Term
| What are the typical Sx of Pancreatitis? |
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Definition
Sx: Abdominal tenderness, distention, guarding, rigidity, mild jaundice, Diminished/Absent bowel sounds, Tachycardia, Tachypnea, Hypotension, Fever, May hear rales (especially in left lung).
* Severe cases may have a Grey Turner sign (bluish discoloration of the limbs) and Cullen sign (bluish discoloration of the periumbilical area) caused by leak of blood from the pancreas in hemorrhagic pancreatitis. |
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Term
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Definition
| DDx: PUD, gallstones, hepatitis, abdominal aneurysm, small bowel obstruction, large bowel obstruction. |
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Term
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Definition
| W/U: CBC, amylase (will be elevated), lipase (will be elevated), urine dipstick for trypsinogen-2, glucose, LFTs, electrolytes, BUN, creatinine, bilirubin, CT, (best imaging study for pancreatitis), KUB, Ultrasound |
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Term
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Definition
| Tx: Fluids, monitor electrolytes, meperidine (Demerol) to relieve pain, antibiotics to prevent sepsis, possible surgery, GI referral |
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Term
| Pancreatitis pt education? |
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Definition
| Pt education: Pt. should be advised to avoid alcohol and binge drinking, also avoid fatty foods and abdominal trauma. Eat small frequent meals, and a diet high in carbs and low in fat. If not treated, many complications can result from pancreatitis such as: kidney failure, breathing difficulties, diabetes, and brain damage. |
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Term
| What is the classic triad of Ectopic pregnancy Sx? |
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Definition
| Classic triad- Abdominal pain, amenorrhea, vaginal bleeding (but pts. rarely present with all three at once) |
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Term
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Definition
| DDx: Abortion, Placenta Previa, Appendicitis, Dysmenorrhea, Ovarian Tumor, Endometrioma, Cervical Cancer, Ruptured Corpus Luteum Cyst |
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Term
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Definition
W/U: Pregnancy test, CBC, CMP, UA, Ultrasound (the absence of a normal IUP on sonogram together with a beta-HCG level above discriminatory zone virtually rules out normal IUP) CT/MRI only if U/S is inconclusive.
*• U/S findings indicative of ectopic pregnancy:Empty uterus with tubal ring, Complex adnexal mass, Moderate-to-large amount free fluid |
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Term
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Definition
| Tx: Consult OBGYN, make sure pt. is hemodynamically stable, Methotrexate to treat unruptured ectopic pregnancy |
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Term
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Definition
| Sx: Usually seen in the early reproductive years (premenarchal) or postmenopausal women,Unilateral, tender adnexal mass found in most pts, Tenderness to palpation is common, Peritoneal findings indicate ADVANCED disease if present |
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Term
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Definition
| DDx: Ectopic Pregnancy, Ovarian cysts, PID, UTI, Appendicitis, Endometriosis, Small/Large Bowel Obstruction, Ovarian Tumor |
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Term
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Definition
| W/U: Pregnancy test, STD (Gonorrhea/Chlamydia) test, UA, CBC, Ultrasound to check blood flow to ovary, CT to show enlarged ovaries and r/o pelvic mass, Laparoscopy (used to **confirm Dx) |
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Term
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Definition
| Tx: NSAIDs, Morphine, Toradol for pain, Antiemetics: Compazine, Reglan to relieve nausea/vomiting, IV fluids, OBGYN consult for evaluation and definitive treatment |
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Term
| What are the Sx for Cystitis? |
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Definition
| Sx: Urgency, frequency, dysuria, and, occasionally, hematuria, dyspareunia, abdominal cramps, and/or bladder pain and spasms. As for interstitial cystitis, these symptoms must be present to diagnose: Pelvic or bladder pain, urinary frequency while awake more than 8 times per day, nocturia, and duration of symptoms longer than 9 months. |
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Term
| What are some DDx for Cystitis? |
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Definition
| DDx: Gonorrhea, Chlamydia, Bladder stone, Bladder tumor, PID, BPH if male, Prostatitis if male, Cystocele if female, Endometriosis if female. |
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Term
| What is the W/U for Cystitis? |
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Definition
