with cancer? | Enlarged, with a hard irregular border |
Alpha fetoprotein is a tumor marker specific for what? | hepatocellular carcinoma |
What is done to confirm hepatocellular carcinoma following a positive alpha fetoprotein blood test? | liver biopsy |
biliary duct obstruction increases which? conjugated or unconjugated bilirubin? | Conjugated |
which type of bilirubin is not water soluble? | unconjugated |
Which bilirubin increases with duct obstruction, hepatic dx, and pancreatic cancer | conjugated |
conjugated bilirubin increases with 3 scenarios: | duct obstruction, hepatic dx, and pancreatic cancer |
Which billirubin can cause urobilinogen (bilirubin in urine) if increased? | Both |
Which bilirubin increases with hemolytic dx, drugs, and spleen disorders? | unconjugated |
3 scenarios that will increase unconjugated bilirubin? | hemolytic dx, drugs, and spleen disorders |
Increased reticulocyte count occurs in this condition = | hemolytic anemia |
What tests for hemolytic anemia? (reticulocyte count) | Coomb's test |
Pain referral to right shoulder or tip of right scapula = | gallbladder (viscerosomatic) |
Cholecystitis: most common demographic | overweight females over 40 |
Cholecystitis: most common cause = | cholelithiasis |
Cholecystitis: Tests | Diagnostic ultrasound; oral cholecystogram; Murphy's sign, Inspiratory arrest Sign |
Gallbladder calcification that can become malignant due to chronic inflammation | Porcelain Gallbladder |
Epigastric pain going straight through the T10-T12 area like a knife = | pancreatitis (Viscerosomatic) |
Chronic pancreatitis most common cause = | alcoholism |
Acute pancreatitis a 911 emergency = T/F ? | true |
Grey Turner sign | bleeding into flanks |
Periumbilical ecchymosis is known as = | Cullen's sign |
Pancreatitis: Labs | Increased amylase and lipase |
What part of pancreas does cancer most commonly attack? | the head |
What does pancreatic cancer present with? (3) | dark urine, clay colored stools, and jaundice |
polydypsia, polyphagia, and polyuria is seen with this common condition = | DM |
Tests glucose levels over a 3 month time period = | HbA1C |
condition of posterior pituitary, resulting in insufficient ADH production | Diabetes Insipidus |
30% correlation between diabetes insipidus and what skeletal condition seen on xray? | DISH |
protrusion of stomach above the diaphragm | hiatal hernia |
presents with palpable tenderness in LUQ, reflex esophagitis, dyspepsia (indigestion), and made worse after eating large meal or laying down = condition? | Hiatal hernia |
Upward reflux of acid contents of the stomach into the esophagus | Reflux Esophagitis |
Reflux Esophagitis is caused by what physical condition? | sliding hiatal hernia |
Destruction of esophagus due to reflux esophagitis (cancer precursor) = | Barrett's Esophagus |
Caused by H. pylori and causes pain when waking, coffee ground emesis, and burning epiagastric pinpoint pain = | Peptic Ulcers |
Has no consistent pain pattern, though sometimes food causes the pain, and other times it relieves the pain = condition? | gastric ulcer |
This condition causes pain 2 hours after eating and causes black/tarry stool = | Duodenal ulcer |
Most common type of peptic ulcer = | Duodenal ulcer |
tests occult blood in stool = | Guaiac Test |
Causes projectile vomiting in a newborn = | pyloric stenosis |
Most common on the lesser curvature of stomach and affects the left supraclavicular lymph node | Stomach cancer |
which node does stomach cancer affect? | left supraclavicular lymph node (Virchow's node) |
left supraclavicular lymph node, aka = | Virchow's node |
Mononucleosis is caused by what virus? | Epstein Barr Virus |
Mononucleosis demopgraphic = | young adults (18-25yoa) |
Special test for mononucleosi = | Paul Bunnell test |
Paul Bunnel test (mononuc.), aka's = (2 more) | Monospot; Heterophile Agglutination |
presents with symptoms similar to the flue such as fever, headache, fatigue, lymphadenopathy in cervicals, and splenomegaly = | Mononucleosis |
Osteopetrosis, aka = | Marble bone |
Bone marrow becomes sclerotic so red blood cells aren't made. The liver and spleen make rbc's and become enlarged = what condition? | Osteopetrosis |
This organ's referral pain is to the peri-umbilical area = | Small-Intestines |
Gas in the intestines = | Adynamic ileus |
Regional ileus, aka = | Crohn's dx |
Crohn's more common in males or females? | females |
nonspecific inflammatory dx that affects the distal ileum and colon. | Crohn's |
Inflammation is patchy with healthy tissue in bewtween; which is referred to as cobblestone appearance = what condition? | Crohn's |
Crohn's dx causes poor absorption of this vitamin | B12 |
What symptoms can Crohn's present with? (2) | Presents with RLQ pain and chronic diarrhea |
Crohn's dx can lead to what kind of syndromes? | malabsorption syndromes (tropical spruce/celiac's) |
How is Crohn's diagnosed? | Sigmoidoscopy |
bilateral SI effusion on X-ray = | Sacroiliitis |
Sacroiliitis occurs with what gut condition? | Enteropathic Arthritis |
Irritable Bowel Syndrome, aka = | Spastic colon |
IBS causes degrees of constipations/diarrhea in response to __________ | stress |
IBS = more common in men or women? | womrn |
Abdominal pain and gas is relieved by what? in IBS | bowel movements |
Dull periumbilical pain that radiates to lower right quadrant occurs in what condition? | Appendicitis |
Dull periumbilical pain that radiates to lower right quadrant = Test name? | McBurney's point |
