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33 Cards in this Set

  • Front
  • Back
What are the components of Charcot's triad?
fever, jaundice, and right upper quadrant pain
Reynold's pentad
Charcot's triad plus shock and mental status changes. This is seen with cholangitis
What is the strongest independent risk factor for AAA?
90 percent of patients with AAA have used tobacco
The classic triad for a ruptured AAA
hypotension, back pain, and a pulsatile mass

present in only 25 to 50 percent of cases of the elderly
The four major causes of acute mesenteric ischemia are?
arterial embolism, arterial thrombosis, nonocclusive ischemia, and mesenteric venous thrombosis
Three most common causes of bowel obstruction
hernias, tumors, adhesions (prior surg or Crohn's)
Current Jelly stools are a symptom of?
S&S of hemorrhoids
pain, BRBPR (bright red blood per rectum), sensation of tissue mass
What is the main cause of PUD?
H. pylori
what are the clinical features of PUD?
Abdominal pain, (often described as gnawing or burning)
Dyspepsia - (belching, bloating, distention, heartburn) or nausea is also reported.
what are the some of the complications of PUD?
Bleeding, perforation, penetration
What is the common treatment for PUD?
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
What is the definition of diarrhea?
increased frequency or volume of stool (e.g. 3 or more liquid or semisolid stools daily for at least 2-3 consecutive days.
What are some of the causes of diarrhea?
Infectious, toxic, dietary (e.g. laxative use), or other GI disease
Antibiotic associated diarrhea is always caused by
C. diff colitis, which in the most severe cases causes the classic pseudomembranous colitis.
Clinical features of secretory diarrhea
Large volume without inflammation - indicates pancreatic insufficiency, ingestion of preformed bacterial toxins, or laxative use.
Clinical features of inflammatory diarrhea (bloody diarrhea with fever)
indicates invasive organisms or IBD
WBCs in stool denote?
inflammatory process
Patients over age 50 with new onset constipation should be evaluated for?
colon cancer
Constipation is defined as?
A decrease in stool volume and an increase in stool firmness accompanied by straining.
Clinical features of small bowel obstruction (SBO)
- 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
Treatment of SBO
surgical, large bowel obstruction being more urgent than SBO
Crohn's disease may involve?
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
Complications of Crohn's disease include?
fistulas, abscesses, aphthous ulcers, renal stones, and predisposition to colon cancer
Symptoms of Crohn's disease
- Diarrhea and abdominal cramps in a patient <40
- low-grade fever, polyarthralgia, anemia, and fatigue frequently are encountered
- blood often present in stool
Symptoms of ulcerative colitis
bloody, pus-filled diarrhea, tenesmus
Difference of onset Crohn's disease & ulcerative colitis
Crohn's has a gradual onset, UC can be sudden or gradual
S/S of appendicitis
-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
Classic features of acute pancreatitis
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
Labs with acute pancreatitis
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
Clinical features of chronic pancreatitis are the same as for acute with the addition of?
fat malabsorption and steatorrhea late in the disease. Fecal fat will be elevated if malabsorption is present
Symptoms and signs of cholangitis
progressive obstructive jaundice, frequently associated with fatigue, pruritus, anorexia, and indigestion
Cholecystitis s/s
* Steady, severe pain and tenderness in the right hypochondrium or epigastrium.
* Nausea and vomiting.
* Fever and leukocytosis.