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Differential Diagnosis Test 2 > Gastrointestinal > Flashcards

Flashcards in Gastrointestinal Deck (26):
1

What are the symptoms of GI disorders?

  • Abdominal pain
  • Dysphagia
  • Odynophagia
  • Melena
  • Epigastric pain with radiation to the back
  • Affected by food
  • Early satiety with weight loss
  • Constipation
  • Diarrhea
  • Fecal Incontinence
  • Arthralgia
  • Referred shoulder pain
  • Psoas abcess
  • Tenderness over Mcburney's point

2

What are some characteristics fo abdominal pain?

  • visceral and referred
  • Pain anterior and posterior at the same level

3

What happens to a person who has dysphagia and what should you consider a possible cause?

Food gets stuck or caught in the esophagus.  Check medications (could slow down esophogeal motility)

4

What is melena and what indicates where the disorder is ?

Melena is black, tarry stools due to intestinal bleeding.  the higher up in the GI the darker the stool

5

Why would a person get full very fast and still lose weight?

There is possibly a blockage or a space occupying lesion

6

What would you want to know about a person who is constipated?

Diet, fiber, Meds (narcotics)

7

What FUPs would you ask a person with diarrhea?

FUPs regarding diet and meds (antibiotics)

8

What  is the problem with Clostridium difficile (c-diff) and what activity do you have to be careful doing with a patient?

C-diff is becoming more prevalent and more difficult (resistant to antibiotics). Be careful when walking patient

9

What are the 3 types of arthralgia?

  • Asymmetric- difficult to differentiate between musculo-skeletal
  • Migratory- moves from joint to joint
  • Oligoarticular-few joints (<4; 6 months history with no mechanism or explanation)

10

What type of patients have arthralgia?

Crohn's disease (25%)

11

What is Kehr's sign and what does it mimic?

Referred pain to the left shoulder due to blood or air in the abdominal cavity, asocciated with trauma. There may also be some rebound tenderness in the abdomen. Kehr's mimcs a heart attack

12

What are tests for Psoas abcess, what are test positions (if indicated) and what is considered positive?

  1. Heel tap-pain with tapping heel or equivalent response is pain when hitting a bump in the car or ambulence
  2. Single-leg hop- unilateral pain is positive
  3. Psoas muscle test- Pt. flexes hip, then therapist palpates psoas through abdominal wall. positve= ab pain in right quadrant
  4. Obturator test-Pt flex hip,knee,holding ankle, IR and ER of hip. Positive= lower quadrant or pelvic pain with IR

13

T/F Psoas abscess requires an immediate referral

True

14

What is positive for tenderness over McBurney's point, what does it suggest, and why is it minimally reliable?

  • Positive= rt lower quadrant pain
  • Suggests appendicitis
  • needs to be inflamed to positive
  • see bottom of pg 340

15

What are signs of GI disorders and what do they indicate?

  • Jaundice- liver absorption issues
  • Skin lesions- Malabsorption problem
  • Temperaure- fever indicates infecton
  • Positive for appendicitis or abcess (requires immediate referal)
  • Unusual BP and HR accompanied by ab pain-splenic rupture

16

What characterstics are associated with Peptic ulcer?

  • can be caused by meds such as NSAIDS and antibiotics (10% from NSAIDS)
  • Light-headedness and nausea= bleeding ulcer (require immediate physician referral)

17

What is Diverticular disease?

Broad variety of symptoms: cramping, bloody stools, left lower abdominal pain and tenderness, left pelvic pain

18

What are signs and symptoms of Appendiciitis (pg 340)?

Right lower quadrant or flank pain, rebound tenderness, nausea, fever, vomitting, right thigh or groin pain, Positive hop test

19

What are signs and symptoms for acute and chronic pancreatitis?

Acute- nausea, vomitting, malaise, weakness, jaundice, bluish discoloration of the abdomen

Chronic- History of alcohol abuse, Upper (left) abdominal/epigastic pain that raidiates to the back, flatulence, constipation

20

What are the 2 conditions grouped under Inflammatory bowel disease and what are their symptoms?

  • Crohn's disease-inflammation of GI tract (distal ileum), diarrhea, constipation, fever, rectal bleeding,night sweats, skin lesions, uvetis, arthritis, migratory arthralgias. Onset-young adults, adolescents
  • Ulcerative colitis- ulceration of the GI tract (colon) so most common symptom is GI bleeds. Same symptoms and onset as Crohn's

21

What are signs and symptoms for pancreatic carcinoma?

upper abdominal/epigastic pain may radiate to the back, light colored stools, constipation, jaundice

22

What are signs and symptoms for irritable bowel syndrome?

Painful abdominal cramps, constipation, diarrhea, N&V, anorexia, flatuelence, foul breath

23

what are signs and symptoms for colorectal cancer?

Rectal bleeding, hemorrhoids, abdominal, back and pelvic pain, changes in bowel patterns

24

Risk factors for patients with colorectal cancer

High red meat consumption, overweight, acohol, tobacco, family hx, hx of polyps, >age 50

25

What are diagnostic test for GI disorders?

  • Endoscopy
  • CT or MRI
  • Colonoscopy

26

What is cause for a physican's referral?

  1. Chronic Laxative use
  2. Eye lesions accompany joint inflammation- inflammatory bowel disease
  3. Prolonged NSAID use with symptoms of peptic ulcer
  4. Atypical pain pattern not reproducible with STTE and history of Cancer