AMLS CH 8 DIFFERENTIAL DIAGNOSIS EXAM WITH CORRECT ANSWERS 2024

In the field, differential diagnosis for abdominal pain is limited to two things: - correct answer 1) the degree of threat to life 2) a suggested organ type and under the 1st diagnosis it has 3 considerations? ( IM NOT PO) - correct answer -immediate life threat, -potential life threat - not a life threat And under the 2nd diagnosis is (a suggested organ type you) will consider 2 things - correct answer the pain is typical of a hollow organ or a solid organ In the field, differential diagnosis for abdominal pain is frequently limited to determining the degree of threat to life and whether the patient is ? (CUPS) - correct answer critical, unstable, potentially unstable, stable (CUPS) Right Hypochondriac Region Underlying organs in this region include the ____and the _________. Pain may be referred to this area from the lungs - correct answer liver gallblader Right Hypochondriac Region What is the largest abdominal organ. - correct answer liver Right Hypochondriac Region in the liver The left lobe extends to the _______ line of the left hypochondriac region. Normally, the liver in an adult is not palpable in the field. - correct answer midclavicular Right Hypochondriac Region The liver is surrounded by it and it allows the organ to swell and expand. - correct answer capsule Right Hypochondriac Region In the Liver Pain from sudden swelling and expansion is described as ____ and dull - correct answer steady Right Hypochondriac Region When this is irritated, either from swelling, chemical irritation, or infection, it rarely swells enough to break - correct answer capsule Right Hypochondriac Region if the capsule break's its close proximity to the diaphragm results in irritation extending to the right ____ nerve with referred pain to the right neck and shoulder. - correct answer phrenic Right Hypochondriac Region Is inflammation of the liver that can have a variety of causes, including viruses, bacteria, drugs, and toxic agents. - correct answer hepatitis Right Hypochondriac Region ____ of the liver may be rapid, resulting in mild pain in the right hypochondriac region with tenderness on palpation - correct answer Enlargement of the liver Right Hypochondriac Region Jaundice is better seen in the ? skin or the sclera - correct answer sclera Right Hypochondriac Region is generally preceded by flu-like symptoms, which may include nasal discharge, nausea, vomiting, diarrhea, chills, fever, and fatigue - correct answer jaundice Right Hypochondriac Region Is a chronic liver disease that can have a variety of causes, including nutritional deficiencies, alcohol ingestion, or prior viral or bacterial inflammation - correct answer cirrhosis Right Hypochondriac Region is Fibrotic changes of the liver, and cause gradual swelling of the liver - correct answer cirrhosis Right Hypochondriac Region In cirrhosis gradual swelling does not cause liver pain; instead, it causes what ? - correct answer dyspnea Right Hypochondriac Region is the accumulation of serous fluid from the liver that accumulates in the abdominal cavity - correct answer ascites Right Hypochondriac Region In ascites the fluid is collected where - correct answer peritoneal space Right Hypochondriac Region Because normal functions of the liver include production of clotting factors and clearing the blood of bilirubin (a byproduct of the destruction of aged red blood cells), any disease of the liver may result in bleeding tendencies, noticed as bruising, and/or jaundice to the skin and sclera. - correct answer Right Hypochondriac Region Gallbladder Located under the ____ lobe of the liver, the gallbladder is also surrounded by the liver capsule - correct answer right Right Hypochondriac Region The gallbladder stores and concentrates bile necessary for digestion of ___. The bile is collected by a tube-like structure called the ___ - correct answer fat cystic duct Right Hypochondriac Region The cystic duct joins the hepatic duct and they form the _____bile duct. - correct answer common bile duct Right Hypochondriac Region The hepatic duct collects bile from the_____ - correct answer liver Right Hypochondriac Region What duct extends from the gallbladder across the abdomen to the left side, passing through the pancreas, and connecting with the pancreatic duct at the sphincter of Oddi - correct answer common bile duct Right Hypochondriac Region Initial pain is often described as intermittent, crampy or colicky, and dull. Pain can occur any time from 30 to 60 minutes after ingestion of food, particularly food with a high fat content. this happens when? - correct