Term
| What organs are you concerned about in the RUQ? |
|
Definition
| liver, gall bladder, duodenum, ascending colon, right kidney, pancreas (head) |
|
|
Term
| What organs are you concerned about in the RLQ? |
|
Definition
| large intestine, cecum, appendix, right ovary, Meckel’s diverticulum |
|
|
Term
| What organs are you concerned about in the LUQ? |
|
Definition
| spleen, stomach, pancreas, left kidney, sigmoid colon |
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|
Term
| What organs are you concerned about in the LLQ? |
|
Definition
|
|
Term
| What organ(s) are you concerned about in the suprapubic region? |
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Definition
|
|
Term
| What is the angle formed by the lower border of the 12th rib and the transverse processes of the upper lumbar vertebrae? |
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Definition
|
|
Term
| What muscle accommodates increased bladder pressure? |
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Definition
|
|
Term
| Epigastric pain be a sign of a problem with what organ? |
|
Definition
| duodenum, stomach, pancreas, biliary tree, liver |
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|
Term
| Periumbilical pain can be a sign of a problem with what organ? |
|
Definition
| small intestine, appendix, proximal colon |
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|
Term
| Sacral pain can be a sign of a problem with what organ? |
|
Definition
|
|
Term
| Hypogastric pain can be a sign of a problem with what organ? |
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Definition
|
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Term
| What type of pain is difficult to localize, varies in quality, and may be gnawing, burning, cramping, or aching? |
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Definition
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Term
| What type of pain is described as a steady, aching pain and is more precisely localized over the involved structure? |
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Definition
|
|
Term
| What type of pain is felt in distant sites, which are innervated at approximately the same spinal levels as the disordered structures? |
|
Definition
|
|
Term
| Pain from the biliary tree can be referred to what what locations? |
|
Definition
| right shoulder, right posterior chest |
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|
Term
| Pain of duodenal or pancreatic origin may be referred to what location? |
|
Definition
|
|
Term
| Pain from pleurisy or acute MI may be referred to what location? |
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Definition
|
|
Term
| What type of condition is commonly indicated by visceral periumbilical pain that gradually changes to parietal pain in the right lower quadrant? |
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Definition
|
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Term
| Doubling over with cramping colicky pain is indicative of what condition? |
|
Definition
| renal stones, biliary colic |
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|
Term
| Sudden knife-like epigastric pain is indicative of what condition? |
|
Definition
|
|
Term
| What term is used to describe chronic or recurrent discomfort or pain centered in the upper abdomen? |
|
Definition
|
|
Term
| What term is used to describe a subjective negative feeling that is non-painful? |
|
Definition
|
|
Term
| What term is used to describe a 3-month Hx of nonspecific upper abdominal discomfort or nausea not attributable to structural abnormalities or PUD? |
|
Definition
| functional, or non-ulcer, dyspepsia |
|
|
Term
| What are some causes of bloating? |
|
Definition
| IBD, belching from aerophagia |
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Term
| If a patient reports chronic upper abdominal discomfort or pain primarily of heartburn, acid reflux, or regurgitation more than once a week, what is likely the Dx? |
|
Definition
| gastroesophageal reflux disease (GERD) |
|
|
Term
| What term describes a rising retrosternal burning pain or discomfort occurring weekly or more often? |
|
Definition
|
|
Term
| Patients with GERD sometimes present with atypical respiratory symptoms such as cough, wheezing, and aspiration PA. T or F? |
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Definition
|
|
Term
| List some “alarm symptoms” of gastric cancer. |
|
Definition
| dysphagia, odynophagia, recurrent vomiting, evidence of GI bleeding, weight loss, anemia |
