Week 8 continued

Question 1

What is Charcot’s triad? What does it diagnose?

Answer 1

• jaundice, fever, RUQ pain
• Dx cholangitis
• Add hypotension and ALOC = Reynold’s pentad

Question 2

What is Cullen’s sign and what does it indicate?

Answer 2

• Blue umbillicus

- Intra or retroperitoneal hemorrhage/pancreatitis

Question 3

What is the significance of striae color?

Answer 3

• Pink/blue = recent
• Purple = Cushing’s
• Silver = old/obese/post partum

Question 4

Name some scrotum conditions that are painful.

Answer 4

• epididymitis
• orchitis
• Torsion
• Tumor (with hemorrhage/infarct)
• Hematocele with trauma
• Strangulated inguinal hernia

Question 5

Name some scrotum conditions that are not painful.

Answer 5

• Hydrocele
• Spermatocele/epididymal cyst
• Varicocele (may be asymptomatic or painful)
• Tumor (no hemorrhage)
• Scrotal hematoma
• Non strangulated inguinal hernia

Question 6

What is functional incontinence caused by?

Answer 6

-Inability to access toilet due to cognitive or physical barrier

Question 7

Define acute pain.

Answer 7

Less than a few days that increases progressively.

Question 8

Define chronic pain.

Answer 8

• 12 weeks or longer (C and G)

- 6 months or longer than the time of expected tissue healing (Jarvis)

Question 9

Differentiate between visceral and parietal pain.

Answer 9

• Visceral: dull, aching, poorly localized

- Parietal: sharp and well localized

Question 10

What are the BC colorectal cancer screening guidelines?

Answer 10

• Fit Q2 years average risk 50-74 yrs, any + FIT gets a colonoscopy
• Colonoscopy Q10 yrs and no additional testing
• Colonoscopy Q5 yrs if single 1st degree relative < 60 with CRC or advanced adenoma(s) or two or more 1st degree relatives with CRC.
• Colonoscopy Q 1-2 yrs if inflammatory bowel disease involving the majority of the colon for over 8 years or the left colon for over 15 years

Question 11

What are the cardinal s/sx of Crohn’s disease?

Answer 11

• Chronic or nocturnal diarrhea
• Abdo pain to RLQ
• Fatigue
• Extraintestinal: uveitis, iritis, arthritis
• Skip lesions

Question 12

What are the hallmarks of diverticulitis?

Answer 12

• LLQ pain
• Constipation
• Painless rectal bleeding

Question 13

How long must one have nausea and vomiting for it to be considered chronic.

Answer 13

At least one month in duration

Question 14

What is Prehn’s sign?

Answer 14

• Considered + if elevation of scrotum decreases pain.
• Indicates Epididymitis
• Elevation = Epididymitis

Question 15

Hallmarks of varicocele?

Answer 15

• Bag of worms
• 80-90% LEFT sided
• Decreases in size if pt lies supine

Question 16

What is the difference between primary and secondary amenorrhea?

Answer 16

• Primary is no period by 14 and no growth or development of sexual characteristics OR 16 even if growth and sexual characteristics
• Secondary is no period for 6 months in a woman who has normal periods

Question 17

Describe primary and secondary dysmenorrhea.

Answer 17

• Primary is associated with ovulatory cycle

- Secondary is painful contractions due to uterine pathology (endometriosis, PID, IBS)