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218 Cards in this Set
- Front
- Back
|
Ballance's sign
|
dullness LUQ, resonant RUQ
|
|
|
Beck's triad
|
JVD Decreased, muffled heart sounds decreased bp cardiac tamponade
|
|
|
bergman's triad
|
fat emboli mental status changes petechiae dyspnea
|
|
|
Blumer's shelf
|
mets to the rectouterine
|
|
|
boas sign
|
right subscapular pain from cholelithiasis
|
|
|
Borchardt's triad
|
emesis then no emesis epigastric distension failure to pass an NgTube gastric volvulus
|
|
|
Carcinoid
|
flushing diarrhea right sided heart failure
|
|
|
Charco's triad
|
Fever Jaundice RUQ pain
|
|
|
Chvostek's sign
|
twitching of facial muscles
|
|
|
Courvoisier's law
|
enlarged non-tender gallbladder seen w/ obstruction of the common bile duct most commonly w/ pancreatic cancer
|
|
|
Cullen's sign
|
blu periumbilical area- retroperitoneal hemorrhage tracking aroudn to the ant abdominal wall through fascial planes- acute hemorrhagic pancreatitis
|
|
|
Cushing's triad
|
HTN Bradycardia Irregular respirations
|
|
|
Danc'e sign
|
Empty right lower quadrant in kids w/ ileocecal intussusception
|
|
|
Fothergill's sign
|
differentiate intra-abdominal mass from 1 in the ab wall if mass is felt while there is tension on the musculature.
|
|
|
Fox's sign
|
ecchymosis of inguinal ligament seen w/ retroperitoneal bleeding
|
|
|
Hamman's sign/crunch
|
crunching on auscultation of the heart from emphysematous mediastinum, seen w/ oerhaave's syndrome, pneumomediastinum
|
|
|
Homan's sign
|
falf pain on forced dorsiflexion of the foot in DVT
|
|
|
Howship-Romberg sign
|
Pain along the inner aspect of the thigh; seen w/ obturator hernia as result of nerve compression.
|
|
|
Kehr's sign
|
severe shoulder pain in pts w/ splenic rupture- referred from diaphragm
|
|
|
Krukenberg tumor
|
mets to the ovary
|
|
|
Kelly's sign
|
visible peristalsis of the ureter
|
|
|
Laplace's law
|
Wall tension = pressure x radius
|
|
|
McBurney's point
|
1/3rd distance form the ant iliac spine to the umbilicus on a line connecting the two tenderness here is a sign of appendicitis.
|
|
|
Meckel's diverticulum rule of 2s
|
2% of population 2 of those are symptomatic 2 ft of the ileocecal valve
|
|
|
Mittleschmerz
|
low quadrant pain in ovulation
|
|
|
Reynold's pentad
|
Fever Jaundice RUQ pain Mental Status changes Shock/sepsis
|
|
|
Rovsing's sign
|
palpation of the LLQ-> pain in RLQ- appendicitis
|
|
|
Saint's triad
|
cholelithiasis Hiatal hernia Diverticular disease
|
|
|
Silk glove sign
|
indirect hernia sac in peds; sac feels like a finger of a silk glove when rolled.
|
|
|
Sister Mary Joseph's sign
|
Mets to umbilical lymph nodes
|
|
|
Virchow' snode
|
mets to left supraclavicular cancer
|
|
|
Virchow' striad
|
risk factors for thrombosis stasis abnl endothelium hypercoagulability
|
|
|
Trousseau's sign
|
carpal spasm after occlusion of blood.
|
|
|
Valentino's sign
|
RLQ pain from perfed peptic ulcer from succus/pus draining into RLQ
|
|
|
Westermark's sign
|
decreased pulm vasc marking on CXR in pt w/ pulmonary embolus
|
|
|
Whipple's triad
|
hypoglycemia CNS and vasomotor symps Relief of symps w/ admin of glucose
|
|
|
Wha is afferent loop syndrome
|
afferent loop of billroth II gastrojejunostomy
|
|
|
ARDS?