answer stone becomes lodged Right Hypochondriac Region inflammation of the gallbladder. - correct answer cholecystitis Right Hypochondriac Region the back-up of bile may cause chemical irritation and inflammation of the gallbladder with associated pain in the upper abdomen or referred to the back or right shoulder, with nausea and vomiting. Fever and jaundice may occur if the condition is acute - correct answer (cholecystitis) Right Hypochondriac Region If the obstruction occurs at the sphincter of Oddi, the ____ may also become obstructed and inflamed. - correct answer pancreas Right hypochondriac pain may also result from referred pain associated with pleuritis or ____in the right pleural cavity with pain and wheezes or rhonchi - correct answer pneumonia Epigastric Region Organs in this region include the ___ and____, with referred pain from the heart and the appendix - correct answer stomach and pancreas Epigastric Region is a muscular, sac-like organ, shaped like an expanded J. It is located primarily in the epigastric region of the abdominopelvic cavity. - correct answer stomach Epigastric Region The outer surface of the stomach is covered by the ______ - correct answer peritoneum Epigastric Region the fat deposit that protects the abdominal organs, and the lesser omentum - correct answer greater omentum Epigastric Region located in the stomach that secrete mucus to help protect the stomach lining from the acids, enzymes, and abrasive materials it contains. - correct answer mucous cells Epigastric Region What secrete hydrochloric acid, enzymes, and intrinsic factor (a substance that makes possible the absorption of vitamin B12 - correct answer Gastric glands Epigastric Region when mucous protection is insufficient or absent, inflammation of the gastric mucosa, causing. - correct answer gastritis Epigastric Region inflammation of the gastric mucosa - correct answer gastritis Epigastric Region When stomach acids and enzymes actually erode through the stomach lining or proximal portions of the small intestine, and forming a ____ - correct answer crater Epigastric Region normal gastric defenses have been breached, a normal resident bacterium called Helicobacter pylori is responsible for ulcer formation at the site of the crater - correct answer peptic ulcer disease Epigastric Region formation of a disruption in the mucosa of the stomach or proximal portion of the small intestine - correct answer peptic ulcer disease Epigastric Region Helicobacter pylori is causes what? - correct answer ulcers Epigastric Region Both gastritis and stomach ulcers are painful, with localized, steady, burning pain in the ____ region. - correct answer epigartic Epigastric Region may perforate the stomach wall, causing bleeding or spillage of stomach contents into the peritoneal space, resulting in signs of peritoneal irritation - correct answer ulcers Epigastric Region Stomach contents and the bilious green color of duodenal contents are considered "______ - correct answer normal Epigastric Region Bright red or "coffee grounds" of digested blood or the dirty yellow prelude to the foul, feculent emesis of bowel obstruction is abnormal with a high probability for immediate or potential ____ ____ - correct answer life threat Epigastric Region what is a tadpole-shaped solid organ approximately 20 cm long. It lies parallel to and beneath the stomach with its head tucked into the curve of the duodenum and its tail touching the spleen - correct answer The pancreas Epigastric Region A swollen, irritated pancreas usually results in peritoneal __________. The resulting pain may develop suddenly and is constant and severe - correct answer irritation Epigastric Region the pancreas is in both the peritoneal and the retroperitoneal spaces, and with radiating pain often described as "______ The patient feels more comfortable when lying still and with knees drawn up. - correct answer boring through to the back Epigastric Region what secretes digestive enzymes and controls blood sugar levels through the production of insulin - correct answer pancreas Epigastric Region When large quantities of digestive ______ pool within the pancreas, the pancreatic secretions begin, Iiterally, to digest the pancreas itself - correct answer enzymes Epigastric Region leakage of fluid from the vascular and/or intracellular space into the interstitial space - correct answer third spacing Epigastric Region In 10 to 15 percent of cases, however, the process does not subside and severe necrosis and hemorrhage result. These patients "look toxic" and are extremely ill. Because the pancreas lies in both the peritoneal and the retroperitoneal