|
|
Term
| Name the condition that describes the proximal displacement of the squamo-columnar junction which replaced by intestinal metaplasia? |
|
Definition
|
|
Term
| Name some conditions that would cause RLQ pain in a female. |
|
Definition
| PID, ruptured ovarian follicle, ectopic pregnancy |
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Term
| LLQ pain with a palpable mass may be indicative of what condition? |
|
Definition
|
|
Term
| Diffuse abdominal pain with absent bowel sounds and firmness, guarding, or rebound on palpation is indicative of what condition? |
|
Definition
| small or large bowel obstruction |
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Term
| Intermittent pain for 12 weeks of the preceding 12 months with relief from defecation, change in frequency of bowel movements, or change in form of stool (loose watery, pellet-like) without structural or biochemical abnormalities are symptoms of what condition? |
|
Definition
|
|
Term
| What term describes involuntary spasm of the stomach, diaphragm, and esophagus that precedes vomiting? |
|
Definition
|
|
Term
| What term describes the forceful expulsion of gastric contents out of the mouth? |
|
Definition
|
|
Term
| What conditions are associated with induced vomiting without nausea? |
|
Definition
|
|
Term
| What term describes the raising of esophageal or gastric contents without nausea or retching? |
|
Definition
|
|
Term
| In what conditions does regurgitation occur? |
|
Definition
| GERD, esophageal stricture, esophageal cancer |
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|
Term
| Vomit that has a fecal odor occurs in what conditions? |
|
Definition
| small bowel obstruction, gastrocolic fistula |
|
|
Term
| What conditions cause hematemesis? |
|
Definition
| esophageal or gastric varices, gastritis, PUD |
|
|
Term
| What term describes “coffee ground” vomit? |
|
Definition
|
|
Term
| Symptoms of blood loss such as lightheadedness or syncope are rare until blood loss exceeds how many milliliters? |
|
Definition
|
|
Term
| What term describes a loss or lack of appetite? |
|
Definition
|
|
Term
| Name some conditions associated with abdominal fullness and early satiety. |
|
Definition
| diabetic gastroparesis, anticholinergic medications, gastric outlet obstruction, gastric cancer, hepatitis |
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|
Term
| Gurgling or regurgitation of undigested food occur in what type of structural condition? |
|
Definition
|
|
Term
| Name some causes of excessive flatus. |
|
Definition
| aerophagia, legumes or other gas-producing foods, intestinal lactase deficiency, IBS |
|
|
Term
| What is the time frame for acute diarrhea? |
|
Definition
|
|
Term
| What is the time frame for chronic diarrhea? |
|
Definition
|
|
Term
| What generally is the cause of acute diarrhea? |
|
Definition
|
|
Term
| What generally is the cause of chronic diarrhea? |
|
Definition
| Crohn’s disease, Ulcerative colitis |
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|
Term
| High-volume, frequent watery stools are usually from what part of the GI tract? |
|
Definition
|
|
Term
| Small-volume stools with tenesmus or diarrhea with mucus, pus, or blood usually occur in inflammatory conditions of what part of the GI tract? |
|
Definition
|
|
Term
| Steatorrhea is seen in what conditions? |
|
Definition
| celiac sprue, pancreatic insufficiency, small bowel bacterial overgrowth |
|
|
Term
| Obstipation is a sign of what type of obstruction? |
|
Definition
|
|
Term
| What term describes red or maroon-colored stools? |
|
Definition
|
|
Term
| What medication classes commonly cause constipation? |
|
Definition
| anticholinergic agents, calcium-channel blockers, iron supplements, opiates |
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|
Term
| What diseases or conditions commonly cause constipation? |
|
Definition
| diabetes, hypothyroidism, hypercalcemia, multiple sclerosis, Parkinson’s disease, systemic sclerosis |
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|
Term
| Melena can occur with as little as how many milliliters of upper GI bleeding? |
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Definition
|
|
Term
| Hematochezia most often occurs with what amount of lower GI bleeding? |
|
Definition
|
|
Term
| Blood on the toilet paper is most commonly indicative of what condition? |
|
Definition
|
|
Term
| Jaundice and icterus are signs of the dysfunction of what organ systems? |