|
acute resp distress syndrome
|
|
|
what is blind loop syndrome
|
bacterial overgrowth of intestine caused by stasis
|
|
|
what is boerhaave's syndrome
|
esophageal perf
|
|
|
what is budd-chiari?
|
thrombosis of hepatic veins
|
|
|
dumping syndrome?
|
hyperosmolar chyme into the small bowel after vagotomy and a gastric drainage proccedure.
|
|
|
What is Fitz-Hugh-Curtis syndrome
|
perihepatic gonorrhea infection
|
|
|
what is gardner's syndrome
|
GI polyps SOD- sebaceous cysts, Osteomas, and Desmoid tumors.
|
|
|
What is mendelson's syndrome?
|
chemical pneumonitis after aspiration of gastric contents
|
|
|
What is mirizzi's syndrome
|
extrinsic obstruction of the common hepatic bile duct from a cystic duct gallstone
|
|
|
What is ogilvie's syndrome
|
nonobstructive colonic dilation
|
|
|
what is peutz-Jeghers
|
benign polyps
|
|
|
what is plummer-vison syndrome
|
esophageal web iron-deficiency anemia dysphagia spoon-shaped nails atrophic oral and tongue mucosa elderly, 10%- squamous cell carcinoma
|
|
|
what is RED reaction syndrome
|
skin erythema from vancomycin infusion
|
|
|
refeeding syndrome
|
hypoK, hypoMg, hypophos
|
|
|
What is Rendu-Osler-Weber syndrome
|
GI tract telangiectasia
|
|
|
what is short-gut?
|
malnutrition from 100cm of viable small bowel
|
|
|
what is sipple syndrome?
|
MEN II
|
|
|
what is tietze's syndrome?
|
costochondritis of rib cartilage; aseptic
|
|
|
what is trousseau's syndrome
|
DVT w/ carcinoma
|
|
|
Wermer's syndrome?
|
MEN I
|
|
|
What is another name for Crohn's
|
regional enteritis
|
|
|
What are common extra-intestinal manifestations of IBD?
|
A PIE SACK Aphthous ulcers Pyoderma gangrenosum Iritis Erythema nodosum Sclerosing cholngitis Arthritis, ankylosing spondylitis Clubbing of fingers kidney- amyloid, nephrotic syndrome
|
|
|
Crohn's epi: incidence populations sex distribution
|
3-6/100,000 jew, low in black; F>M 25-40; 50-65
|
|
|
UC: incidence populations sex distribution
|
10/100,000 Jews, low in AA, + FHx in 20% M>F 20-35; 50-65
|
|
|
What are the initial symptoms of Crohn's and UC?
|
Crohn's- ab pain, diarrhea, feer, weight loss, anal disease UC- bloody diarrhea, fever, weight loss
|
|
|
what is backwash ileitis?
|
mild inflammation of the terminal ileum in UC;
|
|
|
which involves the anus? UC or crohn's
|
crohn's
|
|
|
which involves the rectum? UC or crohn's
|
UC
|
|
|
what are the mucosal findings in crohn's?
|
aphthoid ulcers granulomas linear ulcers transverse fissues swollen mucosa Full thickness wall invovlement
|
|
|
what are the mucosal findings in UC?
|
granular, flat mucosa Ulcers Crypt abscess Dilated mucosal vessels Pseudopolyps
|
|
|
what meds are used for IBD?
|
sulfasalazine roids metronidazole azathioprine, infliximab
|
|
|
what is infliximab?
|
TNF-alpha antibody
|
|
|
what looks like a lead pipe on barium enema?
|
chronic UC
|
|
|
what are the intraop findings in crohn's?
|
fat creeping onto the antimesenteric border of the small bowel short and thick mesentery thick bowel wall fistula abscess
|
|
|
what is teh operation for short strictures of the small bowel in crohn's?
|
stricturoplasty.
|
|
|
what is pouchitis?
|
inflammtion of the pouch of an ileoanal pull through.