Increased WBC (Shilling shift to the left) = what condition? | Appendicitis |
Appendicitis = Exam tests = | McbBurney's Point, Rebound Tenderness (peritonitis), Roving's sign, Psoas sign, Obturator sign |
Special test for Appendicitis = | CT Scan |
chronic constipation causes small outpouchings within colon that becomes infected = condition? | Diverticulitis |
Diverticulitis occurs as a consquence of what inadequecy in the person's diet? | Fiber |
Diverticulitis is associated with pain in which quadrant? | LLQ |
Outpouching of the ileum = | Meckel's Diverticulitis |
Outpouching of Esophagus | Zenker's Diverticulitis |
Cancer of intestine that metastasizes to the liver, causing a release of liver enzymes in circulation and causes flushing in the face. | Carcinoid syndrome |
Cushing's dx = what specific part of this organ is directly related = | adrenal cortex |
Increased production of adrenal cortex hormones = hyperadrenalism and hypercortisolism (what condition?) | Cushing's |
What dx causes hypercortisolism and hyperadrenalism? | Cushing's |
Decreased aldosterone, hypoadrenalism, and hypocortisolism = what condition? | Addison's |
Thin person, decreased bp, hyperpigmented mouth and face, weakness, fatigue, lethargy, vomiting, and hairloss seen in the condition = | Addison's |
Grey Cell tumor of the adrenal medulla = condition? | Pheochromocytoma |
What neurotransmitter is increased in pheochromocytoma? | epinephrine |
causes tachycardia, jitters, and EXTREME HYPERTENSION (s&s similar to hyperthyroidism) | Pheochromocytoma |
Nephrolithiasis's are made of = | calcium = calcium oxalates (M/C), calcium urates, calcium phosphates |
Back pain radiating into the groin. (pain is writhing) = cause? | ureter stones |
What ortho tests for nephrolithiasis | murphy's punch test |
Lab tests for nephrolithiasis = (3) | increased BUN, Uric acid, Creatinine clearance |
Best lab test for nephrolithiasis | Creatinine Clearance |
Most common cause is hydronephrosis due to kidney stone = | Staghorn calculi (stone inside kidney) |
Acute glomerulonephritis, aka | Nephritic syndrome |
Bacterial cause for nephritic syndrome = | Caused by group A hemolytic strep (strep pyogenes-ASO titre) |
RBC casts in urine with small amounts of protein is seen with = | acute glomerulonephritis (Nephritic syndrome) |
HEP stands for = | hypertension, edema, massive proteinuria |
Waxy or fatty casts seen in urine with = what condition? | Nephrotic syndrome |
HEP is seen in what syndrome? | Nephrotic syndrome |
What is nephrotic syndrome called in pregnant women? | pre-eclampsia |
E-coli from UTI can cause what kidney disorder? | pyelonephritis |
This kidney disorder has WBC casts o UA ? | pyelonephritis |
Inherited disorder characterized by many bilateral renal cysts that increase renal size but reduce functional renal tissue = | Polycystic kidney disease |
Urethritis = caused by which bacteria in both males and females = | E coli in females; N. Gonorrhea in males |
nitirites in the urine in what particular -itis? | urethritis |
Non-infectious bladder inflammation that causes burning, painful, and frequent urination with incontinence. PAtient will also have suprapubic pain and low back pain = | Cystitis |
Nephroblastoma, aka = | Wilm's tumor |
Malignant tumor of the kidney, less than 5 years of age, abdominal mass, hematuria= describes what condition | Wilm's tumor |
Often called, "overactive bladder" = | Urinary Incontinence |
Urge, Stress, Overflow = describes what = | Urinary Incontinence |
What muscle weakness attributes to urinary incontinence | Urinary Incontinence |
Most common type of hernia | Indirect Inguinal hernia |
This hernia passes down the inguinal canal and exits at the external inguinal ring and into the scrotum = | Indirect Inguinal hernia |
This hernia occurs more frequently in children then in adults | Indirect Inguinal hernia |
Most common hernia in those over 40 yoa= | Direct Inguinal hernia |
Does not pass through the inguinal canal directly but exits through the external inguinal ring instead. | Direct Inguinal hernia |
This hernia is felt when the patient coughs or bears down = | Direct Inguinal hernia |
This hernia is typically aquired from obesity or heavy lifting | Direct Inguinal hernia |
Appears as a bulge lateral and inferior to the external inguinal ring at the site of the femoral pulse = | Femoral hernia |
abnormal endometrial tissue found outside its normal location. Most commonly found in ovaries = | Endometriosis |
Surgical procedure for endometriosis = | laparscopy |
uterus will have painless nodules that are irregular and firm = | Uterine Fibroids |
Presents with abdominal pain, back pain, menorrhagia, painful intercourse, and possible infertility = ( not an std) | Endometriosis |
Benign uterine tumors of smooth muscle origin (Leiomyoma) and presents with heavy menstrual bleeding, pelvic pain, and painful intercourse = | Uterine fibroids |
Infection of the upper female genital tract. It is most common complication of an STD. | Pelvic Inflammatory Disease |
PID is most common complication of these two STD's = | *Gonorrhea* and chlamydia |
Pregnancy in which implantation occurs outside the endometrial cavity | Ectopic pregnancy |
Presents with spotting, increase bp, and decreased HCG = what does this signify in a woman? | Ectopic pregnancy |
A non viable embryo which develops in the placenta with all the signs of pregnancy/ Very high HCG = | Hydatiform mole |
A malignancy of the placenta due to abnormal epithelium | Choriocarcinoma |