Alimentary system FoCM 1

Question 1

When undergoing an GI systemic inquiry what is the best order to follow

Answer 1

Mouth to rectum (THINK passage of food, i.e. tube system)

Question 2

After presenting/h.o.p complaint what is the first systemic inquiry question?

Answer 2

Have you noticed any changes in your appetite / weight recently ?

Question 3

Once diet/weight has been assessed we ask/examine what ?

Answer 3

The oral cavity

Question 4

What things should we be looking out for in regards to the mouth/teeth/tongue?

Answer 4

• Gum swelling / Bleeding
• Dentition (i.e. missing teeth/hygiene)
• Ulcers
• Infection

NOTE: Exam mouth if Inflam. Bowel Disease is suspected (remember how you got diagnosed)

Question 5

What swallowing questions should we inquiry about?

Answer 5

1. Dysphagia

2. Dyspepsia

Question 6

What do these mean?

Answer 6

1. Difficulty swallowing

2. Burning sensation when swallowing or generally known: HEARTBURN

Question 7

When asking the patient about vomiting, what things should inquiry about?

Answer 7

• Colour
• Consistency (coffee, mucous, food, watery)
• Volume
• Frequency

Question 8

What colors can vomit be and what do they mean?

Answer 8

• Green/Yellow - Bile
• Brown (coffee granules) - Old Blood <== Important (peptic ulcers)
• Clear - Infection which subsequently may be followed by yellow green color
• Red/ Pink - Fresh blood
• Foamy White - Gas stuck in stomach, could be GERD/Gastritis

Question 9

What is the clinical name for blood in vomit?

Answer 9

Haematesis

Question 10

Going back to diet, what should we ask them in terms of food types?

Answer 10

Have you noticed any intolerance to any foods, specifically fat foods? (possible Gall bladder problems )

Question 11

When asking about fat intolerance, what other question should we ask?

Answer 11

Jaundice, ask about yellow eyes/skin

Bonus points: Ask about itchy skin, darker urine & paler poo?

Question 12

When dealing with the abdomen what things should we ask/look out for ?

Answer 12

Abdominal pain (what region, pain type)

Abdominal distension (expansion of the abdomen due to air/fluid)

‘THINK Bloating’

Question 13

Ask about bowel habits

Answer 13

• Change
• Constipation
• Diarrhoea
• Blood
• Mucus
• Maeleana (dark stick poo, upper gi problem)
• Faecal Incontinence

Question 14

Perianal questions?

Answer 14

Haemorrhoids

Generally; :Pain, itching etc.