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Flashcards in Abdominal Exam Deck (47)
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1
Q

what is a key to the abdominal exam?

A

get an accurate description of the problem

2
Q

when asking about abdominal pain, what should you do?

A

have the patient point to where they feel the pain and try to identify the size of the pain

3
Q

what is an extra timing question you must ask for belly pain?

A

timing in relation to

  • food
  • BM
  • nausea
4
Q

nocturnal symptoms that affect sleep are

A

more concerning

5
Q

BHC / CBH

A

bowel habit change / change in bowel habits

6
Q

what can positional changes pain indicate?

A

adhesional types of pain

7
Q

what GI problem could surgical history create?

A

adhesion

8
Q

what is LNMP?

A

last normal menstrual period

9
Q

what are common causes of GI complaints?

A

DM (slow motility, early satiety, nausea, side effect of medication)
renal

depression
arthritis

hyperlipidemia
endometriosis

10
Q

what meds can influence GI symptoms?

A

NSAIDS
new or changes in meds

DM
statins (hepatotoxicity, renal failure)
biphosphonantes (GERD, reflux, esophogeal erosion)

antibiotics (diarrhea)
diuretics
laxatives (abdominal cramping)

11
Q

what family hx considerations are involved in GI?

A

IBD
colon CA
liver dz

12
Q

what special considerations in the social hx involve GI?

A
IV drug use (liver damage)
diet changes/exercise (hemorrhoids)
recent travel
water source
ill contacts
tobacco, alcohol use
13
Q

how can regurg pts be SOB?

A

at night, they aspirate small amts of the regurgitant products

14
Q

what is visceral pain?

A

constriction or dilation of hollow organs
(sheath touching the organ)
-typically felt as a cramp
-comes and goes

15
Q

what is parietal pain?

A
inflammation of the peritoneum
(sheath touching the abdominal wall)
-steady, aching, severe
-more precisely localized
-aggravated by movement, coughing
16
Q

what is referred pain?

A

inflammation along shared nerve roots

17
Q

what is NUD?

A

non ulcerative dyspepsia

-no organic source for the pain and symptoms

18
Q

will the pt be able to localize visceral pain?

A

not often

19
Q

what is a less common form of visceral pain?

A

capsular distention of solid organs (capsule surrounded by fluid)

20
Q

what do pts do when they have severe visceral pain?

A

they will become restless and writhing (don’t like to be still)

21
Q

what do pts do when they have parietal pain?

A

lie still

22
Q

how will you know if it is a referred pain?

A

when nothing matches up

-pressure at site of pain doesn’t increase pain

23
Q

what is waterbrash?

A

stomach content taste

24
Q

what is the difference between vomit and regurgitation?

A

effort and amount

25
Q

what is pyrosis?

A

heartburn

26
Q

where can pyrosis be located?

A

epigastric

retrosternal

27
Q

how is pyrosis relieved?

A

acid suppression therapy

28
Q

what will be the next step if acid suppression therapy doesn’t work?

A

upper endoscopy to look for sphincter problems

29
Q

what is dyspepsia?

A

upper abdominal pain (NOT heartburn)

30
Q

what is odynophagia?

A

pain with swallowing

31
Q

what does odynophagia indicate?

A

inflammation

32
Q

what is dysphagia?

A

difficulty swallowing

33
Q

what are the classes of dysphagia?

A
obstructive or non
oro pharyngeal (neuro/strokes) vs esophageal
chocking sensation
34
Q

how is diarrhea identified?

A

increased frequency and decreased consistency

-with urgency (pathologic) or without (non-pathologic)

35
Q

how is constipation identified?

A
decreased frequency
increased consistency
difficult passage (straining)
painful BM (tumor, tear, ulcer)
need manual manipulation
36
Q

what does pain with thin stools mean?

A

wierd

37
Q

what is hematochezia?

A

blood in stool (maroon or red)

  • usually a lower source
  • mixing in of blood with stool
  • below ligament of treitz (rest of small and large bowel)
38
Q

what is melena?

A

black or tarry stool

  • usually an upper source
  • above ligament of treitz (stomach and duodenum)
39
Q

what is BRBPR?

A

bright red blood per rectum (bleeding from the rectum, not from the bowels

40
Q

what are the screening questions that go along with the GI exam?

A

alcohol consumption
viral hepatitis
colon cancer screening

41
Q

what constitutes excessive drinking?

A

f: > 3 per occasion or 7 per week
m: > 4 per occasion or 14 per week

42
Q

what is HAV?

A

hepatitis A virus, food borne illness

-usually goes away on its own

43
Q

what is HBV?

A

hepatitis B virus, blood born illness

  • more common amongst asians, lived in Vietnam
  • latent for a long long time
44
Q

what is HCV?

A

hepatitis C virus,

  • more common with baby boomers
  • latent for a long long time
  • has no vaccine
45
Q

what do all hepatitities cause?

A

cirrhotic liver

46
Q

how often do you have a colonoscopy?

A

every 10 yrs after the age of 50 (average)

  • every 5 yrs beginning 10 yrs prior to age of family’s diagnosis age (family hx)
  • personal hx of adenomatous polyps at least every 5 yrs
  • personal hx of IBD (especially UC) annually beginning 10 yrs post dx
47
Q

what is a stethescope sign?

A

push using your stethescope on the painful area

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