|
Definition
| hepatic and/or biliary dysfunction |
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|
Term
| Jaundice and icterus can be a sign of what hematologic conditions? |
|
Definition
| sickle cell anemia, hemolytic anemia |
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|
Term
| If a person's skin appears jaundiced but their sclera does not appear icteric, what condition might you suspect? |
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Definition
|
|
Term
| Diarrhea is common with what general classes of medications? |
|
Definition
| penicillins, macrolides, magnesium-based anti-acids, metformin, herbal and alternative medicines |
|
|
Term
| When the liver is functioning properly, what type of bilirubin is produced? |
|
Definition
|
|
Term
| Acholic stools are commonly due to a problem with what organ systems? |
|
Definition
| liver and/or biliary tract |
|
|
Term
| Name some risk factors for Hepatitis A. |
|
Definition
| Travel or meals in areas of poor sanitation, ingestion of contaminated water or foodstuffs |
|
|
Term
| Name some risk factors for Hepatitis B. |
|
Definition
| parenteral or mucous membrane exposure to infectious body fluids such as blood, serum, semen, or saliva, especially through sexual contact with an infected partner or use of shared needles for IVDU |
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|
Term
| Name some risk factors for Hepatitis C. |
|
Definition
| IVDU or blood transfusion |
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|
Term
| If a female pt has a CC of losing urine during sneezing, coughing, or laughing, what is likely the Dx? |
|
Definition
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|
Term
| Complaints of changes in the force or stream of urination, dribbling, hesitation, or straining in a male patient are suggestive of what Dx? |
|
Definition
|
|
Term
| Suprapubic pain is most commonly indicative of a problem with what organ? |
|
Definition
|
|
Term
| Prostatic pain is most often felt in what area? |
|
Definition
| perineal area or occasionally the rectum |
|
|
Term
| What term describes an unusually intense and immediate desire to void? |
|
Definition
|
|
Term
| What term describes abnormally frequent voiding? |
|
Definition
|
|
Term
| In men, painful urination without frequency or urgency is most suggestive of what condition? |
|
Definition
|
|
Term
| What term describes a significant increase in the 24-hour urine volume, roughly defined as exceeding 3 liters? |
|
Definition
|
|
Term
| What term refers to urinary frequency at night, sometimes described as awakening the patient more than once? |
|
Definition
|
|
Term
| What term refers to involuntary loss of urine? |
|
Definition
|
|
Term
| Kidney pain, fever, and chills suggest what Dx? |
|
Definition
|
|
Term
| What is the term for a collateral pathway of recanalized umbilical veins radiating up the abdomen that decompresses portal vein HTN? |
|
Definition
|
|
Term
| What physical findings are suggestive of alcohol abuse? |
|
Definition
| hepatosplenomegaly, ascites, caput medusa, spider angiomas, palmar erythema, peripheral edema |
|
|
Term
| Name a screening tool for alcohol abuse. |
|
Definition
| CAGE questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), or the screening question about heavy drinking days (“How many times in the past year have you had 4 or more drinks a day (women) or 5 or more drinks a day (men)?) |
|
|
Term
| How is Hepatitis A transmitted? |
|
Definition
|
|
Term
| Chronic infection is most common in which type of hepatitis? |
|
Definition
|
|
Term
| For a person with average risk, at what age should colorectal screening begin? |
|
Definition
|
|
Term
| Name some high risk factors for colorectal cancer. |
|
Definition
| family Hx of familial adenomatous polyposis, FHx of hereditary nonpolyposis colon cancer, Hx of IBD (chronic UC, Crohn’s disease). |
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|
Term
| Pink-purple vertical striae on the abdomen are classically associated with what condition? |
|
Definition
|
|
Term
| What term describes prolonged gurgles of hyperperistalsis? |
|
Definition
|
|
Term
| In what rare condition would you expect liver dullness on the left and an air bubble on the right? |
|
Definition
|
|
Term
| Rebound tenderness is generally indicative of what condition? |
|
Definition
|
|
Term
| Bilateral enlargement of the kidneys is suggestive of what condition? |
|
Definition
| polycystic kidney disease |