|
|
|
what do you need for crohn's resection?
|
grossly negative margins
|
|
|
What is an anal fistula?
|
rectum to perianal skin
|
|
|
what causes an anal fistula?
|
crypt/gland infection
|
|
|
what are the signs and symps of anal fistula?
|
perianal drainage, perirectal abcess, "diaper rash, itching
|
|
|
what disease should be considered with fistula in ano?
|
Crohn's
|
|
|
how is the dx made?
|
exam, proctoscope
|
|
|
what is goodsall's rule?
|
ant. fistulas go straight post. curl like a tail
|
|
|
What is the management of anal fistula?
|
define the anatomy, marsupialization of the tract - sitz baths and dressing changes - seton placement if fisutla is through the sphincter muscle
|
|
|
what is a aseton?
|
thick suture placed through fistula tract to slow transection of sphincer muscle- allow scar tissue formed to hold sphincter muscle in place. allow for continence
|
|
|
what % develop abcess after a fistula?
|
50%
|
|
|
how do you find an opening to the fistula in the OR?
|
methylene blue- look for bubbles.
|
|
|
what are the signs of a perirectal abscess?
|
rectal pain, drainage of pus, fever, perianal mass
|
|
|
what is the cause of a perianal abcess?
|
crypt abscess in dentate line w/ spread.
|
|
|
what is an inflammatory polyp?
|
pseudo polyp in UC
|
|
|
what is a hamartomatous polyp?
|
normal tissue in abnormal configuration
|
|
|
what is a hyperplastic polyp?
|
normal, benighn
|
|
|
what are the neoplastic polyps?
|
tubular adenomas tubulovillous adenomas villous adenomas
|
|
|
what determines malignant potential of a polyp?
|
size, histo, atypia?
|
|
|
what is the most common type of adenomatous polyp?
|
tubular
|
|
|
what is the size cut off for a polyp to have tumor potential?
|
2cm is high risk 33-55%
|
|
|
What is the cancer potential of a polyp?
|
villous > tubovillous > tubular
|
|
|
What is the % of carcinomas found in the polyps?
|
tubular- 5% tubulovillous 20% Villous- 40%
|
|
|
where are polyps found?
|
rectosigmoid
|
|
|
what are the signs/symps of rectal polyps?
|
bleeding, change in bowel habits, mucus per rectum, electrolyte loss, totally asymptomatic
|
|
|
what are teh diagnostic tests for polyps?
|
fecal occult blood, CBC, BE, endoscopy; all suspect tissue should be biopsied and sent to path.
|
|
|
what is the Rx of polyps?
|
endoscopic resection;
|
|
|
What gene is affected in FP?
|
APC gene
|
|
|
What are teh signs/ symps of SBO?
|
ab discomfort, cramping, nausea, ab distention, emesis, high-pitched bowel sounds
|
|
|
What labs should be ordered w/ an SBO?
|
E-lytes, CBC, type and screen, urinalysis
|
|
|
what are classic electrolyte/acid-base findings w/ proximal obstruction?
|
hypovolemic, hypochloremic, hypokalemic, alkalosis
|
|
|
what must be ruled out on an SBO exam?
|
hernia incarceration
|
|
|
what major AXR findings are associated w/ SBO?
|
distended loops of bowel, air fluid levels on upright film
|
|
|
what is the danger of complete SBO?
|
closed loop strangulation of the bowel-> necrosis
|
|
|
what is the initial management of all pts w/ SBO?
|
NPO, NGT, IVF, Foley
|
|
|
what are the tests that can differentiate partial from complete SBO?
|
CT w/ oral contrast, small bowel follow through.
|
|
|
what are teh causes of SBO?
