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GI: Abdominal pain
GI Midterm: Abdominal Pain
35
Anatomy
Graduate
01/18/2012

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Cards

Term
Liver has referred pain where?
Definition
- right shoulder
- substernal area
- right middle back
Term
The bladder may have referred pain to the bilateral lower buttcheeks
Definition
Term
The ureters can have referred pain to where?
Definition
ipsilateral inner thigh
Term
ROS for abdominal pain?
Definition
- Headaches, dizziness
- Respiratory: SOB, cough
- GI
- GU: sexual/menstrual hx or changes
- Skin: jaundice, pallor, ulcers, easy bruising
Term
Important past medical hx question to ask pt with abdominal pain?
Definition
- NSAID
- HTN, cholesterol, smoking (CAD, vascular)
- Previous surgeries (adhesions)
- Alcohol (pancreas, liver, ulcers)
- Travel, camping, unusual exposure
Term
Order of events for abdominal exam:
Definition
- Inspect
- Auscultate
- Percuss
- Palpate
Term
Red flags of abdominal pain:
Definition
- Severe pain
- Signs of shock (tachycardia, hypotension, diaphoresis, confusion)
- Signs of peritonitis
- Abdominal distention
Term
Signs and Symptoms of Peritonitis:
Definition
- Swelling and tenderness ranging from dull aches to sever sharp pain
- Fever and chills
- Loss of appetite
- Thirst
- N/V
- Reduced urine output
- Not being able to pass gas/stool
Term
Best test for appendicitus:
Definition
CT with contrast

if pregnant or a child> ultrasound
Term
best test to look at gall bladder or liver:
Definition
ultrasound
Term
any female complaining of abdominal pain, always do a __ __
Definition
urine hcg (pregnancy test)
Term
renal colic clinical clues:
Definition
- flank pain
- radiation to groin
- hematuria
- costovertebral angle tenderness
Term
Renal colic test:
Definition
- urinalysis
- renal CT
Term
biliary colic characteristics:
Definition
- episodic
- crampy
- dark urine
Term
test to dx biliary colic:
Definition
ultrasound
Term
Diverticulitis symptoms:
Definition
LLQ pain
fever diarrhea
Term
Test for diverticulitis:
Definition
CT scan
Term
Pancreatitis pts often have hx of alchol abuse or gallstones. Important test would be __ __.
Definition
serum lipase
Term
AAA clinical clues:
Definition
- orthostatic hypotension
- pulsatile abdominal mass
- decreased lower extremity pulses
Term
Test for AAA:
Definition
abdominal CT scan
Term
Symptoms of chronic mesenteric ischemia:
Definition
- postprandial pain
- weight loss
- CAD or PVD
Term
2 tests to look for chronic mesenteric ischemia:
Definition
- Mesenteric duplex ultrasonography
- Angiogram (TOC)
Term
Stones located in the cystic duct cause __ __ and ___.
Definition
- biliary cholic
- cholecystitis
Term
Stones in the common bile duct aka ____ , can cause __ ___ and/or __ if the pancreatic duct is blocked.
Definition
- choledocolithiasis
- Ascending cholangitis
- pancreatitis
Term
Risk factors for cholelithiasis:
Definition
- INCREASING AGE
- Obesity
- Female
- Pregnancy
- Gallbladder stasis due to rapid weight loss (diet, sx, TPN)
- Family history
- Crohn disease
- Hemolytic anemias like Thalassemia or Sickle Cell Disease b/c these lead to increased bilirubin excretion and bilirubin stones
Term
Biliary colic occurs when a gallstone is lodged in the __ __.
Definition
cystic duct
Term
Symptoms during biliary colic that suggest cholecystitis instead:
Definition
- episode longer than 4-6 hours
- fever
- marked tenderness
Term
complications of biliary colic:
Definition
- pancreatitis
- ascending cholangitis
- acute cholecystitis
Term
stone lodged in cystic duct:
Definition
cholecystitis
Term
stone lodged in common bile duct:
Definition
choledocolithiasis
Term
Dark urine is due to bilirubin in the urine (bilirubinuria). This occurs in patients with __ ___ which means it is either from __ __ __ ___ or ___.
Definition
- conjugated hyperbilirubinemia
- common bile duct obstruction
- hepatitis
Term
Dark urine suggests __ and may precede __.
Definition
- bilirubinuria
- icterus
Term
Fever on top of dark urine in pt with history of cholelithiasis suggests that the __ __ __ is obstructed and that __ __, a life threatening condition, has developed.
Definition
- common bile duct
- ascending cholangitis
Term
Findings of choledocolithiasis:
Definition
- Cholangitis
- Jaundice
- Dilated common bile duct on ultrasound
- Elevated alkaline phosphatase
- Elevated amylase
Term
Findings of ascending cholangitis:
Definition
- jaundice
- fever
- RUQ
- leukocytosis
- elevated alkaline phosphatase
- elevated bilirubin
- bacteremia
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