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Questions and Answers
What is a potential cause of acalculus cholecystitis?
What is a potential cause of acalculus cholecystitis?
What is Murphy's sign indicative of?
What is Murphy's sign indicative of?
What distinguishes mild pancreatitis from severe pancreatitis?
What distinguishes mild pancreatitis from severe pancreatitis?
Which sign is NOT typically associated with hepatitis?
Which sign is NOT typically associated with hepatitis?
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What is a common risk factor for the development of hepatitis?
What is a common risk factor for the development of hepatitis?
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Which complication is most commonly associated with Crohn's disease?
Which complication is most commonly associated with Crohn's disease?
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What is a common sign of diverticulitis?
What is a common sign of diverticulitis?
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Which of the following is NOT a recognized cause of bowel obstruction?
Which of the following is NOT a recognized cause of bowel obstruction?
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Which statement about hemorrhoids is accurate?
Which statement about hemorrhoids is accurate?
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What is a potential consequence of untreated appendicitis?
What is a potential consequence of untreated appendicitis?
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What symptom might indicate a bowel obstruction?
What symptom might indicate a bowel obstruction?
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Which demographic is commonly affected by diverticulosis?
Which demographic is commonly affected by diverticulosis?
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Which of the following pathophysiological conditions describes inflammation of the small outpockets in the intestinal tract?
Which of the following pathophysiological conditions describes inflammation of the small outpockets in the intestinal tract?
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What is the main cause of damage to the mucosal GI surfaces in acute gastroenteritis?
What is the main cause of damage to the mucosal GI surfaces in acute gastroenteritis?
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Which of the following risk factors is associated with acute gastroenteritis?
Which of the following risk factors is associated with acute gastroenteritis?
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Which symptom is NOT typically associated with acute gastroenteritis?
Which symptom is NOT typically associated with acute gastroenteritis?
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What is a common cause of peptic ulcers?
What is a common cause of peptic ulcers?
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Which is NOT a typical treatment for acute gastrointestinal bleeding?
Which is NOT a typical treatment for acute gastrointestinal bleeding?
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What is a common symptom of ulcerative colitis?
What is a common symptom of ulcerative colitis?
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Which of the following conditions is characterized by bleeding distal to the ligament of Treitz?
Which of the following conditions is characterized by bleeding distal to the ligament of Treitz?
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What type of fluid management is typically recommended for acute gastroenteritis?
What type of fluid management is typically recommended for acute gastroenteritis?
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Which of the following risk factors is NOT associated with gastrointestinal emergencies?
Which of the following risk factors is NOT associated with gastrointestinal emergencies?
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What is a common cause of upper gastrointestinal bleeding?
What is a common cause of upper gastrointestinal bleeding?
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What sign is associated with bleeding that might suggest pancreatitis or retroperitoneal hemorrhage?
What sign is associated with bleeding that might suggest pancreatitis or retroperitoneal hemorrhage?
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Which of the following is a typical symptom of esophageal varices?
Which of the following is a typical symptom of esophageal varices?
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When addressing an emergency involving upper gastrointestinal bleeding, which treatment step is critical?
When addressing an emergency involving upper gastrointestinal bleeding, which treatment step is critical?
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What condition is primarily caused by portal hypertension?
What condition is primarily caused by portal hypertension?
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Which assessment method is NOT part of the focused history during a medical assessment?
Which assessment method is NOT part of the focused history during a medical assessment?
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What is the first step in the general treatment of a patient with gastrointestinal emergencies?
What is the first step in the general treatment of a patient with gastrointestinal emergencies?
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Study Notes
Division 4: Medical Emergencies
- This division covers medical emergencies, specifically focusing on gastroenterology.
- Topics include general pathophysiology, assessment, management, and specific illnesses.
General Pathophysiology
- General Risk Factors: Excessive alcohol consumption, excessive smoking, increased stress, ingestion of caustic substances, and poor bowel habits.
- Emergencies: Acute emergencies often stem from underlying chronic problems.
Abdominal Pain
- Types: Visceral, somatic, referred.
- Causes: Inflammation, distention, and ischemia.
General Assessment (Part 1)
- Scene Size-up and Initial Assessment: Assess the scene and immediately address life-threatening conditions.
- Scene Clues: Gather information from the scene for context.
- Focused History: Obtain SAMPLE (Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading up), OPQRST (onset, provocation, quality, radiation, severity, timing) history.
- Associated Symptoms: List additional symptoms beyond the main complaint.
- Pertinent Negatives: Note anything absent from the patient's presentation.
General Assessment (Part 2)
- Physical Exam: General assessment and vital signs.
- Abdominal Assessment: Inspection, auscultation, palpation.
- Specific Signs: Cullen's sign, Grey-Turner's sign.
General Treatment
- Airway Management: Maintain the airway and support breathing using high-flow, high-concentration oxygen or assisted ventilation.
- Circulation: Monitor vital signs and cardiac rhythm.
- IV Access: Establish intravenous (IV) access.
- Transport: Transport the patient in a comfortable position.
Specific Illnesses
- Gastrointestinal Tract: Upper and lower gastrointestinal tract, liver, gallbladder, pancreas, vermiform appendix are discussed.
Upper Gastrointestinal Bleeding
- Causes: Peptic ulcer disease, gastritis, varices rupture, Mallory-Weiss tear, esophagitis, and duodenitis.
- Signs and Symptoms: General abdominal discomfort, hematemesis and melena, classic signs/symptoms of shock, changes in orthostatic vital signs.
- Treatment: Follow general treatment guidelines, begin volume replacement using two large-bore IVs, and distinguish life-threatening from chronic problems.
