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33 Cards in this Set
- Front
- Back
What are the components of Charcot's triad?
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fever, jaundice, and right upper quadrant pain
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Reynold's pentad
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Charcot's triad plus shock and mental status changes. This is seen with cholangitis
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What is the strongest independent risk factor for AAA?
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Smoking
90 percent of patients with AAA have used tobacco |
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The classic triad for a ruptured AAA
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hypotension, back pain, and a pulsatile mass
present in only 25 to 50 percent of cases of the elderly |
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The four major causes of acute mesenteric ischemia are?
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arterial embolism, arterial thrombosis, nonocclusive ischemia, and mesenteric venous thrombosis
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Three most common causes of bowel obstruction
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hernias, tumors, adhesions (prior surg or Crohn's)
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Current Jelly stools are a symptom of?
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Intussusception
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S&S of hemorrhoids
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pain, BRBPR (bright red blood per rectum), sensation of tissue mass
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What is the main cause of PUD?
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H. pylori
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what are the clinical features of PUD?
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Abdominal pain, (often described as gnawing or burning)
Dyspepsia - (belching, bloating, distention, heartburn) or nausea is also reported. |
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what are the some of the complications of PUD?
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Bleeding, perforation, penetration
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What is the common treatment for PUD?
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1. remove irritating factors, (smoking, ETOH, NSAIDS)
2. Combination therapy - PPI with clarithromycin and amoxicillin - Bismuth plus TCN, metronidazole, and a PPI - ranitidine bismuth citrate, clarithromycin and amoxicillin, TCN or metronidazole |
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What is the definition of diarrhea?
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increased frequency or volume of stool (e.g. 3 or more liquid or semisolid stools daily for at least 2-3 consecutive days.
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What are some of the causes of diarrhea?
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Infectious, toxic, dietary (e.g. laxative use), or other GI disease
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Antibiotic associated diarrhea is always caused by
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C. diff colitis, which in the most severe cases causes the classic pseudomembranous colitis.
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Clinical features of secretory diarrhea
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Large volume without inflammation - indicates pancreatic insufficiency, ingestion of preformed bacterial toxins, or laxative use.
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Clinical features of inflammatory diarrhea (bloody diarrhea with fever)
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indicates invasive organisms or IBD
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WBCs in stool denote?
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inflammatory process
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Patients over age 50 with new onset constipation should be evaluated for?
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colon cancer
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Constipation is defined as?
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A decrease in stool volume and an increase in stool firmness accompanied by straining.
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Clinical features of small bowel obstruction (SBO)
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- abdominal pain, distention, vomiting of partially digested food, and obstipation
- bowel sounds are high-pitched and come in rushes. - upright radiographs may illustrate air-fluid levels |
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Treatment of SBO
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surgical, large bowel obstruction being more urgent than SBO
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Crohn's disease may involve?
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The mouth, esophagus, stomach, small intestine and large bowel. Most often the terminal ileum and right colon are involved, but the rectum is usually spared
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Complications of Crohn's disease include?
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fistulas, abscesses, aphthous ulcers, renal stones, and predisposition to colon cancer
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Symptoms of Crohn's disease
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- Diarrhea and abdominal cramps in a patient <40
- low-grade fever, polyarthralgia, anemia, and fatigue frequently are encountered - blood often present in stool |
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Symptoms of ulcerative colitis
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bloody, pus-filled diarrhea, tenesmus
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Difference of onset Crohn's disease & ulcerative colitis
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Crohn's has a gradual onset, UC can be sudden or gradual
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S/S of appendicitis
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-initially, intermittent periumbilical or epigastric pain
- after 12 hours, the pain usually moves to the RLQ (McBurney's point), becomes constant and is worsened by movement - nausea and anorexia are common - vomiting may occur, but after the onset of pain -Psoas sign and obturator sign - Leukocytosis (usually 10,000-20,000 cells/mL. Higher levels are associated with perforation and peritonitis -low-grade fever is common; high-grade fever is unlikely |
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Classic features of acute pancreatitis
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Classic presentation is epigastric pain radiating to the back. The pain typically lessens when the patient leans forward or lies in a fetal position.
- N/V are common - Fever, leukocytosis, and sterile peritonitis may occur - Severe hypovolemia, ARDS, and tachycardia of >130 indicate a grave prognosis |
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Labs with acute pancreatitis
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Serum amylase and lipase increase, usually > 3 times normal, within 24 h in 90% of cases; lipase remains elevated longer than amylase and is slightly more accurate for diagnosis
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Clinical features of chronic pancreatitis are the same as for acute with the addition of?
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fat malabsorption and steatorrhea late in the disease. Fecal fat will be elevated if malabsorption is present
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Symptoms and signs of cholangitis
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progressive obstructive jaundice, frequently associated with fatigue, pruritus, anorexia, and indigestion
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Cholecystitis s/s
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* Steady, severe pain and tenderness in the right hypochondrium or epigastrium.
* Nausea and vomiting. * Fever and leukocytosis. |