Gastro Document Flashcards
Ab pain findings
Cutaneous hyperplasia is pain upon ___, assc w
Murphys sign, seen w
Obturator sign
indicates inflam over the
assc w
picking up ab wall skin, acute appendicitis
splinting/tenderness upon palpation of RUQ, acute cholecystitis
internal rotation hip causes hypogastric pain
fascia of obturator internus muscle
acute appendicitis
Ab pain
Psoas sign- extend
or patient can
Positive indicates inflam over _, assc w
Rebound tenderness ab pain upon
assc w
thigh to full extent
actively flex thigh against pressure
psoas, acute appendicitis
quick release of pressure during deep ab palpation
diffuse peritoneal inflamm (peritonitis from ruptured viscus)
Ab pain findings
Referred pain from biliary colic location, referred to
Rovsings sign pain in ___, upon ___, suggests
RUQ Tympani
normal is
tympani suggests
epigastric/RUQ, inferior to right lower scapula border
RLQ, pressure to LLQ, AA
tympanic percussion to liver
dull to percussion
intraper air from ruptured viscus
Gastro bleeding findings
Desmoid tumor of
can be
if present w multiple polyps, suggests __, variant of
Large midline ab surgical scar may indicate ____
presents w possibility of ___, leakage occurs at
in 75% of cases, involves
fibroblasts
superficial/intra-ab
Gardners syndrome, FAP
open ab aortic aneurysm repair
aorto-enteric fistula, suture line (less likely if endovasc)
distal duodenum
Gastro bleeding
Mucosal hyperpigmentation
due to ___, indicates
produces ___ polyps
latter is risk for
Telangectasia of mucosa may indicate
inheritance
presents w
abnormal vessels in GI tract may produce
dark spots on lips/buccal mucosa
melanin, PJ syndrome
hamartomatous/adenomatous
colon ca/GI bleeding
HHT (OWR)
AD
diffuse mucosal/visceral telangectasia
blood loss/Fe def anemia
Ab wall vein distension commonly found in __, due to
other conditions assc w
Alcoholism findings (2)
Asterixis finding in
others
ask patient to
patient loses ___ tone and produces
portal HTN, cirrhosis
SVC syndrome, IVC occlusion
DC, lacrimal/parotid gland enlarged
met enceph
Uremia, hypercarbic RD, drug OD)
extend hands at wrist and hold
extensor, flappy motion (aka liver flap)
Caput medusa due to ___, part of
presentation
Cutaneous vasculitic rash w ____ suggests
possible comps
Feminization such as
due to high ___ in ____
Kayser Fleischer ring
due to
specific for
test of choice
portal HTN, porto-systemic venous collaterals, cirrhosis
large periumbilical veins
HepC, mixed cryoglobulinemia
vasculitis w glomerulonephritis/IC related small vessel vasculitis
gynecomastia/teste atrophy
estrogen, cirrhosis
brown corneal ring
copper deposition
Wilsons dz
slit lamp exam
Diffuse hyperpigmentation finding in ___, due to
other findings
Palmar erythema due to
result of liver ___ poorly
most prominent in
Scleral icterus visible w ___ bilirubin >
Shifting dullness indicates ___ due to
Spider angiomas due to
presentation
not found below
hemochromatosis, Fe overload
cardiomyopathy, DM, poly-endocrine hypofxn (hypogonad), OA (hands)
inc estrogen in cirrhosis
metabolizes
thenar/hypothenar
total, 2-2.5
ascites, portal HTN
high estrogen (cirrhosis)
red lesions (neovasc), blanch w pressure
chest
Castells sign
examiner percusses
usually sounds
instruct pt to
negative if ___ throughout
positive when percussion becomes ____
indicates
Splenomegaly can be due to
most inferior interspace of LAA line
tympanic
breathe deeply
percussion is tympanic
dull
splenomegaly
portal HTN (cirrhosis)
Charcots triad
indicates
Courvoisiers sign
indicates
most commonly due to
Steatorrhea finding in
presentation
described as
fever, jaundice, RUQ pain
ascending cholangitis
enlarged, nontender gall bladder
extrahepatic biliary obs
carcinoma of panc head
malabsorption
malodorous, hard to flush
floating, greasy
Gilberts disease problem w
described as
produces mild ____ in response to mild illness
lab findings AST/ALT/ALP usually
bilirubin conj
benign, congenital
indirect hyperbilirubinemia (<5)
normal