|
ABC GIVES BAD CRAMPS Adhesions Bulge- hernia Cancer Gallstone ileus intussusception Volvulus External compression SMA syndrome Bezoars, Bowel wall hematoma Abcesses Diverticuliltis Crohn's disease Radiation enteritis Annular pancreas Meckel's diverticulum Peritoneal adhesions Stricture
|
|
|
Ballance's sign
|
dullness LUQ, resonant RUQ
|
|
|
Beck's triad
|
JVD Decreased, muffled heart sounds decreased bp cardiac tamponade
|
|
|
bergman's triad
|
fat emboli mental status changes petechiae dyspnea
|
|
|
Blumer's shelf
|
mets to the rectouterine
|
|
|
boas sign
|
right subscapular pain from cholelithiasis
|
|
|
Borchardt's triad
|
emesis then no emesis epigastric distension failure to pass an NgTube gastric volvulus
|
|
|
Carcinoid
|
flushing diarrhea right sided heart failure
|
|
|
Charco's triad
|
Fever Jaundice RUQ pain
|
|
|
Chvostek's sign
|
twitching of facial muscles
|
|
|
Courvoisier's law
|
enlarged non-tender gallbladder seen w/ obstruction of the common bile duct most commonly w/ pancreatic cancer
|
|
|
Cullen's sign
|
blu periumbilical area- retroperitoneal hemorrhage tracking aroudn to the ant abdominal wall through fascial planes- acute hemorrhagic pancreatitis
|
|
|
Cushing's triad
|
HTN Bradycardia Irregular respirations
|
|
|
Danc'e sign
|
Empty right lower quadrant in kids w/ ileocecal intussusception
|
|
|
Fothergill's sign
|
differentiate intra-abdominal mass from 1 in the ab wall if mass is felt while there is tension on the musculature.
|
|
|
Fox's sign
|
ecchymosis of inguinal ligament seen w/ retroperitoneal bleeding
|
|
|
Hamman's sign/crunch
|
crunching on auscultation of the heart from emphysematous mediastinum, seen w/ oerhaave's syndrome, pneumomediastinum
|
|
|
Homan's sign
|
falf pain on forced dorsiflexion of the foot in DVT
|
|
|
Howship-Romberg sign
|
Pain along the inner aspect of the thigh; seen w/ obturator hernia as result of nerve compression.
|
|
|
Kehr's sign
|
severe shoulder pain in pts w/ splenic rupture- referred from diaphragm
|
|
|
Krukenberg tumor
|
mets to the ovary
|
|
|
Kelly's sign
|
visible peristalsis of the ureter
|
|
|
Laplace's law
|
Wall tension = pressure x radius
|
|
|
McBurney's point
|
1/3rd distance form the ant iliac spine to the umbilicus on a line connecting the two tenderness here is a sign of appendicitis.
|
|
|
Meckel's diverticulum rule of 2s
|
2% of population 2 of those are symptomatic 2 ft of the ileocecal valve
|
|
|
Mittleschmerz
|
low quadrant pain in ovulation
|
|
|
Reynold's pentad
|
Fever Jaundice RUQ pain Mental Status changes Shock/sepsis
|
|
|
Rovsing's sign
|
palpation of the LLQ-> pain in RLQ- appendicitis
|
|
|
Saint's triad
|
cholelithiasis Hiatal hernia Diverticular disease
|
|
|
Silk glove sign
|
indirect hernia sac in peds; sac feels like a finger of a silk glove when rolled.
|
|
|
Sister Mary Joseph's sign
|
Mets to umbilical lymph nodes
|
|
|
Virchow' snode
|
mets to left supraclavicular cancer
|
|
|
Virchow' striad
|
risk factors for thrombosis stasis abnl endothelium hypercoagulability
|
|
|
Trousseau's sign
|
carpal spasm after occlusion of blood.
|
|
|
Valentino's sign
|
RLQ pain from perfed peptic ulcer from succus/pus draining into RLQ
|
|
|
Westermark's sign
|
decreased pulm vasc marking on CXR in pt w/ pulmonary embolus
|
|
|
Whipple's triad
|
hypoglycemia CNS and vasomotor symps Relief of symps w/ admin of glucose
|
|
|
Wha is afferent loop syndrome
|
afferent loop of billroth II gastrojejunostomy
|
|
|
ARDS?
