GI Disorders: Recognition, Signs, and Clues

A comprehensive collection of vocabulary-style flashcards covering hallmark signs, key symptoms, diagnostic clues, and red flags for GI, hepatic, biliary, and pancreatic disorders from the lecture notes.

Peritonitis (Possible Perforation)

A critical abdominal condition characterized by a rigid, board-like abdomen with severe pain, fever, and tachycardia; treat as a potential emergency.

Dyspepsia

The most common manifestation of GI dysfunction, presenting as digestive discomfort with pain, fullness, bloating, early satiety, belching, heartburn, and regurgitation.

Normal Bowel Sounds

Normal intestinal gurgles or clicks occurring every $5\text{--}15\text{ sec}$ ($5\text{--}30\text{ per minute}$).

Absent Bowel Sounds

The total lack of bowel motility sounds, which can only be determined after auscultating for a full $5\text{ minutes}$.

ALT and AST

Liver enzyme laboratory values that, when elevated, specifically indicate liver cell injury.

ALP (Alkaline Phosphatase)

A laboratory parameter that points toward biliary pathway obstruction when elevated.

Oral Candidiasis

An oral fungal infection presenting with cheesy white plaque/curd-like appearance, burning, or tingling; linked to immunosuppression, antibiotics, or diabetes.

Stomatitis

Inflammation of the oral mucosa causing redness, edema, painful ulcerations, and bleeding; often seen after chemotherapy, radiation, allergy, or myelosuppression.

Dumping Syndrome

A condition where highly concentrated feedings pull fluid into the small intestine, causing nausea, cramping, dizziness, diaphoresis, diarrhea, dehydration, hypotension, and tachycardia.

GERD (Gastroesophageal Reflux Disease)

Incompetence of the lower esophageal sphincter allowing acid back up, causing heartburn, dyspepsia, chest pain, regurgitation, dysphagia, and morning hoarseness.

Barrett's Esophagus

A premalignant condition with an altered esophageal lining caused by chronic acid exposure from GERD; confirmed by EGD with biopsy.

Achalasia

An esophageal motility disorder characterized by ineffective peristalsis, causing dysphagia and the sensation that food is sticking in the esophagus.

Esophageal Diverticula

An outpouching of the esophageal wall that traps old food, resulting in halitosis and regurgitation of undigested food.

Hiatal Hernia Volvulus

A red-flag complication of hiatal hernia presenting with sudden constant epigastric/chest pain, nonproductive retching, and an inability to pass an NG tube.

Boerhaave Syndrome

Esophageal perforation following forceful vomiting or severe straining; presents with excruciating retrosternal pain, dysphagia, fever, leukocytosis, and hypotension.

Acute Gastritis

Sudden irritation of the stomach lining by agents like NSAIDs, steroids, alcohol, or stress, presenting with dyspepsia, burning pain, bloating, and early satiety.

Chronic Gastritis

Long-term thinning of the gastric lining caused by H. pylori, NSAIDs, bile reflux, or autoimmune destruction, which can impair intrinsic factor and lead to vitamin $B_{12}$ malabsorption and pernicious anemia.

Gastric Ulcer

A peptic ulcer characterized by epigastric pain immediately or within about $30\text{ minutes}$ after eating, which is aggravated by food.

Duodenal Ulcer

A peptic ulcer characterized by delayed epigastric pain occurring $2\text{--}3\text{ hours}$ after meals or waking the patient at night; pain is typically relieved by eating or antacids.

IBS (Irritable Bowel Syndrome)

A noninflammatory motility disorder with normal bowel structure, marked by recurrent abdominal pain (improving after BM), bloating, and alternating diarrhea or constipation.

Celiac Disease

An autoimmune malabsorption condition triggered by gluten (wheat, barley, rye) that flattens small intestinal villi, leading to steatorrhea, weight loss, and dermatitis herpetiformis.

