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88 Cards in this Set
- Front
- Back
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What is epigastric pain that radiates to the back, is gnawing, burning, boring, aching, pressing and hunger-like?
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Peptic Ulcer and Dyspepsia
*usually in the duodenum and stomach. Dyspepsia causes similar symptoms and no ulceration. |
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Where is cancer of the stomach usually located?
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The cardia and gastroesophageal junction. Predominately adenocarcinoma
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What is steady pain that is epigastric, radiating to the back and may be poorly localized?
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Acute pancreatitis
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What is steady deep pain that radiates to the back?
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Chronic pancreatitis
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What kind of pain is steady, deep, epigastric and in either quadrant?
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pancreatic cancer
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What is pain that is epigastric/right quadrant, radiating to the back, scapula, shoulder, steady, aching and not related to peristalsis?
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Sudden Obstruction of the cytic or common bile duct (biliary colic), Acute Cholesystitis
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What kind of pain may be cramping, LLQ, and eventually
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Acute inflammation of the colonic diverticula.
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What is pain that begins as poorly localized periumbilical pain followed by right lower quadrant pain that is mild--> increases in intensity to steady and severe.
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Acute Appendicitis
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What type of pain is best described as cramping?
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Acute mecanical obstruction
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Where is the pain for obstruction of the small bowel?
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periumbilical or upper abdominal
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Where is the pain for obstruction of the large bowel?
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Lower abdominal or generalized
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What type of pain may be periumbilical at first then diffuse, cramping to steady?
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Mesenteric ischemia: blood supply to the mesentary and bowel is blocked from thrombus or embolus.
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What is obstruction of the bowel lumen usually caused by?
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adhesions, hernias,cancer, diverticulitis (of colon).
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What kind of ulcer is most likely to wake the patient at night and occur intermittantly over a few weeks, disappear the re-occur?
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Duodenal ulcer
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Food and antacids will cause more relief in which type of ulcer?
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Duodenal
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Nausea, vomiting, belching, bloating, heartburn and weight loss are symptoms of what?
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Peptic or gastric ulcer
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Weight loss is more common in what type of ulcer?
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gastric
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Dyspepsia is most common in what age group?
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20-29 years
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People over 50 are most likely to get what kind of ulcer?
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Gastric ulcer
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People 30-60 get what kinds of ulcer most commonly?
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Duodenal Ulcer
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This history of pain is shorter in gastric ulcer or gastric cancer?
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Gastric cancer
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Gastric cancer has pain that is...
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persistent and slowly progressive
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What type of pain is definitively NOT relieved by foods and antacids?
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Stomach adenocarcinoma
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Anorexia, nausea, early satiety, weight loss, bleeding are symptoms of what?
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stomach cancer
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Food will aggravate
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stomach cancer
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What age group is most susceptible to stomach cancer?
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50-70
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What factors aggravate a pathology of the pancreas?
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Lying supine
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How does timing, pain and aggravating differ in acute and chronic pancreatitis?
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actue has an acute onset and persistent pain. Chronic is a chronic and recurrent course, BOTH have steady and deep pain. Alcohol aggravates chronic.
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Leaning forward with the trunk flexed alleviates what type of pain?
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Pancreatic
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Nausea, vomiting, abdominal distension, fever, diarrhea with fatty stools
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Pancreatitis. Fatty stools more common in chronic.
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A history or ETOH abuse and gallstones are risk factors for what?
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Acute and chronic pancreatitis
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What additional symptoms may be present for pancreatic cancer?
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weight loss, jaundice and depression
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What is characteristic for attacks of rapid onset, last several hours, subside gradually and often are recurrent?
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Biliary colic
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Anorexia, nausea, vomiting, fever, sudden movement and deep breathing are associated with what?
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Acute cholescystitis
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Actue pancreatitis, Acute cholestasis, Acute diverticulitis, Acute diarrhea, Appendicitis Chron's have what symptom in common
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fever
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What can present with fever, constipation and occasionally brief diarrhea?
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Acute diverticulitis
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Vomiting of what is characteristic of a high obstruction?
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BIle and mucous
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Vomiting of what is characteristic of a low obstruction?
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fecal material
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Vomiting, diarrhea (bloody), constipation and shock occur in what?
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Mesenteric Ischemia
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What occurs to suspect perforartion of appendix?
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Temporary stoppage of pain
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What type of dysphagia is not affected by attempts to swallow solid food?
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Oropharyngeal
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Aspiration into the lungs or regurgitation into the nose with attempts to swallow are characteristic of what problem?
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Oropharyngeal dysphasia due to motor disorders affecting the pharyngeal muscles.
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A long history of heartburn and relief with regurgitation are suggestive of what?
