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1

where does gallbaldder pain refer?

right shoulder or subscapular region
liver are and back

2

where does pancreas pain refer?

Left mid back
and epigastrium

3

vomit bile w/I 15 minutes of eating; believed by be cause by reflux of bile into stomach

Bilious vomiting

4

Foreceful emesis w/o prior nausea or retching. Found often in increased ICP, but can be seen in other conditions

Projectile vomiting

5

Vomiting of food eaten more than 6 hours previously

Gastric retention

6

Most common; explosive bouts of n/v in conjunction w/ watery diarrhea, cramping, abdominal pain, myalgias, HA and fever. Rapid recovery usually within 7-10 days

Viral gastroenteritis

7

Greater than 1 Liter per day of diarrhea
decreased absorption of Na/Cl
includes fatty acid induced diarrhea

Secretory diarrhea

8

Diarrhea stops when patients fasts. Elevated osmotic gap on stool analysis. Can be due to laxatives with magnesium

Osmotic diarrhea

9

2 causes of inflammatory diarrhea?

Ulcerative colitis
Parasites

10

Motility disorders that can cause diarrhea?

IBS
Hyperthyroid
Carcinoid
Scleroderma
Diabetes

11

Abdominal distention, diarrhea, postprandial abdominal distention. Hypomotility leads to bacterial overgrowth. WIll have watery diarrhea or steatorrhea.

Scleroderma

12

Abdominal pain; hematemesis or "coffee ground" emesis; passing melena tarry stool (stool may be frankly bloody or maroon with massive or brisk upper GI bleeding)

Upper GI bleeding

13

Left lower quadrant pain
tenderness, fever, and leukocytosis. Tender mass is noted frequently

Diverticulitis

14

Due to neurologic or neuromuscular dz. Have problems starting swallowing. Possibility of aspiration/ regurgitation. Common in elderly, cortical brainstem lesion. More problem with liquids than solids

Transfer dysphagia

15

Most common cause of motor dysphagia. Slowly progressive motility disorder. Lack of relaxation of LES. hallmark- loss of cels in myenteric ganglia. Episodes of aperistalsis. Sensitivity to gastrin and cholinergic agents. Liquids and solid both difficult. Pain and regurg common.

achalasia

16

tx of achalsaia

open LES with balloon dilation
Botox injections
surgical myotomy

17

Type of scleroderma
calcinosis
Reynards phenomenon
esophageal dysmotility
sclerodacytyl
telangiectasia

CREST syndrome

18

non-progressive dysphagia
liquids and solids affected
substernal chest pain
can appear like angina
Will have periods normal peristalsis

Diffuse esophageal spasm

19

high amplitude contractions in distal esophagus
Principal symptom is chest pain
Non-progressive
Liquids and solids

Nut cracker esophagus

20

Tx of diffuse esophageal spasm

nitrate/ calcium channel blockers

21

Dx of diffuse esophageal spasm and nutcrack esophagus

esophageal manometry

22

Tx of nutcracker esophagus

calcium channel blockers
nitrates

23

Anxiety disorder. Say they have problem swallowing but they don't

globus hystericus

24

Acid stimulation of chemoreceptors
prolonged severe contractile waves
distention of stretch receptors
common with GERD
Similar to IBS; seen in patients w/ nutcracker esophagus

Esophageal chest pain

25

most common histology of esophageal cancer

squamous cell carcinoma

26

Only have difficulty with solid food. rapid onset

Mechanical obstruction

27

test of choice for transfer dysphagia

barium swallow

28

rings of fibrous tissue that occur in the lower esophagus and cause intermittent dysphagia to solids. Trouble with large piece of bread or meat

Esophageal rings (Schatski’s Ring)

29

Tx for Schatski’s Ring

balloon or bougie dilation

30

rings that occur in the proximal esophagus

esophageal webs