Abdominal Exam 2

Question 1

What word should never be used in documentation?

Answer 1

normal

Question 2

GERD

Answer 2

• LES isn’t contracting
• common symptoms: heartburn dysphagia, regurgitation
• atypical symptoms: coughing/wheezing, hoarseness, otitis media (in babies), non cardiac chest pain (pretty common)

Question 3

GERD lifestyle modifications to help

Answer 3

losing weigh, avoiding known triggers/large meals, waiting 3 hours after a meal before lying down, elevated head of the bed by 8 inches

Question 4

Classes of Drugs for GERD

Answer 4

Antacids, H2 receptors antagonist, proton pump inhibitors (PPI)

Question 5

Constipation

Answer 5

• most common digestive complaint in the US

- symptom, not a disease

Question 6

Rome III Criteria for Constipation: must have experienced at least 2 of the following over the proceeding 3 months..

Answer 6

1. fewer than 3 bowel movements/week
2. Straining
3. Lumpy or hard stools
4. Sensation of incomplete defecation
5. Manual maneuvering required to defecate

Question 7

Constipation: Bristol Stool Scale

Answer 7

• way patients and physicians can agree on what the feces look like
• 7 types

Question 8

Constipation: associated symtoms

Answer 8

nausea, vomiting, abdominal pain, dark/bloody stools, low back pain, tenesmus, inability to pass gas (obstruction)

Question 9

Constipation: abdomen exam, pelvic exam for females, anorectal exam

Answer 9

1. distention or masses may indicate impaction
2. palpate posterior vaginal wall at rest to check for prolapsed rectum
3. Perianal excoriation, anal fissure, prolapse during straining

Question 10

What forms skin tags?

Answer 10

• skin rubbing together

- more cosmetic than a health problem

Question 11

Lifestyle modifications for constipations

Answer 11

increase fiber, water, use bathroom right away, increase exercise

Question 12

Gastroenteritis: Two Viral biggies

Answer 12

1. Norovirus: sudden onset with uncontrolled vomitting 12-48 hrs after exposure, resolution about 36 hours after symptoms begin
2. Rotavirus: by time kids are 5, they will have it if not immunized; can cause death in children

Question 13

Gastroenteritis: Three Bacterial biggies

Answer 13

1. Salmonella
2. C. Difficile - most common hospital acquired GI illness
3. E. Coli - most common cause of traveler’s diarrhea

Question 14

Gastroenteritis: One Parasitic biggies

Answer 14

Giardia - causes diarrhea, bloating, abdominal cramping, N/V

-transmission person to person, animals to humans; most commonly gotten from infected water

Question 15

Drug associated diarrhea

Answer 15

sorbitol, PPIs, antibiotics, laxatives

Question 16

IBD

Answer 16

not equal to inflammatory bowel disease

-associated with diarrhea, constipation, bloating, abdominal pain