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Esophageal stricture
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What is pain in the chest, back, weight loss and improvement with regurgitation of bolus?
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esophageal cancer
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What is chest pain that mimics angina/MI and lasts minutes to hours?
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Diffuse esophageal spasm
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What esophageal disorder is associated with regurgitation at night, chest pain post eating and nocturnal cough
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Achlasia
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What two esophageal disorders present with similar symptoms?
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Scleroderma and Achlasia
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What is change in frequency or form of bowel movement without structural or chemical abnormality?
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IBS
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What causes hard stools with mucous, periods of diarrhea, intermittant pain for 12 weeks of preceeding 12 months. relief with defacation.
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IBS
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What can be attributed to change in bowel habits, diarrhea, abdominal pain, bleeding, tenesmus and pencil shaped stools?
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Cancer of the rectum or sigmoid colon
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Symtoms: Rectal fullness, abdominal pain, diarrhea, common in debilitated, elderly and bedridden
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Fecal impaction. DIarrhea occurs around it.
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What is colicky abdominal pain, distension?
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Obstructing lesions
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Currant jelly stools occur in what?
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Intussusception
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Pain from anal fissures, hemmhoroids and perirectal abcess can do what?
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Spasm of the external sphinctor and inhibition of the defacation reflex.
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What kinds of drugs cause constipation?
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Opiates, anticholinergics, antacids containing Calcium or aluminum
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What GI symptoms do you expect for depression?
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Constipation
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MS and hirschsprungs have what GI symptoms?
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Constipation
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Pregnancy, hypothyroidism and hypercalcemia affect the bowel how?
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Constipation
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Where does pain from duodenum and pancreas radiate?
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to the back
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Where does pain from the biliary tree radiate?
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right shoulder and right posterior chest
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Pain from pleurisy or acute MI can be referred where in the abdomen?
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epigastric area
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Referred pain is well or diffusely localized?
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well localized
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What neuropeptides are associated with pain, bowel dysfuction and stress?
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substance P and 5-hydroxytryptophan
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What is the first thing to do in evaluating abdominal pain?
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Timing
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Doubling over with cramping colicky pain indicates what?
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renal stone
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Sudden knifelike epigastric pain occurs in what?
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gallstone pancreatitis
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Sensitivity to pain diminishes in what type of patients?
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older
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Angina from inferior wall CAD can present as what?
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Indigestion. But it is precipitated by excertion and relieved by rest
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What is chonic or recurrent discomfort centered in the upper abdomen?
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dyspepsia
*discomfort can be bloating, nauseam upper abdominal fullness and heartburn |
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Reduced salivary flow, delayed gastric emptying, medications and hiatal hernia are risk factors for what?
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GERD
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The following foods aggravate what?
Alcohol, chocolate, citrus, coffee onions, peppermint |
Heartburm
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Cough, wheezing and aspiration pneumonia are symptoms of what?
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GERD
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Hoarseness and chronic sore throat can be symptoms of what?
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GERD
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What patients need to have upper GI endoscopy?
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-don't respond to GERD Rx
-older than 55 with GERD sx -detect esophagitis, peptic strictures, barret's esophagus |
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What other conditions mimic appendicitis?
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PID, ruptured ovarian follicle, ectopic pregnancy
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What is cramping pain that radiates to the right or left lower quadrant?
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Renal stones
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What could be present if a patient has LLQ pain with a palpable mass?
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Diverticulitis
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What could be present with diffuse abdominal pain with absent bowel sounds, firmness, guarding, rebound on palpation?
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Small or large bowel obstruction
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Anorexia, nausea and vomiting are also seen with what?
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Pregnancy, diabetes, adrenal insufficiency, hypercalcemia, uremia, liver disease
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What is a raise in esophageal or gastric contents without nausea or retching called?
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regurgitation
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Small bowel obstruction and gastrocolic fistula give what characteristic to vomit?
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Fecal odor
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Coffee ground appearance of vomit suggests what?
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Blood altered by gastric acid
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What is the volume of blood lost when a patient experiences lightheadness and syncope?
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500 ml
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unpleasant abdominal fullness after a light meal occurs in?
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diabetic gastroparesis, anticholinergic meds, gastric outlet obstruction, gastric cancer, hepatitis
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What infections can cause esophageal ulceration?
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Candidia, CMV, herpes simplex
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What is the actual amount that defines diarrhea?
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200+ gm in 24 hours
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What is the time cutoff for acute diarrhea?
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2 weeks
*Chronic diarrhea |
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What sorts of pathology results in steatorrhea?
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Celiac Sprue, pancreatic insufficiency, small bowel bacterial overgrowth
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