CLIN SKILLS - GIT History

Question 1

GIT history systems review

Answer 1

• changes in appetite or eating habits?
• do you feel fuller than normal after meals (post-prandial fullness) or feel fuller sooner when eating (early satiation)?
• dysphagia (difficulty swallowing) or odynophagia (painful swallowing?)
• GORD - feeling of acid at the back of your chest, throat or neck?
• abdominal pain?
• bloating/distension?
• nausea or vomiting? haematemesis?
• changes in stools or urine?
• changes in flatulence?
• change in colour of your skin or eyes? (jaundice/icterus) have you had an itch? (pruritus due to toxin buildup)
• travel?
• systemic - fever, lethargy, changes in weight

Question 2

follow up questions for GORD

Answer 2

• is it worse on laying down or after particular foods?

Question 3

follow up questions to ask for abdominal pain

Answer 3

• aggravating/relieving: posture, food, bowel movements, meds, time of day

Question 4

follow up questions for stools

Answer 4

• consistency/shape, frequency, colour, floating, pain, continence, blood (fresh = haematochezia, dark = melena)

Question 5

follow up question for weight change

Answer 5

• why? how much? Over how long?

Question 6

categories of investigation/tests

Answer 6

• bedside: blood tests, PEF, physical exams, history
• imaging: X-ray, CT, MRI, U/S
• specialist: spirometry