|
acute resp distress syndrome
|
|
|
what is blind loop syndrome
|
bacterial overgrowth of intestine caused by stasis
|
|
|
what is boerhaave's syndrome
|
esophageal perf
|
|
|
what is budd-chiari?
|
thrombosis of hepatic veins
|
|
|
dumping syndrome?
|
hyperosmolar chyme into the small bowel after vagotomy and a gastric drainage proccedure.
|
|
|
What is Fitz-Hugh-Curtis syndrome
|
perihepatic gonorrhea infection
|
|
|
what is gardner's syndrome
|
GI polyps SOD- sebaceous cysts, Osteomas, and Desmoid tumors.
|
|
|
What is mendelson's syndrome?
|
chemical pneumonitis after aspiration of gastric contents
|
|
|
What is mirizzi's syndrome
|
extrinsic obstruction of the common hepatic bile duct from a cystic duct gallstone
|
|
|
What is ogilvie's syndrome
|
nonobstructive colonic dilation
|
|
|
what is peutz-Jeghers
|
benign polyps
|
|
|
what is plummer-vison syndrome
|
esophageal web iron-deficiency anemia dysphagia spoon-shaped nails atrophic oral and tongue mucosa elderly, 10%- squamous cell carcinoma
|
|
|
what is RED reaction syndrome
|
skin erythema from vancomycin infusion
|
|
|
refeeding syndrome
|
hypoK, hypoMg, hypophos
|
|
|
What is Rendu-Osler-Weber syndrome
|
GI tract telangiectasia
|
|
|
what is short-gut?
|
malnutrition from 100cm of viable small bowel
|
|
|
what is sipple syndrome?
|
MEN II
|
|
|
what is tietze's syndrome?
|
costochondritis of rib cartilage; aseptic
|
|
|
what is trousseau's syndrome
|
DVT w/ carcinoma
|
|
|
Wermer's syndrome?
|
MEN I
|
|
|
What is another name for Crohn's
|
regional enteritis
|
|
|
What are common extra-intestinal manifestations of IBD?
|
A PIE SACK Aphthous ulcers Pyoderma gangrenosum Iritis Erythema nodosum Sclerosing cholngitis Arthritis, ankylosing spondylitis Clubbing of fingers kidney- amyloid, nephrotic syndrome
|
|
|
Crohn's epi: incidence populations sex distribution
|
3-6/100,000 jew, low in black; F>M 25-40; 50-65
|
|
|
UC: incidence populations sex distribution
|
10/100,000 Jews, low in AA, + FHx in 20% M>F 20-35; 50-65
|
|
|
What are the initial symptoms of Crohn's and UC?
|
Crohn's- ab pain, diarrhea, feer, weight loss, anal disease UC- bloody diarrhea, fever, weight loss
|
|
|
what is backwash ileitis?
|
mild inflammation of the terminal ileum in UC;
|
|
|
which involves the anus? UC or crohn's
|
crohn's
|
|
|
which involves the rectum? UC or crohn's
|
UC
|
|
|
what are the mucosal findings in crohn's?
|
aphthoid ulcers granulomas linear ulcers transverse fissues swollen mucosa Full thickness wall invovlement
|
|
|
what are the mucosal findings in UC?
|
granular, flat mucosa Ulcers Crypt abscess Dilated mucosal vessels Pseudopolyps
|
|
|
what meds are used for IBD?
|
sulfasalazine roids metronidazole azathioprine, infliximab
|
|
|
what is infliximab?
|
TNF-alpha antibody
|
|
|
what looks like a lead pipe on barium enema?
|
chronic UC
|
|
|
what are the intraop findings in crohn's?
|
fat creeping onto the antimesenteric border of the small bowel short and thick mesentery thick bowel wall fistula abscess
|
|
|
what is teh operation for short strictures of the small bowel in crohn's?
|
stricturoplasty.
|
|
|
what is pouchitis?
|
inflammtion of the pouch of an ileoanal pull through.
|
|
|
what do you need for crohn's resection?
