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What is the order in which you should perform an abdominal physical exam? 1. inspection 2. auscultation 3. percussion 4. palpation What are examples of things that can cause colicky pain? Renal stones bilirubin is unconjugated, which means that it has not been metabolized by the liver or made into a water soluble form of bilirubin Indirect bilirubinWhat does a high LDH indicate when identifying a specific type of anemia? Hemolysis What does a low iron and ferritin with a HIGH Total Iron Binding Capcity indicate? Iron deficiency anemia What diagnosis would you con
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What is the order in which you should perform an abdominal physical exam?
**1. inspection
What does a high LDH indicate when identifying a specific type of anemia? Hemolysis What does a low iron and ferritin with a HIGH Total Iron Binding Capcity indicate? Iron deficiency anemia What diagnosis would you consider for a 30 year old with heart burn, early satiety, burping and generalized abdominal pain? Dyspepsia related to gastritis What diagnosis would you consider for a 50 YEAR OLD SMOKER with heart burn and abdominal pain? Colon cancer
**- acute/chronic pancreatitis
What is the terminology for when the gallbladder is so distended that you can palpate it? Courvoiser Sign What is the terminology for inspiratory arrest that occurs when you are putting pressure on the RUQ due to inflammed gallbladder? Murphey's Sign Which liver enzyme is specific for hepatocytes? ALT Which liver enzyme is more specific to alcohol, statins and tylenol use? AST If the ratio of AST to ALT is 2 to 1, what does this indicate? Liver damage due to alcohol, statins or tylenol If the ratio of ALT is twice as high as AST, what does this indicate?
What type of anemia would someone with melena have? Iron deficiency anemia What is the gold standard diagnostic test for a patient with Melena? Endoscopy What are the leading causes for dysphagia? Alzheimer disease + stroke This type of dysphagia is due to a tumor that is obstructing the passage of food Mechanical dysphagia This type of dysphagia is due to a neurological deficit resulting in the inability to swallow Functional dysphagia
What is the gold standard diagnostic test for dysphagia? Video fluoroscopic swallow study IF a patient over the age of 50 comes in with dysphagia, what would you assume? Esophegeal cancer If a patient comes in with SUDDEN dysphagia, what would you assume? Patient had a stroke What is the term used to describe the chronic immunological disease that manifests in intestinal inflammation? Inflammatory Bowel Disease What is the term used to describe a clinical syndrome of uncertain etiology characterized by lower abdominal pain and alternating diarrhea and/or constipation Irritable Bowel Syndrome
What level of severity is the patient with Ulcerative Colitis that has 6 - 10 diarrhea's a day with systemic symptoms? Severe disease What level of severity is a patient with Ulcerative Colitis that is having 10 or more bloody stools a day? Fulminant disease Which medications should be avoided during an acute phase of ulcerative colitis? Imodium or lomotil What are the medications that can be used to treat Ulcerative Colitis? 1st line is ASA THERAPY- Mesalamine (oral or rectal) Topical or systetmic steroids Immunomodulating Drugs
Using the Crohn's Disease activity index calculator, what does a score of 220 - 450 indicate? MODERATE-SEVERE disease Using the Crohn's Disease activity index calculator, what does a score greater than 450 indicate? Severe fulminant disease What are the treatment options for a patient with Mild Crohn's disease?
What are the symptoms of IBS? Bloating Cramping Diarrhea Nausea Constipation Abdominal pain Gas Incomplete bowel movements Fatigue What are the signs and symptoms of bowel obstructions? Sudden onset of colicky abdominal pain Nausea/vomiting Diarrhea early/ constipation late Signs of dehydration Abdominal distention
Bowel sounds may be high pitched/ hyperactive or totally absent Mass may be palpable What are the diagnostic tests that can be performed to identify a bowel obstruction? Abdominal xray films will reveal air-fluid levels in the bowel What is the treatment plan for a patient with a bowel obstruction? Hospitalize the patient and refer them immediately Laparotomy for a patient with a complete bowel obstruction IV hydration and electrolyte replacement D/C all medications that decrease intestinal motility Placement of NG tube to decompress
What are the treatment options for hemorrhoids?
What is the management of colorectal cancer? Surgical resection Chemotherapy based on staging Radiation What are the screening recommendations for the average risk person for colorectal cancer? Beginning at age 50 through 75 For African Americans begin screening at 45 years Perform colonoscopy every 10 years What are the screening recommendations for high risk people with a family history of colorectal cancer before age 60? Colonoscopy every 5 years starting at age 40 or 10 years younger at age of diagnosis of youngest affected relative
