Duke PA Approach to the Patient with Gastrointestinal Disease
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| accessory organs to the GI system | salivary glands, liver, gall bladder, pancreas
🗑
|
||||
| many GI disorders are __, which means there is a lack of laboratory or radiographic abnormalities | functional
🗑
|
||||
| chronic or recurrent pain or discomfort in the upper abdomen. Incorporates a variety of symptoms including early satiety or fullness. | dyspepsia
🗑
|
||||
| dyspepsia is a diagnosis of __ | exclusion
🗑
|
||||
| hematemesis is more commonly associated with __ | upper GI bleeds
🗑
|
||||
| hematochezia is more commonly associated with __ | lower GI bleeds
🗑
|
||||
| __ fibers are more associated with visceral pain | C
🗑
|
||||
| __ fibers are more associated with parietal pain and is more sharp in nature | A
🗑
|
||||
| __ pain is poorly localized, and is produced by dermatome that innervates the involved tissue | visceral
🗑
|
||||
| __ pain is initiated by pain receptors in parietal peritoneum, is sharp and well localized | somatic
🗑
|
||||
| __ is poorly localized, and is felt in areas that may be remote from site of disease | referred
🗑
|
||||
| __ has a very high predictive rate for appendicitis | anorexia
🗑
|
||||
| patients with __ pain resist movement | peritoneal
🗑
|
||||
| if movement (jumping jacks) causes abdominal pain think __ | peritoneal
🗑
|
||||
| abdominal pain that doesn't interfere with sleep is associated with __ | IBS
🗑
|
||||
| __ pain gets better after a bowel movement | IBS
🗑
|
||||
| any inoccent diagnosis is always a diagnosis of __ | exclusion
🗑
|
||||
| some common causes of chronic abdominal pain | GERD, non-ulcer dyspepsia, IBS, IBD, chronic pancreatitis, infectious diarrhea
🗑
|
||||
| pain or discomfort is the predominant feature of __, this distinguishes it from GERD | Dyspepsia
🗑
|
||||
| only patients with __ of dyspepsia require management | dyspepsia
🗑
|
||||
| in the setting of dyspepsia some warning signs for cancer are | bleeding, anemia, weight loss >10% of body weight, progressive dysphagia, odynophagia, persistant vomiting, history of PUD, FH of malignancy, abdominal mass
🗑
|
||||
| 20th century disease associated with western lifestyle | diverticular disease
🗑
|
||||
| diverticulosis is most commonly found in what region | sigmoid colon
🗑
|
||||
| __% of patients with diverticular disease will develop diverticulitis | 20
🗑
|
||||
| presence of small mucosal herniations in colonic wall | diverticulosis
🗑
|
||||
| inflammation of diverticula | diverticulitis
🗑
|
||||
| diverticular pain is most common in the __ region | LLQ, suprapubic
🗑
|
||||
| can present as left sided appendicitis | diverticulitis
🗑
|
||||
| associated symptoms of diverticulitis | fever, malaise, constipation, diarrhea, nausea, vomiting, dysuria, urinary frequency
🗑
|
||||
| lab evaluation with diverticulitis | leukocytosis with left shift
🗑
|
||||
| Imaging for diverticulitis | CT, plain films assess-free air, ileus, obstruction
🗑
|
||||
| classic antibiotic treatment for diverticulitis | cipro and metronidazole
🗑
|
||||
| treatment for diverticulitis | clear liquids, 7-10 day course of antibiotics (cipro/metronidazole)
🗑
|
||||
| complications of diverticulitis | bleeding,intra-abdominal abscesses, fistulas, obstruction
🗑
|
||||
| diverticular disease accounts for 50% of episodes of __ | lower GI bleed
🗑
|
||||
| acute upper GI bleeding is __x more common than lower GI bleeding | 3
🗑
|
||||
| most common causes of acute upper GI bleed | peptic ulcers, esophageal varices
🗑
|
||||
| most common causes of lower GI bleed | diverticulosis, vascular malformation
🗑
|
||||
| most common presentation of lower GI bleed | hematochezia
🗑
|
||||
| defined as increased frequency or fluidity of stool | diarrhea
🗑
|
||||
| diarrhea <6 weeks duration | acute diarrhea
🗑
|
||||
| diarrhea >6 weeks duration | chronic diarrhea
🗑
|
||||
| most common cause of acute diarrhea | infection
🗑
|
||||
| majority of acute diarrheas are __ in etiology | viral
🗑
|
||||
| double digit stools per day | C. dif
🗑
|
||||
| most common protozoan cause of chronic diarrhea | giardia
🗑
|
||||
| bulky, frothy stools | osmotic diarrhea
