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What is a positive Cullen sign and what does it suggest?
Blue discoloration around the umbilicus and is indicative of Acute Pancreatitis
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What is a Grey-Turner’s sign and what does it suggest?
Blueish discoloration in the flanks indicative of Acute Pancreatitis
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Positive Rovsing’s Sign?
Acute Diverticulitis
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Periumbical pain that is acute & may start at McBurney’s point is indicative of what condition?
Acute Appendicitis
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Area located between the superior iliac crest and umbilicus in the RLQ ?
McBurney’s Point (Acute Appendicitis)
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Positive Murphy’s Sign suggests?
Cholecystitis
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RLQ intermittent abdominal pain 1 hour after eating. Diarrhea with Mucus. Fever, malaise, weight loss. Higher risk of colon cancer.
Chron’s Disease
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High levels of acid in the stomach causing severe gastric ulcers. Patient will complain of epigastric pain. Stools may be tarry.
Zollinger Ellison Syndrome
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Screening for Zollinger-Ellison Syndrome
Serum fasting gastrin level
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Obturator Sign - how do you do it & what does it indicate?
Rotate Right hip through full range of motion - pain with flexion of hip as patient is lying supine
Indicates Acute Appendicitis
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What maneuver do you have the patient lie supine and Flex hip 90 degrees and ask patient to push against resistance and to straighten leg?
Psoas/Illiopsoas
(Acute Appendicitis)
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What Sign do you do Deep palpitation of LLQ results in refered pain to the RLQ? Indication?
Rovsing’s Sign
Diverticulitis
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Gold Standard test to diagnose GERD?
Esophageal Motility Studies
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Main concern for chronic heartburn/GERD?
Barrett’s Esophagus
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How is Barrett’s Esophagus diagnosed?
Upper Endoscopy with Biopsy
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Severe midepigastric pain that radiates to the midback is common with what condition?
Acute Pancreatitis
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Why is Barrett’s Esophagus concerning?
Precancerous- increases risk of esophageal cancer
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First line treatment for GERD?
Lifestyle (lose weight, small meals, no mints, no caffeine, no alcohol, no NSAIDs)
2nd OTC antacids/H2 blockers
3rd PPI
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Another name for Markle Test?
Heel Jar
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Abdominal guarding,rebound, boardlike abdomen. Patient has no appetite.?
Acute Appendicitis
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Fluctuating bowel movement patterns characterized by recurrent abdominal pain?
IBS
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Treatment for IBS?
Increase Fiber
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How is H. pylori diagnosed?
Upper endoscopy with biopsy
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Worrisome symptoms with GERD?
Dysphagia, iron deficiency anemia (blood loss), weight loss, hemoccult positive
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Tx of H. Pylori positive ulcers?
-Triple Therapy (Clarithromycin + Amoxicillin x14 days + PPI for 6-8 was)
-Quadruple Therapy (Bismuth, Flagyl, Tetracycline, PPI)
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H. pylori Negative Ulcer treatment?
Lifestyle changes + PPI or H2Blockers
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Best diagnostic test to diagnose Diverticulitis?
CT Scan
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Best diagnostic test for Cholecystitis?
Ultrasound
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Best diagnostic test for bowel obstruction?
KUB
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Treatment for acute Diverticulitis?
IV Abx
(Uncomplicated case, tolerating P.O. intake & low grade fever - manage with outpatient ABX - Cipro/Flagyl)
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Abdominal Pain accompanied by elevated triglycerides?
Pancreatitis
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What must a person have to become infected with Hep D?
Hep B
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What Hepatitis has the highest risk of cirrhosis and liver cancer?
Hep C
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Lone elevation in the GGT may be indicative of what?
Alcoholism
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Hep C Test?
What do you order if that test is positive?
HCV
RNA
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Hep A anti-HAV + IgG
Immunity (infection Gone)
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Hep A anti-HAV + IgM
Acutely Infected
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Hep A - IgM & IgG
Never infected or immunized——- needs immunization
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Screening for Hep B?
HBsAG (Hep B Surface Antigen)
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Anti-HBs tells you?
Whether the pt is immune to Hep B through shot or not
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anti-HBs tells you?
Whether the patient has had Hep B (pt may be chronically or previously infected)
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ALT > AST what should you think?
Viral Hepatitis
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Higher levels of Alk Phosphate are normal in who?
Teens with growth spurts
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If patient has current Hep B infection what can you give?
Immunoglobulin
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When patient focuses on hand their vertigo symptoms stop. Is this peripheral or central vertigo?
Peripheral
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What is associated with bloody, mucus & pus stools?
Ulcerative Colitis
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What is recommended first for an initial treatment of uncomplicated case of H. pylori negative peptic ulcer disease?
Misoprostol (Cytotec)
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What type of grain can be eaten by a patient with Celiac Disease?
Rice Cereal
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