spaces, pancreatic exudate-containing toxins and activated pancreatic enzymes permeate the retroperitoneum, often including the anterior or peritoneal cavity. These toxins and enzymes induce a chemical burn and increase the permeability of blood vessels. - correct answer Epigastric Region This may damage tissue directly, causing hemorrhage, respiratory failure (from injury to alveolar membranes of the lungs), and/or cardiac failure (e.g., from circulating myocardial depressant factor). - correct answer Circulating activated enzymes Epigastric Region When tissue damage is extensive, the endocrine function is also affected, causing ? - correct answer hyperglycemia Epigastric Region Referred pain from the where can cause epigastric pain? - correct answer heart Epigastric Region Close proximity of infarcted myocardial tissue to vagus nerve fibers stimulates________ reflexes, causing indigestion, nausea, and vomiting - correct answer vasovagal Left Hypochondriac Region contains the ______ and the ______ with referred pain from the left pleural space - correct answer pancreas spleen Left Hypochondriac Region what is a solid organ located between the stomach and the left kidney with the diaphragm on top - correct answer spleen Left Hypochondriac Region The adult spleen is rather flat, about 1 to 1 1/2 inches thick, and about the size of an adult s ______ - correct answer hand Left Hypochondriac Region the spleen is surrounded by a capsule and is suspended on a stalk of blood ____. The capsule allows the spleen to ? - correct answer vessels swell and expand Left Hypochondriac Region when capsule is irritated—from swelling, chemical irritation, or infection—pain is often perceived as being ______ - correct answer steady and dull. Left Hypochondriac Region The spleen's close proximity to the diaphragm results in the irritation frequently extending to the distribution of the left phrenic nerve. This causes referred pain, usually to the left neck and shoulder - correct answer left neck and shoulder Left Hypochondriac Region The work of the spleen is to remove ______ blood cells and other components of blood from the circulation - correct answer abnormal Left Hypochondriac Region It is also important in preventing ______ and helping with immune responses. - correct answer infection Left Hypochondriac Region Rupture of the capsule is causes sharp, intense pain that then lets up, only to recur more _____ later. - correct answer intensly Left Hypochondriac Region bleeding from a ruptured spleen can be _______. The abdominal pain will steadily increase in intensity following syncope, postural hypotension, referred pain to the ______, and signs of peritoneal irritation - correct answer profuse left neck/shoulder, Left Hypochondriac Region if this happen signs and symptoms of shock may not be readily apparent, especially if the patient is lying down. Orthostatic blood pressure checks should be done as a field test for volume loss - correct answer splenic capsule is leaking Left Hypochondriac Region The spleen is not necessary for _____; however, it takes the liver time to pick up the extra load - correct answer survival Left Hypochondriac Region is most commonly seen within the first year of removal of the spleen and commonly presents with the history of an upper respiratory infection that "just didn't get better." - correct answer Sepsis Left hypochondriac pain may also result from referred pain associated with pleuritis or pneumonia in the_____ pleural cavity much like the referred pain to the right - correct answer left Umbilical and Hypogastric Regions The umbilical region contains the small and large intestine, and ______ with referred pain from the appendix - correct answer aorta Umbilical and Hypogastric Regions The hypogastric region contains the _____and _____with referred pain from intestinal obstruction - correct answer bladder aorta Umbilical and Hypogastric Regions is also known as - correct answer central abdomen Umbilical and Hypogastric Regions _______ inflammation of the intestine. _____ inflammation of the ileum. _______ inflammation of the colon (large intestine). - correct answer enteritis ileitis colitis Umbilical and Hypogastric Regions _______ inflammation of the gastrointestinal tract. - correct answer gastroenteritis Umbilical and Hypogastric Regions ___ also called the small bowel, is a muscular, hollow tube lined with a series of finger-like projections called villi, which, in turn, are covered with microvilli that absorb nutrients - correct answer small intestine Umbilical and Hypogastric Regions small intestine has three segments: the - correct answer