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
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|
Term
|
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
|
|
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
|
Definition
|
|
Term
| biliary colic characteristics: |
|
Definition
- episodic
- crampy
- dark urine |
|
|
Term
| test to dx biliary colic: |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Pancreatitis pts often have hx of alchol abuse or gallstones. Important test would be __ __. |
|
Definition
|
|
Term
|
Definition
- orthostatic hypotension
- pulsatile abdominal mass
- decreased lower extremity pulses |
|
|
Term
|
Definition
|
|
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
|
|
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
|
|
Term
| stone lodged in common bile duct: |
|
Definition
|
|
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
|
|
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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