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Flashcards in Abdominal Exam Deck (47):
1

what is a key to the abdominal exam?

get an accurate description of the problem

2

when asking about abdominal pain, what should you do?

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

3

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

timing in relation to
-food
-BM
-nausea

4

nocturnal symptoms that affect sleep are

more concerning

5

BHC / CBH

bowel habit change / change in bowel habits

6

what can positional changes pain indicate?

adhesional types of pain

7

what GI problem could surgical history create?

adhesion

8

what is LNMP?

last normal menstrual period

9

what are common causes of GI complaints?

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

depression
arthritis

hyperlipidemia
endometriosis

10

what meds can influence GI symptoms?

NSAIDS
new or changes in meds

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

antibiotics (diarrhea)
diuretics
laxatives (abdominal cramping)

11

what family hx considerations are involved in GI?

IBD
colon CA
liver dz

12

what special considerations in the social hx involve GI?

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

13

how can regurg pts be SOB?

at night, they aspirate small amts of the regurgitant products

14

what is visceral pain?

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

15

what is parietal pain?

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

16

what is referred pain?

inflammation along shared nerve roots

17

what is NUD?

non ulcerative dyspepsia
-no organic source for the pain and symptoms

18

will the pt be able to localize visceral pain?

not often

19

what is a less common form of visceral pain?

capsular distention of solid organs (capsule surrounded by fluid)

20

what do pts do when they have severe visceral pain?

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

21

what do pts do when they have parietal pain?

lie still

22

how will you know if it is a referred pain?

when nothing matches up
-pressure at site of pain doesn't increase pain

23

what is waterbrash?

stomach content taste

24

what is the difference between vomit and regurgitation?

effort and amount

25

what is pyrosis?

heartburn

26

where can pyrosis be located?

epigastric
retrosternal

27

how is pyrosis relieved?

acid suppression therapy

28

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

upper endoscopy to look for sphincter problems

29

what is dyspepsia?

upper abdominal pain (NOT heartburn)

30

what is odynophagia?

pain with swallowing

31

what does odynophagia indicate?

inflammation

32

what is dysphagia?

difficulty swallowing

33

what are the classes of dysphagia?

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

34

how is diarrhea identified?

increased frequency and decreased consistency
-with urgency (pathologic) or without (non-pathologic)

35

how is constipation identified?

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

36

what does pain with thin stools mean?

wierd

37

what is hematochezia?

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

what is melena?

black or tarry stool
-usually an upper source
-above ligament of treitz (stomach and duodenum)

39

what is BRBPR?

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

40

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

alcohol consumption
viral hepatitis
colon cancer screening

41

what constitutes excessive drinking?

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

42

what is HAV?

hepatitis A virus, food borne illness
-usually goes away on its own

43

what is HBV?

hepatitis B virus, blood born illness
-more common amongst asians, lived in Vietnam
-latent for a long long time

44

what is HCV?

hepatitis C virus,
-more common with baby boomers
-latent for a long long time
-has no vaccine

45

what do all hepatitities cause?

cirrhotic liver

46

how often do you have a colonoscopy?

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

what is a stethescope sign?

push using your stethescope on the painful area

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