|
grossly negative margins
|
|
|
What is an anal fistula?
|
rectum to perianal skin
|
|
|
what causes an anal fistula?
|
crypt/gland infection
|
|
|
what are the signs and symps of anal fistula?
|
perianal drainage, perirectal abcess, "diaper rash, itching
|
|
|
what disease should be considered with fistula in ano?
|
Crohn's
|
|
|
how is the dx made?
|
exam, proctoscope
|
|
|
what is goodsall's rule?
|
ant. fistulas go straight post. curl like a tail
|
|
|
What is the management of anal fistula?
|
define the anatomy, marsupialization of the tract - sitz baths and dressing changes - seton placement if fisutla is through the sphincter muscle
|
|
|
what is a aseton?
|
thick suture placed through fistula tract to slow transection of sphincer muscle- allow scar tissue formed to hold sphincter muscle in place. allow for continence
|
|
|
what % develop abcess after a fistula?
|
50%
|
|
|
how do you find an opening to the fistula in the OR?
|
methylene blue- look for bubbles.
|
|
|
what are the signs of a perirectal abscess?
|
rectal pain, drainage of pus, fever, perianal mass
|
|
|
what is the cause of a perianal abcess?
|
crypt abscess in dentate line w/ spread.
|
|
|
what is an inflammatory polyp?
|
pseudo polyp in UC
|
|
|
what is a hamartomatous polyp?
|
normal tissue in abnormal configuration
|
|
|
what is a hyperplastic polyp?
|
normal, benighn
|
|
|
what are the neoplastic polyps?
|
tubular adenomas tubulovillous adenomas villous adenomas
|
|
|
what determines malignant potential of a polyp?
|
size, histo, atypia?
|
|
|
what is the most common type of adenomatous polyp?
|
tubular
|
|
|
what is the size cut off for a polyp to have tumor potential?
|
2cm is high risk 33-55%
|
|
|
What is the cancer potential of a polyp?
|
villous > tubovillous > tubular
|
|
|
What is the % of carcinomas found in the polyps?
|
tubular- 5% tubulovillous 20% Villous- 40%
|
|
|
where are polyps found?
|
rectosigmoid
|
|
|
what are the signs/symps of rectal polyps?
|
bleeding, change in bowel habits, mucus per rectum, electrolyte loss, totally asymptomatic
|
|
|
what are teh diagnostic tests for polyps?
|
fecal occult blood, CBC, BE, endoscopy; all suspect tissue should be biopsied and sent to path.
|
|
|
what is the Rx of polyps?
|
endoscopic resection;
|
|
|
What gene is affected in FP?
|
APC gene
|
|
|
What are teh signs/ symps of SBO?
|
ab discomfort, cramping, nausea, ab distention, emesis, high-pitched bowel sounds
|
|
|
What labs should be ordered w/ an SBO?
|
E-lytes, CBC, type and screen, urinalysis
|
|
|
what are classic electrolyte/acid-base findings w/ proximal obstruction?
|
hypovolemic, hypochloremic, hypokalemic, alkalosis
|
|
|
what must be ruled out on an SBO exam?
|
hernia incarceration
|
|
|
what major AXR findings are associated w/ SBO?
|
distended loops of bowel, air fluid levels on upright film
|
|
|
what is the danger of complete SBO?
|
closed loop strangulation of the bowel-> necrosis
|
|
|
what is the initial management of all pts w/ SBO?
|
NPO, NGT, IVF, Foley
|
|
|
what are the tests that can differentiate partial from complete SBO?
|
CT w/ oral contrast, small bowel follow through.
|
|
|
what are teh causes of SBO?
|
ABC GIVES BAD CRAMPS Adhesions Bulge- hernia Cancer Gallstone ileus intussusception Volvulus External compression SMA syndrome Bezoars, Bowel wall hematoma Abcesses Diverticuliltis Crohn's disease Radiation enteritis Annular pancreas Meckel's diverticulum Peritoneal adhesions Stricture
|
