实习知道（Internship knows）.doc

实习知道（Internship knows） Digestive system diagnostic formula Common symptoms: abdominal pain, diarrhea, nausea, vomiting, and mass 1. acute and chronic gastritis = unclean or stimulating food + epigastric pain, abdominal distention, nausea and vomiting 2. GERD = acid + retrosternal burning sensation + gastroscopy esophageal erosion with red strip (heartburn, acid reflux, regurgitation) 3. peptic ulcer disease Chronic gastric ulcer = regularity of upper abdominal pain (pain after a meal) + melena Duodenal ulcer pain (= hunger after meal 4 hours) or night pain and melena Peptic ulcer perforation = sudden severe abdominal pain (peritonitis sign) + X-ray, free gas under diaphragm 4. gastroesophageal varices = upper gastrointestinal bleeding + previous liver disease 5. bacterial dysentery = unclean diet + + mucusbloodandpus + tenesmus abdominal pain 6. UC = left lower abdominal pain + mucusbloodandpus + (meaning, after remission) + antibiotics ineffective Treatment: sulfasalazine (SASP) 7. acute pancreatitis (edema) = binge / chronic biliary history + persistent epigastric pain + bend pain relief + amylase detection Acute pancreatitis (hemorrhagic necrosis type) = edema type symptoms + waist and abdomen or periumbilical abdominal wear purple + wash water meat + + high calcium low blood glucose liquid Bleeding necrosis type: hematuria, amylase value is not necessarily high, sometimes it will decline. When diagnosed, choose CT One week blood amylase was measured more than one week 8. pyloric obstruction = vomiting, food retention + water oscillation 9. = history of hepatitis cirrhosis and portal hypertension (+ + + splenomegaly ascites spider) + ultrasound (shrinking liver) 10. cholecystitis = paroxysmal right upper abdominal pain + Murphy sign + nausea and vomiting 11. gallstone = paroxysmal right upper abdominal colic + + Murphy sign + + B echo strong echo clusters and acoustic shadows 12. patients with acute obstructive suppurative cholangitis triad (KO = + + chills fever