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Definition of visceral pain
- Vague, dull, poorly localized pain
- Associated with stretching, inflammation, or ischemia of organ capsules
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Definition of parietal pain
Sharp, well-localized pain
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Pain of peritonitis
Rebound tenderness and gaurding
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45 y/o obese female presents with fever, RUQ pain, and nausea exacerbated by eating
Cholecystitis
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Symptoms of lead poisoning
- Diffuse abdo pain
- Nausea
- Confusion
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Metabolic causes of abdo pain
- DKA
- Acute intermittent porphyria
- Hypercalcemia
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Infectious causes of abdo pain (apart from gastroenteritis)
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Vascular causes of abdo pain
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An elderly pain with a history of A-fib, treated with digoxin complains of very severe abdo pain
Think about mesenteric ischemia
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Why does A fib predispose to mesenteric ischemia?
Embolus
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Causes of viral esophagitis
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Causes of bacterial esophagitis
- Lactobacillus
- Streptococcus
- Cryptosporidium
- Pneumocystis carinii
- M. TB
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Vesicles and discrete erosions of the esophagus on endoscopy indicates...
HSV or VZV esophagitis
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Treatment for candida esophagitis
Oral fluconazole
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Treatment for HSV and CMV esophagitis
- HSV--acyclovir
- CMV--gancyclovir
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Boerhaave's syndrome
A tear through the full thickness of the esophagus (as opposed to Mallory-Weiss, which is partial thickness) due to forceful vomiting
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Zenker's diverticulum
An outpouching in the pharynx or esophagus, due to a defect in the muscular wall. Presents with halitosis, frequent aspiration, and esophageal obstruction.
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Barium swallow: achalasia v. diffuse esophageal spasm
- Achalasia--bird's beak
- DES--corkscrew shaped
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Causes of delayed gastric emptying
- Diabetes
- Gastroparesis
- Gastric outlet obstruction
- Anticholinergics
- Fatty foods
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Complications of GERD
- Esophagitis
- Peptic stricture
- Barrett's esophagus (transformation of squamous epithelium to columnar)
- Esophageal cancer
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Complications of peptic ulcer disease
- Bleeding
- Perforation (perforation of the posterior duodenum can lead to pancreatitis)
- Gastric outlet obstruction
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