Esophageal Varices
- Cause: Portal hypertension, chronic alcohol abuse and liver cirrhosis, and ingestion of caustic substances.
- Signs and Symptoms: Hematemesis, dysphagia, painless bleeding, hemodynamic instability and classical signs of shock.
- Treatment: Follow general treatment guidelines, aggressive airway management, and aggressive fluid resuscitation.
Acute Gastroenteritis
- Cause: Damage to mucosal GI surfaces, pathologic inflammation causing hemorrhage and erosion of mucosal and submucosal layers.
- Risk Factors: Alcohol and tobacco use, chemical ingestion (NSAIDs, chemotherapeutics), Systemic infections.
- Signs & Symptoms: Rapid onset of vomiting and diarrhea, hematemesis, hematochezia, melena, diffuse abdominal pain, and classical signs of shock.
- Treatment: Follow general treatment guidelines, fluid volume replacement, and consider antiemetics.
Chronic Gastroenteritis
- Similarities: Similar to acute gastroenteritis.
- Differences: Long-term mucosal changes, or permanent damage, primarily due to microbial infection. More frequent in developing countries.
Peptic Ulcers
- Pathophysiology: Erosions caused by gastric acid, symptoms vary based on where in the tract the ulcer is located.
- Causes: NSAID use, alcohol/tobacco use, H. pylori.
- Signs and Symptoms: Abdominal pain, hemorrhagic rupture, acute pain, hematemesis, melena.
- Treatment: Follow general guidelines, histamine blockers and antacids considered.
Lower Gastrointestinal Bleeding
- Pathophysiology: Bleeding distal to the ligament of Treitz.
- Causes: Diverticulosis, colon lesions, rectal lesions, inflammatory bowel disorder
- Signs and Symptoms: Acute/chronic determination, quantity/color of blood in stool, abdominal pain, signs of shock.
- Treatment: General treatment guidelines, establishing IV access with two large-bore catheters.
Ulcerative Colitis
- Pathophysiology: Causes unknown, it's an inflammatory condition.
- Signs/Symptoms: Abdominal cramping, nausea/vomiting, diarrhea, fever, weight loss.
- Treatment: Follow general treatment guidelines.
Crohn's Disease
- Pathophysiology: Causes unknown, can affect the entire GI tract, showing inflammation in the mucosal linings, and damaging the mucosa, causing hypertrophy and fibrosis of the underlying muscle, also causes fissures and fistulas
- Signs/Symptoms: Difficult to differentiate, varying GI bleeding, nausea/vomiting, diarrhea, abdominal pain/cramping, fever, weight loss
- Treatment: Follow general treatment guidelines
Diverticulitis
- Pathophysiology: Inflammation of small outpouches in the mucosal lining of the intestinal tract, common in the elderly
- Signs and Symptoms: Abdominal pain/tenderness, fever, nausea/vomiting, lower GI bleeding.
- Treatment: Follow general treatment guidelines.
Hemorrhoids
- Pathophysiology: Mass of swollen veins in the anus/rectum
- Signs and symptoms: Limited bright red bleeding, painful stools, lower GI bleeding, possibly idiopathic.
- Treatment: General treatment guidelines.
Bowel Obstruction
- Pathophysiology: Blockage in the hollow space of the small or large intestines.
- Causes: Hernias, intussusception, volvulus, adhesions, other causes (foreign bodies, gallstones, tumors, bowel infarction).
- Other Problems: Decreased appetite, fever, malaise, nausea, vomiting, diffuse visceral pain, abdominal distention, signs of shock.
- Treatment: Follow general treatment guidelines.
Accessory Organ Diseases
- Specific Organs: Liver, gallbladder, pancreas, vermiform appendix.
Appendicitis
- Pathophysiology: Inflammation of the appendix. Common in older children and young adults. Untreated, can lead to rupture.
- Signs and Symptoms: Nausea, vomiting, low-grade fever, pain localized to the right lower quadrant (RLQ) along McBurney's point.
- Treatment: Follow general treatment guidelines.
Cholecystitis
- Pathophysiology: Inflammation of the gallbladder, potentially due to gallstones, bacterial infection or even acalculous cholecystitis which is without gallstones (as in burns and sepsis).
- Signs and Symptoms: Right upper quadrant pain, Murphy's sign, and nausea/vomiting.
- Treatment: Follow general treatment guidelines.
Pancreatitis
- Pathophysiology: Inflammation of the pancreas
- Causes: Classified as metabolic, mechanical, vascular, infectious based on the cause. Potential causes are alcohol abuse, gallstones, elevated serum lipids, or drugs.
- Signs & Symptoms: Mild pancreatitis, epigastric pain, abdominal distention, nausea/vomiting, elevated amylase and lipase levels; Severe pancreatitis, refractory hypotensive shock, blood loss, and respiratory failure.
- Treatment: Follow general treatment guidelines.
Hepatitis
- Pathophysiology: Injury to liver cells, typically due to inflammation or infection. Types include viral (A, B, C, D, E) and alcoholic hepatitis, also trauma and other causes.
- Signs and Symptoms: Right upper quadrant abdomen tenderness, loss of appetite, weight loss, malaise, clay-colored stool, jaundice, scleral icterus, photophobia, nausea vomiting.
- Treatment: Follow general treatment guidelines, use PPE and follow BSI precautions.
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Description
Test your knowledge on gastroenterological conditions, including acalculus cholecystitis, pancreatitis, and biliary issues. This quiz covers symptoms, common complications, and demographic factors associated with various gastrointestinal disorders. Challenge yourself to identify key signs and risk factors related to these conditions.
