Unit2 Aaron Vargo

Front 1

What are two mnemonics that can be used to remember the parts of an admission order?

Back 1

AADC VAAN DISSL
ADMIT VITALS AND PHYSICAL EXAM

Front 2

What population is most at risk for cholelithiasis (gallstones)?

Back 2

Females, 60 years of age or older

Front 3

What quadrant would a patient with cholelithiasis have pain in?

Back 3

Right upper quadrant

Front 4

Back pain in between the shoulder blades and pain in the right shoulder may indicate what?

Back 4

Cholelithiasis (gallstones)

Front 5

When is a laparoscopic cholecystectomy indicated?

Back 5

Patient symptomatic
Gallbladder calcified
Stones over 3 cm

Front 6

What location is commonly thought of as the position of the appendix?

Back 6

McBurney's point

Front 7

What structure supplies the blood for the appendix?

Back 7

Mesoappendix - separate mesentery
Appendiceal artery

Front 8

What immunoglobulin is secreted by the submucosa of the appendix?

Back 8

IgA

Front 9

What mechanism causes the pain in appendicitis?

Back 9

Distention of lumen walls

Front 10

What mechanism leads to inflammation of the appendix?

Back 10

Impairment of lymphatic/venous drainage, causing mucosal ischemia

Front 11

Appendicitis occurs most commonly in what age population?

Back 11

10-30 years of age

Front 12

What are the 4 most common symptoms of appendicitis?

Back 12

Reflex anorexia
Nausea
Vomiting
Visceral pain

Front 13

Pain is experienced in what quadrant during appendicitis?

Back 13

Right lower quadrant

Front 14

What is known as pain in the right lower quadrant with compression of the left lower quadrant?

Back 14

Rovsing sign

Front 15

Psoas sign is what?

Back 15

pain elicited by extending the hip with the knee in full extension

Front 16

Psoas sign is positive in what?

Back 16

Appendicitis
Psoas inflammation

Front 17

Obturator sign is what?

Back 17

Pain increased by internal rotation and flexion of the right thigh

Front 18

Acute hypotension, tachycardia, a tense distended abdomen, and absent bowel sounds are indicative of what?

Back 18

Appendix perforation

Front 19

What is remarkable on a CBC of an appendicitis patient?

Back 19

Elevated WBCs
Elevated neutrophils

Front 20

Red blood cells in the urine are usually a sign of what?

Back 20

UTI

Front 21

What cells are contaminants in a urinalysis?

Back 21

Epithelial cells

Front 22

Which cast is a normal finding in concentrated urine?

Back 22

Hyaline

Front 23

Fatty casts in the urine are indicative of what?

Back 23

Heavy proteinuria

Front 24

What antibiotics can cause sulfur crystals in the urine?

Back 24

Sulfa antibiotics

Front 25

What is the normal range for alkaline phosphatase (ALP) in a CMP?

Back 25

30 to 120 U/L

Front 26

What is the normal range for chloride in a CMP?

Back 26

98 to 106 mEq/L

Front 27

A fever of over 101 and a WBC count over 18,000 in an appendicitis patient indicates what?

Back 27

Appendix rupture/perforation

Front 28

What is the recommended daily intake for calcium?

Back 28

1000 to 1500 mg/day

Front 29

What is the daily absorption of calcium?

Back 29

600 mg

Front 30

What 3 substances regulate calcium levels?

Back 30

Parathyroid hormone
Vitamin D
Calcitonin

Front 31

What hormone is secreted in response to low serum calcium?

Back 31

PTH

Front 32

Hypercalcemia is a serum calcium level over what?

Back 32

12 mg/dL

Front 33

90% of hypercalcemia cases are caused by what two conditions?

Back 33

Hyperparathyroidism
Cancer

Front 34

What is the most important thing to remember in treating hypercalcemia?

Back 34

Treat the underlying condition

Front 35

What four things should you remember about the presentation of hypercalcemia?

Back 35

Groans (constipation, malaise, abd pain)
Moans (behavioral changes)
Bones (bone pain)
Stones (kidney stones)

Front 36

What test involves the patient standing with knees straight, raising onto the toes, and then dropping onto the heels - all this causing abdominal pain?

Back 36

Markle's (HeelJar) Test
(test for peritoneal irritation)

Front 37

What is the most common GI disorder?

Back 37

GERD

Front 38

What GI disorder is characterized by inappropriate relaxation of the lower esophageal sphincter?

Back 38

GERD

Front 39

What is the most common symptom of GERD?

Back 39

Heartburn

Front 40

In what region do congenital hernias most often occur?

Back 40

Groin

Front 41

What is the most common type of abdominal wall hernia?

Back 41

Inguinal hernia

Front 42

What is the overall efficiency percentage for water absorption?

Back 42

99%

Front 43

What type of diarrhea results from ingestion of a poorly absorbed, osmotically active substance?

Back 43

Osmotic diarrhea

Front 44

What type of diarrhea results from disordered electrolyte transport or reduced electrolyte absorption?

Back 44

Secretory

Front 45

What is the most common cause of secretory diarrhea?

Back 45

Infection

Front 46

What enzymes are responsible for chemical digestion in the mouth?

Back 46

Amylase
Lipase

Front 47

What enzyme is involved in the immediate breakdown of starches?

