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md3002 gi > History Taking: Abdomen > Flashcards

History Taking: Abdomen Flashcards

1
Q

in history of presenting complaint, what questions should you ask about?

A
  • Mouth symptoms
  • Abdominal pain
  • Anorexia and weight change
  • Heartburn and reflux
  • Dyspepsia and indigestion
  • Odynophagia and dysphagia
  • Abdominal distension and swellings / lumps
  • Nausea and vomiting
  • GI tract bleeding
  • Jaundice
  • Change in bowel habit – constipation / diarrhoea
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2
Q

what are mouth symtpoms?

A
  • Bad breath – (halitosis) secondry to gingival (gingivitis), dental, pharyngeal infection
  • Dry mouth – xerostomia
  • Altered taste – dysgeusia
  • Foul taste – cacogeusia
  • Cracked painful lips – inflammation of mucous membranes of mouth - stomatitis
  • gingivitis = inflammation of the gums
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3
Q

qhat questions should you ask regarding pain?

A
  • does it stop you from doing anything?
  • are the lying still or writing around?
  • do symptoms tie with signs?
  • SOCRATES
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4
Q

what are one of the causes of somatitis?

inflmmation of the side of the mouth

A

anaemia

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5
Q

how many areas can the abdomen be divided into?

A

9 or 4 quadrants

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6
Q

what are causes of weight gain?

A
  • fluid gain (cardiac failure, liver disease, nephrotic syndrome)
  • hypothyroidism
  • depression
  • increased energy input/output

obesity is an increasing cause of morbidity and a risk for other conditi

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7
Q

what are causes of weight loss?

A
  • malignancy
  • malabsorption
  • metabolic diseases
  • psychiatric causes
  • manutrition

indicates serious undderlying pathology

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8
Q

describe heart burn and reflux

A

heart burn = hot burning retrosternal discomfort
- may be exacerbated by food, lying flat or bending forward
- if principal symtoms GORD is likely

GORD = gastroesophageal refluc disease

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9
Q

what is dyspepsia?

A
  • pain or discomfort centred in upper abdomen
  • exacerbated by food
  • releived by antiacid (Gaviscon)
  • associated with nausea, belching, bloating
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10
Q

what is odynophagia?

A
  • pain on swallowing
  • exacerbated by hot liquids

potential causes:
- oesophageal ulcers
- oesophagitis
- could have dysphagia
- oesophageal candidiasis

dysphagia = difficulty swallowing

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11
Q

dysphagia

A
  • means difficulty in swallowing
  • sensation of obstruction during passage of liquid or solid food
  • always investigate firther
  • dont confuse with globus

globus = takes a few times to go fown but no problem

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12
Q

what are the 4 main causes of dysphagia?

A
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13
Q

what questions should you ask for dysphagia?

A
  • where do they feel the food sticking?
  • intermittent/progressive
  • solids/liquids?
  • asociated symtpoms
  • pain?
  • complete obstruction and regurgitation of food?
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14
Q

what is haematemesis?

causes?

A

vomitting blood - fresh red or coffee ground

causes:
- gastric or duodenal ulcer (most common causes)
- gastric erosions
- varices
- gastric carcinoma

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15
Q

what is Melaena?

A
  • passage of black tarry stools
  • usually secondary to blood on eosophagus
  • bad smell
  • most common caused by chronic peptic ulceration
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16
Q

causes of lower GI tract bleeding?

A
  • haemorrhoids
  • anal fissure
  • diverticular disease
  • large bowel polys or cacinoma
  • IBD
17
Q

most common cause of jaundice?

A
  • pre hepatic
  • hepatic
  • post hepatic

Painless jaundice suggests carcinoma of head of pancreas

18
Q

change in bowel habit, is a red flag, what qustions should be asked?

A

Once obvious causes have been excluded, investigate persistent (>4wks) change in bowel habit

  • Questions to ask:
    – ‘Hastherebeenanychangeinyourbowelhabit?’ ‘Inwhatway?’
    – Duration
    – Colour of stool – mucous / fresh or altered blood
    – Constipation/diarrhoea,ormixtureofboth
    – Associated symptoms e.g. pain / nausea or vomiting / weight loss / appetite / tenesmus (feeling of not fully emptying bowels)
    – Changesindietormedication/otherillnesses
19
Q

common causes of constipation?

A
  • diet/dehydration
  • painful anal conditions
  • immobility
  • medication
20
Q

common causes of diarrhoea?

A
  • diet
  • stress
  • infection
  • inflmmation - medication
21
Q

what are the main upper GI red glags?

A
  • Dysphagia
  • Evidence of blood loss
  • Unexplained weight loss
  • Upper abdominal or epigastric mass
  • Unexplained back pain
  • Painless jaundice
  • Persistent vomiting
  • Unexplained iron deficiency anaemia
  • Unexplained worsening dyspepsia without other symptoms if >55 yrs old

md3002 gi (10 decks)

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