Appendicitis

Inflammation of the appendix characterized by progressive pain starting periumbilically and migrating to the RLQ, with rebound tenderness, McBurney tenderness, and Rovsing sign.

Rovsing Sign

A physical exam indicator for appendicitis where pressure applied to the LLQ elicits pain in the RLQ.

Diverticulitis

Infection and inflammation of a sigmoid colon pouch presenting with acute crampy LLQ pain, fever, leukocytosis, and altered bowel habits.

Crohn's Disease

Transmural, skip-lesion inflammation with a cobblestone pattern anywhere from mouth to anus; frequently causes fistulas, steatorrhea, and B12/iron deficits.

Ulcerative Colitis

Uniform and continuous mucosal inflammation extending proximally from the rectum, causing severe bloody diarrhea ($10\text{--}20\text{ liquid stools/day}$) and tenesmus.

Toxic Megacolon

A life-threatening complication of ulcerative colitis signaled by severe abdominal distention, fever, and tachycardia.

Strangulated Hernia

An incarcerated hernia whose blood supply is compromised, presenting as a hard, tender, red/purple/black bulge with severe pain and nausea.

Hemorrhoids

Swollen or varicose veins of the anorectal area causing frank bright red blood on toilet paper or in the toilet, itching, and localized swelling.

Cullen Sign

Superficial edema and bruising around the umbilicus, indicating severe intraperitoneal or retroperitoneal bleeding.

Grey Turner Sign

Ecchymosis or bruising along the flanks, indicating retroperitoneal hemorrhage.

Hepatitis A

An acute liver infection spread via the fecal-oral route, frequently linked with food-borne outbreaks.

Hepatitis B

A viral hepatitis transmitted through blood and body fluids; has a slower onset, can cause arthralgias/rash, and carries a chronic carrier risk.

Hepatitis C

The most common chronic hepatitis, transmitted via blood/body fluids; often asymptomatic for years until significant cirrhosis occurs.

Hepatitis D

A viral hepatitis that depends on the presence of Hepatitis B to replicate, leading to higher rates of liver failure.

Hepatitis E

A fecal-oral transmitted viral hepatitis that typically presents with jaundice and carries high mortality/danger in pregnant women.

Cirrhosis

Chronic liver scarring and failure characterized by portal hypertension, ascites, jaundice, pruritus, spider angiomas, palmar erythema, and caput medusae.

Hepatic Encephalopathy

Central nervous system toxicity from elevated serum ammonia levels in liver failure, manifesting as confusion, asterixis, constructional apraxia, and fetor hepaticus.

Asterixis

A motor disturbance characterized by a flapping tremor of the hands when wrists are extended; a classic finding in hepatic encephalopathy.

Cholecystitis

Gallbladder inflammation (commonly in patients fitting the 4 F's: Fat, Female, Fertile, Forty) presenting with RUQ biliary colic after fatty meals, radiating to the right shoulder, and a positive Murphy sign.

Murphy Sign

Inspiratory arrest caused by pain during deep palpation of the right upper quadrant; indicates acute cholecystitis.

Choledocholithiasis

Obstruction of the common bile duct by a gallstone, leading to jaundice, tea-colored dark urine, and clay-colored stools.

Acute Pancreatitis

Inflammation of the pancreas causing severe epigastric pain that bores to the back (relieved by leaning forward), accompanied by amylase and lipase levels elevated to approximately $3\times\text{ normal}$.

Chronic Pancreatitis

Irreversible fibrosis of the pancreas causing loss of endocrine/exocrine function, leading to persistent steatorrhea, weight loss, and ductal calcifications.

Chvostek Sign

Facial muscle twitching elicited by tapping over the facial nerve; indicates hypocalcemia (e.g., in acute pancreatitis).

Trousseau Sign

Carpopedal spasm induced by inflating a blood pressure cuff above systolic pressure; indicates hypocalcemia.

Pancreatic Pseudocyst

A fluid-filled sac located in or adjacent to the pancreas, clinically presenting as a palpable epigastric mass with persistent fever.