🗑
|
||||
| If I don't eat I don't get diarhea | osmotic diarrhea
🗑
|
||||
| greasy, frothy stools, diarrhea, and weight loss | fat malabsorption
🗑
|
||||
| steatorrhea | fat malabsorption
🗑
|
||||
| bloating, soft diarrhea | carbohydrate malabsorption
🗑
|
||||
| edema, muscle wasting | protein malabsorption
🗑
|
||||
| gold standard test for steatorrhea | fecal fat analysis
🗑
|
||||
| functional causes of constipation | low fiber diets, sedentary activities, slow transit time
🗑
|
||||
| new onset constipation in middle age and up should get __ | colonoscopy
🗑
|
||||
| drugs that cause constipation | calcium channel blockers, diuretics, anticholinergics
🗑
|
||||
| endocrine/metabolic disorders that cause constipation | diabetes, renal failure, hypercalcemia, hypothyroidism, hypokalemia
🗑
|
||||
| neurological causes of constipation | MS, Parkinson's, spinal cord disorders, Hirschsprung's disease, psychosis
🗑
|
||||
| acute causes of N/V | appendicitis, cholecystitis, pancreatitis, peritonitis, small or large bowel obstruction
🗑
|
||||
| chronic causes of N/V | esophageal disorders, PUD, gastric malignancy
🗑
|
||||
| difficulty swallowing | dysphagia
🗑
|
||||
| difficulty swallowing both liquids and solids | motility disorders
🗑
|
||||
| difficulty swallowing solids | mechanical obstruction
🗑
|
||||
| painful swallowing | odynophagia
🗑
|
||||
| pathophysiology of odynophagia | inflammation of esophageal mucosa
🗑
|
||||
| pyrosis | heart burn
🗑
|
||||
| classsic symptom of GERD | pyrosis
🗑
|
||||
| early satiety is worrisome for __ in older patients | malignancy
🗑
|
||||
| if you think your patient has a GI bleed you need to get __ | orthostatics
🗑
|
||||
| reason for not doing a rectal exam | you don't have a finger and the patient doesn't have a rectum
🗑
|
||||
| there should not be stool in the __ | rectal vault
🗑
|
||||
| if stool is present in the rectal vault do a __ | stool guaiac
🗑
|
||||
| with acute abdomen the most helpful thing to get is __ | CBC
🗑
|
||||
| study of choice for acute appendicitis in adults | CT
🗑
|
||||
| study of choice for acute appendicitis in children | ultrasound
🗑
|
||||
| the lower 10-15 cm of the colon | rectum
🗑
|
||||
| divides the squamous epithelium from mucosal or columnar epithelium in the anus | dentate line
🗑
|
||||
| marks where sensory fibers end in the anus | dentate line
🗑
|
||||
| pruritis ani | anal itching
🗑
|
||||
| chronic scratching can result in __ | lichenification, fissures, and infection
🗑
|
||||
| systemic illnesses that may cause pruritis ani | diabetes, malignancies, thyroid disease
🗑
|
||||
| ingested irritants that may cause pruritis ani | tomatoes, citrus, caffeinated drinks
🗑
|
||||
| infections that may cause pruritis ani | intertrigo, HPV, HSV, scabies, pinworms
🗑
|
||||
| medications that may cause pruritis ani | colchicine
🗑
|
||||
| sever pain with or immediately after bowel movement (described by patient as a cut) suggests | anal fissure
🗑
|
||||
| dull, aching pain after bowel movement suggests | extensive inflammation of internal hemorrhoids
🗑
|
||||
| BRBPR | bright red blood per rectum
🗑
|
||||
| bright red blood on paper after wiping | almost always from an anal rectal lesion (usually hemorrhoids)
🗑
|
||||
| most common reason for BRBPR in younger people | ulcerative colitis
🗑
|
||||
| when anal fissures are lateral suspect __ | underlying conditions such as TB, syphilis, occult abscesses or carcinoma
🗑
|
||||
| treatment for anal fissures | stool softeners, barrier ointments, sitz baths, topical steroids, nitro 2% ointment, botox
🗑
|
||||
| abnormal openings between anal canal and perianal skin | fistulas
🗑
|
||||
| painless bleeding after defecation is most common presentation for | internal hemorrhoids
🗑
|
||||
| rarely bleed but often exquisitely painful, especially if thrombosed | external hemorrhoids
🗑
|
||||
| exquisitely tender, bleed easily, usually caused by hard to pass stool | anal fissure
🗑
|
||||
| treatment for external hemorrhoids | sitz baths, topical steroids, stool softeners, early removal of clot if thrombosed, recovery is often prolonged
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
bwyche
Popular Medical sets