|
|
Term
| List some risk factor for abdominal aortic aneurysm. |
|
Definition
| age 65 yo or older, Hx of smoking, male gender, first-degree relative with Hx of AAA repair |
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|
Term
| Name two physical exam tests used to test for ascites. |
|
Definition
| Test for shifting dullness, Test for fluid wave |
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|
Term
| A positive Rovsing’s sign is indicative of what condition? |
|
Definition
|
|
Term
| A positive Murphy’s sign is indicative of what condition? |
|
Definition
|
|
Term
| Infection with what organism is associated with PUD? |
|
Definition
|
|
Term
| Weight loss is more common in a gastric or duodenal ulcer? |
|
Definition
|
|
Term
| Heartburn is more common in a gastric or duodenal ulcer? |
|
Definition
|
|
Term
| What age group is duodenal ulcer common in? |
|
Definition
|
|
Term
| What age group is gastric ulcer common in? |
|
Definition
|
|
Term
| What is the predominate type (histologically-speaking) of stomach cancer? |
|
Definition
|
|
Term
| Epigastric pain that radiates to the back that is relieved by leaning forward with the trunk flexed is indicative of inflammation of what organ? |
|
Definition
|
|
Term
| What is the (histologically-speaking) predominate type of pancreatic cancer? |
|
Definition
|
|
Term
| Left lower quadrant pain is most common associated with what condition? |
|
Definition
|
|
Term
| What are the most common causes of acute mechanical intestinal obstruction? |
|
Definition
| adhesions or hernias (small bowel), cancer, diverticulitis (colon) |
|
|
Term
| Right upper quadrant or upper abdominal quadrant pain that may radiate to the right scapular area that is aggravated by jarring or deep breathing is most likely indicative of what condition? |
|
Definition
|
|
Term
| Blood supply to the bowel and mesentery blocked from thrombosis or embolus or reduced from hypoperfusion is descriptive of what condition? |
|
Definition
|
|
Term
| What type of disorder associated with dysphagia is sometimes relieved with nitroglycerin? |
|
Definition
|
|
Term
| Change in the frequency or form of bowel movements without structure or chemical abnormal is indicative of what condition? |
|
Definition
|
|
Term
| Inflammation of the mucosa and submucosa of the rectum and colon with ulceration that typically extends proximally from the rectum is characteristic of what condition? |
|
Definition
|
|
Term
| Chronic transmural inflammation of the bowel wall, in a skip pattern typically involving the terminal ileum and/or proximal colon is indicative of what condition? |
|
Definition
|
|
Term
| What condition causes watery diarrhea of large volume following the ingestion of milk and milk products? |
|
Definition
|
|
Term
| A pt who has a PMHx of bulimia nervosa who has variable onset of watery diarrhea of large volume; what type of condition do you suspect? |
|
Definition
| Abuse of osmotic purgatives (laxatives) |
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|
Term
| A pt who has a recent SHx of bowel resection comes to your office complaining of stools that are light gray and on examination, you notice glossitis. What condition do you suspect? |
|
Definition
|
|
Term
| A pt comes into your office complaining of black stools for one day; she went to a bachelorette party two nights ago, had “far too many shots” and spent most of that night vomiting and retching. What condition do you suspect? |
|
Definition
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|
Term
| A man comes into your office stating that he recently noticed blood on the toilet paper after a bowel movement; denies any pain. What Dx is most likely? |
|
Definition
|
|
Term
| A 30 year old woman comes into your office complaining of pink urine and reddish stools; she denies any past medical Hx but states she is a strict vegetarian. What do you suspect? |
|
Definition
|
|
Term
| A 45 year old man who has a past PHx of alcoholism and who has been diagnosed with cirrhosis comes into your office complaining of black, tarry stools for the past week; what Dx is most likely? |
|
Definition
| esophageal or gastric varices |
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|
Term
| On an XR with barium swallow, you see a classic “bird’s beak” sign; what Dx is most likely? |
|
Definition
|
|
Term
| On an XR with barium swallow, you see a “nutcracker” esophagus; what Dx is most likely? |
|
Definition
|
|
Term