Back 47

Amylase

Front 48

What enzyme is involved in the breakdown of triglycerides?

Back 48

Lipase

Front 49

Lipase is activated when?

Back 49

When it comes in contact with the acidic environment of the stomach

Front 50

What are the four sections of the stomach?

Back 50

Cardia
Fundus
Body
Pylorus

Front 51

What are the 3 sections of the small intestines?

Back 51

Duodenum
Jejunum
Ileum

Front 52

Absorbing monosaccharides, amino acids, lipids, vitamins, electrolytes, and water are functions of what?

Back 52

Small intestines

Front 53

Completing absorption, producing vitamines, forming feces, and eliminating feces are functions of what?

Back 53

Large intestines

Front 54

A mutation in the gene NOD2/CARD15 on chromosome 16 is associated with what disease?

Back 54

Crohn's disease

Front 55

What bacterial organism is found in the blood and interstitial tissue of many people with Crohn's disease?

Back 55

Mycobacterium avium

Front 56

The abdominal wall is innervated by what nerves?

Back 56

T7 - T12
L1

Front 57

What nerve serves the umbilicus?

Back 57

T10

Front 58

What abdominal muscle originates in the pubis and the pubic symphysis?

Back 58

Rectus abdominis

Front 59

What abdominal muscle originates at the lower 8 ribs?

Back 59

External abdominal oblique

Front 60

Which type of gangrene is caused by insufficient blood supply?

Back 60

Dry

Front 61

What causes the black coloration of gangrenous tissue?

Back 61

Hydrogen sulfide produced by bacteria, resulting in black iron sulfide that remains in the tissues

Front 62

What bacteria most often causes wet gangrene?

Back 62

S. pyogenes

Front 63

What bacteria is responsible for gas gangrene?

Back 63

Clostridium perfringes

Front 64

Abnormal vaginal bleeding, pelvic pain, and an adnexal mass are indicative of what in a female?

Back 64

Ectopic pregnancy

Front 65

What is the length of a normal adult appendix?

Back 65

6-15 cm

Front 66

What is the diameter of a normal adult appendix?

Back 66

0.3 - 1.0 cm
Mean 0.7 cm

Front 67

What is a fecalith?

Back 67

A hard mass consisting of thickened feces

Front 68

What is the wall thickness in a normal adult appendix?

Back 68

Less than 0.3 cm
Mean 0.15 cm

Front 69

What is the name of epithelial cells that secrete mucus?

Back 69

Goblet cells

Front 70

What are the two layers of the abdominal fascia?

Back 70

Camper's (superficial fatty layer)
Scarpa's (deep membranous)

Front 71

What nerves serve the intestines, rectum, & anus?

Back 71

L1, L2

Front 72

What nerves serve the kidney & adrenal gland?

Back 72

T10, T11

Front 73

What nerves serve the liver, gallbladder, stomach, pancreas, & spleen?

Back 73

T5-T9

Front 74

What are the layers of the abdominal musculature that a surgeon must cut through to get to the appendix?

Back 74

External oblique
Internal oblique
Transversus abdominis
Peritoneum

Front 75

Cholecystitis presents with pain in what quadrant?

Back 75

RUQ

Front 76

Hepatitis could present with pain in what quadrant?

Back 76

RUQ

Front 77

Pancreatitis could present with pain where?

Back 77

Epigastric region

Front 78

What infection is often associated with peptic ulcer disease?

Back 78

H. pylori

Front 79

What is the name for a sharp increase in tenderness with a sudden stop in inspiratory effort?

Back 79

Murphy's sign

Front 80

What sign is associated with cholecystitis?

Back 80

Murphy's sign

Front 81

A patient's abdominal wall pain increases when they raise their head and shoulders while laying in a supine position. What sign is this?

Back 81

Carnett's sign

Front 82

What is the most common cause of left lower quadrant pain in adults?

Back 82

Diverticulitis

Front 83

Ureterolithiasis is most likely to present with pain in what quadrant?

Back 83

RLQ

Front 84

Acute cholangitis presents with pain in what quadrant?

Back 84

RUQ

Front 85

Cholangitis is what?

Back 85

Inflammation of the bile duct or the entire biliary tree

Front 86

Clay colored stools are associated with what liver disease?

Back 86

Hepatitis

Front 87

Salpingitis is what?

Back 87

1) Inflammation of the uterine tube
2) inflammation of the pharyngotympanic tube

Front 88

What are 3 symptoms of diverticulitis?

Back 88

Fever/chills
Anorexia
Constipation

Front 89

What is the normal range of daily urine output in adults?

Back 89

750 - 2000 mL

Front 90

Constipation is fewer than how many stools per week(for women and men)?

Back 90

Less than 3/week for females
Less than 5/week for males

Front 91

What is the greatest risk factor for an abdominal aortic aneurysm?

Back 91

Atherosclerosis

Front 92

For ATP to be biologically active, it must be bound to what electrolyte?

Back 92

Magnesium

Front 93

Parathyroid hormone affects what 3 electrolytes?

Back 93

Phosphorus
Magnesium
Calcium

Front 94

Increased magnesium and phosphorus can be indicators of what?

Back 94

Chronic renal failure

Front 95

What hormone is a regulator of potassium?

Back 95

Aldosterone