| W/U: pregnancy test if female, STD tests, UA, CBC, CMP, wet smear for fungal agents, serological tests for SLE (ANA), TB test, cystoscopy with biospy, ultrasound, CT, MRI (r/o stones, tumors, endometriosis) |
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Term
| What is the Tx for Cystitis? |
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Definition
Tx = depends on the cause:
Viral: Acyclovir,
Chlamydia: Doxycycline,
Mycobacteria: INH, Rifampin, Ethambutol and Pyrazinamide,
Fungal: amphoteracin B |
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Term
| What are the Sx for Cholecystitis? |
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Definition
Sx :fever, chills, anorexia, dyspepsia, jaundice, may have nausea and vomiting, tenderness in the RUQ or epigastric region, often with guarding or rebound, positive Murphy’s sign
Remember female, forty, fat, fertile= very common for cholecystitis |
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Term
| What are some DDx for Cholecystitis? |
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Definition
| DDx: Appendicitis, Hepatitis, Pyleonephritis, PUD, Pregnancy, Pancreatitis, GERD, Gallstones |
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Term
| What is the W/U for Cholecystitis? |
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Definition
| W/U: pregnancy test, CBC, CMP, LFTs (elevated direct bilirubin/alk phos, GGT**(most sensitive for cholecystitis), Amylase, Lipase, UA, Cardiac Enzymes, Ultrasound, HBS (hepatobiliary scintigraphy), ERCP, Ab Xray |
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Term
| What is the Tx for Cholecystitis? |
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Definition
Tx: Bowel rest, intravenous hydration, analgesia, and intravenous antibiotics 7-14 days
Mild cases: antibiotic therapy with a single broad-spectrum antibiotic 7-14 days
Antiemetics, Analgesics for pain: Meperidine (Demerol) is DOC
Generally have complete remission after 1-4 days
Pts. preparing for surgery should be NPO, may need a Laparoscopic cholecystectomy |
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Term
| What is the pt education for cholecystitis? |
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Definition
| Pt. Education: If untreated, can lead to sepsis, perforation, gangrene |
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Term
| What are the Sx of IBS in women? |
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Definition
Sx: Recurrent abdominal pain or discomfort atleast 3 days out of the month in the last 3 months associated with 2 or more of the following
- Improvement with defication
- Onset associated with a change in the frequency of stool
- Onset associated with a change in the form of stool |
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Term
| What is the W/U for IBS in women? |
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Definition
| W/U: routine blood tests, stool studies for infection, radiographic imaging, or endoscopic procedures such as upper endoscopy, sigmoidoscopy, and colonoscopy in selected patients. The DRE may be the most important component of the physical examination of an IBS patient |
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Term
| What is the Tx for IBS in women? |
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Definition
| Tx: No cure, dietary therapy (low residue, high fiber, no lactose) Antidiarrheal-Imodium, anticonstipation-laxitives, pysch agents- SSRI’s |
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Term
| What is the pt education for IBS in women? |
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Definition
| Pt Ed: Diet, exercise, and hydration can potentially correct issue. |
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Term
| What are the Sx for Appenditicitis? |
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Definition
| S&S- Generalized periumbilical pain first few hrs, Nausea and vomiting, anorexia, Localized RLQ pain afer 2-3 hrs, Constipation or diarrhea, Fever |
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Term
| What is the W/U for Appendicitis? |
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Definition
| W/U: Labs: CBC: Mild leukocytosis , U/A: hematuria/pyuria sometimes present (25%), CRP- in response to infection or inflammation, CMP - essentially normal, Ultrasound, Helical (spiral) CT – better than U/S |
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Term
| What are some DDx for Appendicitis? |
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Definition
| DDX: Abdominal abscess, Chrons, constipation, endometriosis, ectopic pregnancy, ovarian torsion, gastroenteritis, UTI |
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Term
| What is the Tx for Appendicitis? |
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Definition
| TX: Surgical appendectomy: Laparoscopic ,Laparotomy, --IV antibiotics, When in doubt surgery is a lower risk than the complications of a ruptured appendicitis |
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Term
| What is the DDx for IBS in women? |
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Definition
| DDX = Inflammatory bowel disease, Celiac disease, Colon cancer, bowel infection, lymphocytic colitis. |
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