| Complaints of black, non-sticky stools in a pt with no PMHx with a negative FOBT are suggestive of what? |
|
Definition
| ingestion of iron, bismuth salts such as Pepto-Bismol, licorice, or even commercial chocolate |
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|
Term
| You see an “apple core lesion” in the colon on an KUB XR; what Dx is most likely? |
|
Definition
|
|
Term
| Polyuria, thirst, and nocturia with low levels of ADH are most commonly associated with what disorder? |
|
Definition
|
|
Term
| A female pt who is gravida 3 para 3 who complains of losing small amounts of urine when she laughs or coughs very hard. What Dx is most likely? |
|
Definition
|
|
Term
| A 45 yo pt with a PHx of DM Type 2 complains that whenever she voids, it doesn’t feel as though she is completely emptying her bladder as she often needs to void again. A distended bladder is palpated upon exam. What Dx is most likely? |
|
Definition
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|
Term
| A parent brings in her 6 month old female infant worried about her belly button which is protruding. What Dx is most likely? |
|
Definition
|
|
Term
| A patient who had abdominal surgery two months ago comes into the office complaining of a painless, bulge underneath the surgical scar. What Dx is most likely? |
|
Definition
|
|
Term
| What term is characterized by a small midline protrusion thorough a defect in the linea alba that occurs between the xiphoid process and the umbilicus? |
|
Definition
|
|
Term
| What term describes benign, fatty tumors usually in the subcutaneous tissues almost anywhere in the body that are usually soft and often lobulated? |
|
Definition
|
|
Term
| During an abdominal exam, you ask your pt to do a crunch and notice a protrusion whenever they curl up. What is most likely the Dx? |
|
Definition
|
|
Term
| What is the most common cause of a protuberant stomach? |
|
Definition
|
|
Term
| What term describes an apron of fatty tissue on the abdomen that often extends below the inguinal ligaments? |
|
Definition
|
|
Term
| What is a common cause of a pelvic mass in a female? |
|
Definition
|
|
Term
| During the abdominal exam, you have the pt lay on their side and you percuss and hear tympany higher up and dullness at the bottom. You also notice bulging flanks when the pts sits up. What do you suspect? |
|
Definition
|
|
Term
| What is a common cause of abdominal distention and tympany upon percussion post-surgically? |
|
Definition
| adynamic (paralytic) ileus |
|
|
Term
| In what conditions do you expect bowel sounds to be increased? |
|
Definition
| diarrhea or early intestinal obstruction |
|
|
Term
| In what conditions do you expect bowel sounds to be decreased and then absent? |
|
Definition
| adynamic ileus and peritonitis |
|
|
Term
| High pitched tinkling bowel sounds coinciding with an abdominal cramp are indicative of what condition? |
|
Definition
|
|
Term
| A hepatic bruit can be indicative of what conditions? |
|
Definition
| carcinoma of the liver or alcoholic hepatitis |
|
|
Term
| A soft humming noise with both systolic and diastolic components is heard in the epigastric and umbilical area. What is the term for this rare noise? |
|
Definition
|
|
Term
| A pt comes in complaining of chest pain whenever she breathes in along with upper abdominal pain and tenderness. You hear a friction rub on exam. What is most likely the Dx? |
|
Definition
|
|
Term
| A 30 year female comes into the office complaining of dyspareunia. On exam, you note tenderness maximally just above the inguinal ligaments bilaterally and a positive chandelier sign on gynecological exam. What is most likely causing the abdominal tenderness? |
|
Definition
|
|
Term
| Tenderness at McBurney’s point is most commonly indicative of what Dx? |
|
Definition
|
|
Term
| Upon physical exam, you palpate the liver and find that is hard and small. What Dx is most likely? |
|
Definition
|
|
Term
| An enlarged liver that is firm or hard and has an irregular edge or surface is suggestive of what condition? |
|
Definition
|
|
Term
| What is the term that describes a normal variation in the right lobe of the liver that is easily palpable as it projects toward the iliac crest that is often found in lanky people? |
|
Definition
|
|
Term
| An enlarged liver with a smooth, tender edge is suggestive of what type of condition? |
|
Definition
| an inflammatory condition such as hepatitis or venous congestion such right-sided heart failure |
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