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GI Exam 2
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
2 mins
Peutz-Jeghers Syndrome
Mechanism and Characteristics
Symptomatic Age: 10-30 Years
LKB1/STK11 Gene Mutation
Autosomal Dominant
Signs and Symptoms
Benign GI Hamartomatous Polyps
Mucocutaneous Hyperpigmentation
Positive Family History
Increased Risk of Colorectal Carcinoma
1 min
Stomach Cancer
Adenocarcinoma
Intestinal Type
Intestinal Type
Smoked Foods Containing Nitrosamines
Achlorhydria
Type A Blood
Helicobacter pylori
Diffuse Type
Diffuse Type
Signet Ring Cells
Linitis Plastica (Leather Bottle Stomach)
Assessment
Acanthosis Nigricans
Left Supraclavicular Lymph Node
Virchow's Node
Subcutaneous Periumbilical Mets
Sister Mary Joseph's Nodule
Complications
Bilateral mets to ovaries
Krukenberg's tumor
3 mins
Acute Pancreatitis Disease
Autodigestion of Pancreas by Pancreatic Enzymes
Symptoms
Epigastric Abdominal Pain Radiating to Back
Anorexia
Nausea
Labs
Increased Amylase and Lipase
Complications
Disseminated Intravascular Coagulation (DIC)
Infection
Hypocalcemia
Systemic Inflammatory Response Syndrome (SIRS)
Acute Respiratory Distress Syndrome (ARDS)
Pancreatic Pseudocyst
Hemorrhage
3 mins
Acute Pancreatitis Causes
"GET SMASHHED" Mnemonic
Gallstones
(Ethanol) Alcohol
Trauma
Steroids
Mumps
Autoimmune
Scorpion Sting
Hypercalcemia
Hypertriglyceridemia > 1000
ERCP
Drugs
1 min
Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
2 mins
Acute Pancreatitis Assessment
Mechanism
Heavy Alcohol Use and Gallstones
Signs and Symptoms
Abdominal Pain
Nausea/Vomiting/Anorexia
Abdominal Rigidity/Guarding
Decreased or Absent Bowel Sounds
Hypotension and Tachycardia
Jaundice
Increased White Blood Cells
2 mins
Cholecystitis Causes
Gallbladder Inflammation
6 Fs
Female
Fair (Caucasian)
Fat (Obese)
Fertile (Pregnant)
Forty (Advanced Age Over 40)
Flatulence
2 mins
Cholecystitis Assessment
RUQ Pain
Referred Shoulder Pain
Clay Colored Stools
Jaundice
Nausea and Vomiting
Dyspepsia (Indigestion)
Fever
Considerations
Increased WBCs
Fatty or Spicy Foods
Ultrasound
2 mins
Cholecystitis Interventions
Supportive Therapy
Antibiotics
Low Fat Diet
NG Tube
Analgesics
Lithotripsy
Cholecystectomy
T Tube
2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min
Budd-Chiari Syndrome
Causes
Pregnancy and Postpartum
Hematologic Disorders
Tumors
Chronic Infections
Mechanism
Thrombosis of Major Hepatic Veins
Centrilobular Congestion and Necrosis
Symptoms
Abdominal Pain
Ascites
Hepatomegaly
Nutmeg Liver
3 mins
Appendicitis
Mechanism and Characteristics
Fecalith leading to obstruction and infection
Most commonly affects teenagers
Presentation
Initial peri-umbilical visceral pain
Subsequent somatic right lower quadrant pain
Diagnosis
Rebound tenderness
Positive psoas sign
Pain at McBurney's point
Leukocytosis
Fever
Treatment
Appendectomy
1 min
Fluorouracil (5-FU)
Mechanism
Antimetabolite
"Thymine-less Death"
Indications
Slow-growing Solid Tumors
Co-administered with Leucovorin for Stomach Cancer
Basal Cell Carcinoma (Topical)
Side Effects
Myelosuppression
Mucositis
Severe Diarrhea
3 mins
Hemochromatosis Signs and Symptoms
Signs and Symptoms
Micronodular Cirrhosis
Hepatocellular Carcinoma
Diabetes
Bronze Skin Coloring
CHF
Arthropathy
Testicular Atrophy
Impotence
2 mins
Hemochromatosis Pathophysiology
Pathophysiology
Hemosiderin Deposition
Autosomal Recessive
HLA-A3
Secondary to Transfusion Therapy
Increase Iron
Increase Ferritin
Increased Transferrin Saturation
2 mins
Liver Enzyme Tests: AST and ALT
AST/ALT Ratio
AST: 8-20 U/L
ALT: 8-20 U/L
1 min
Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
2 mins
Cirrhosis Assessment
Mechanism
Degeneration and Destruction of Liver Cells
Signs and Symptoms
Jaundice
Fatigue
Palmar Erythema
Spider Angiomas
Hepatosplenomegaly
Edema
Gynecomastia
Change in LOC
2 mins
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