num um 3. ileum. Umbilical and Hypogastric Regions complex causing chronic inflammation of the small or large intestine; colitis. - correct answer inflammatory bowel disease disease Umbilical and Hypogastric Region ________ is a general term that refers to inflammation of the entire gastrointestinal tract and is characterized by vomiting followed by diarrhea - correct answer Gastroenteritis Umbilical and Hypogastric Region is a blanket term that refers to both ulcerative colitis and Crohn's disease - correct answer Inflammatory bowel disease Umbilical and Hypogastric Region is a chronic inflammatory disease that can occur anywhere in the digestive tract, usually in the small or large intestine - correct answer Crohn's disease Umbilical and Hypogastric Region A side effect of frequent diarrhea is ______ and electrolyte imbalance. - correct answer dehydration Umbilical and Hypogastric Region cholera bacteria bound to the intestinal lining release toxins that stimulate a massive fluid secretion across the intestinal epithelium. Without treatment, the victim may die of acute dehydration in a matter of ____ - correct answer hours Umbilical and Hypogastric Region Onset is usually sudden, within 2 to 8 hours of ingesting contaminated food. Symptoms usually begin with nausea, vomiting, and abdominal pain described as crampy or colicky and intermittent, followed by diarrhea - correct answer food poisoning, salmonella, Shigella, staphylococcal enterotoxin Umbilical and Hypogastric Region cells that form the outer surface of the body and the lining of the body cavity and principal tubes and passageways leading to the exterior. - correct answer epithelium Umbilical and Hypogastric Region Important elements of the patient history include determining a possible relationship between onset of symptoms and ____________, the progression of symptoms, and the frequency of stools within a given time period - correct answer intake of food or wate Umbilical and Hypogastric Region Signs include the patient lying in the fetal position, a side-lying position with knees drawn up, which reduces movement of the peritoneum. Shallow respirations and complaints that coughing worsen the pain are also characteristics of ____ - correct answer peritoneal irritation Umbilical and Hypogastric Region Patients may be in extremis, complain of terrible pain, and often writhe in agony - correct answer bowl ischemia or infarction Umbilical and Hypogastric Region The horseshoe-shaped also called the colon or the large bowel, - correct answer large intestine Umbilical and Hypogastric Region the large intestine begins at the end of the ____ and ends at the ____ - correct answer ileum anus Umbilical and Hypogastric Region The large intestine lies below the _______ and _____, and almost completely frames the small intestine - correct answer stomach liver Umbilical and Hypogastric Region Bloody diarrhea is more common with inflammatory bowel disease. _____ is not as common - correct answer Vomiting Umbilical and Hypogastric Region Diverticula are formed when various areas of the muscular wall of the colon are weakened and develop little pockets in the mucosa that get forced outward, a condition known as __________ - correct answer diverticulosis. Umbilical and Hypogastric Region is pockets in the walls of an organ - correct answer diverticula Umbilical and Hypogastric Region This is the presence of diverticula - correct answer diverticulosis the presence of diverticula Umbilical and Hypogastric Region is inflammation of diverticula. Inflamed diverticula of the colon may perforate, causing spillage into the peritoneal space - correct answer diverticulitis Umbilical and Hypogastric Region diverticulitis most commonly, the left lower quadrant. Another characteristic is the pronounced change in bowel habit, most often diarrhea, with the presence of fever. Bleeding may be present but not always obvious. Bleeding may also be massive - correct answer Umbilical and Hypogastric Region Diverticulitis is more common in older adults; however, it can occur in those younger than _____ years of age - correct answer 50 Umbilical and Hypogastric Region The abdominal aorta is considered a hollow organ that protrudes primarily into the __________ space - correct answer retroperitoneal Umbilical and Hypogastric Region It does not have peristaltic movement but does have the ability to contract. Its three layers contain nerve fibers that are sensitive to both _____ and _____ - correct answer stretching and tearing Umbilical and Hypogastric Region The most common problem causing abdominal pain from the aorta is an - correct answer aneurysm