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Primary Care PT > Screening the GI system > Flashcards

Screening the GI system Flashcards

1
Q

Upper GI system checklist

A

Swallowing difficulties
• Indigestion, heartburn
• Food intolerance
• Bowel dysfunction

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2
Q

Lower GI checklist

A
  • Color of stool
  • Shape, caliber of stool
  • Constipation
  • Diarrhea
  • Difficulty initiating
  • Incontinence
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3
Q

Potential causes of dysphasia

A

Muscle Incoordination

  • myasthenia gravis
  • multiple sclerosis
  • ALS
  • Parkinson’s

Mechanical Obstruction

  • neoplasms
  • goiter of thyroid gland
  • C-spine osteophytes
  • aortic aneurysm
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4
Q

Possible causes of indigestion, heartburn, dyspepsia

A
  • GERD
  • Peptic ulcer
  • NSAID use
  • insidious onset
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5
Q

Questions to ask about indigestion, heartburn, dyspepsia

A
  • How long have you had these symptoms?
  • Do you know what is causing them?
  • Are they constant or intermittent?
  • How are you treating the symptoms?
  • Any associated symptoms (e.g., fatigue, weakness, shortness of breath)?
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6
Q

Patient self management for indigestion, heartburn, dyspepsia

A

 Antacids: Milk of Magnesia, Tums, Maalox
 Histamine (H2) Antagonists: Tagamet, Zantac, Pepcid AC
 Dietary modification

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7
Q

Common irritants/triggers for food intolerance

A 
 Cheeses
 Chocolate
 Citrus fruits
 Nuts
 Red Wine
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8
Q

Upper GI system: Bowel dysfunction/melena

A

• Passage of black, tarry stools

  • GI bleeding, probably upper GI in origin
  • Esophagus
  • Stomach
  • Duodenum

• Follow-up questions:
• How long have you been having black, tarry stools?
• Have you felt lightheaded?
• Any nausea, vomiting, diarrhea, fatigue, lightheadedness, abdominal/back pain, or sweats
associated with these stools?

• Check HR and BP

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9
Q

Lower GI system: Bowel dysfunction

A 
Indicators of Possible Issues
 Color of stool
 Shape, caliber of stool
 Constipation
 Diarrhea
 Difficulty initiating
 Incontinence

Screening Questions
“Have you recently noticed any problems or difficulties with bowel function?”
“Noticed any changes in bowel habits? Frequency? Type?”

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10
Q

Potential causes of constipation

A

Impaired mobility

  • inadequate dietary fiber
  • inactivity
  • diverticulitis
  • hypothyroidism
  • hypercalcemia
  • scleroderma

Neurologic dysfunction

  • MS
  • SC injury

Psychosocial dysfunction

  • depression
  • situational stress
  • anxiety
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11
Q

Diarrhea potential causes

A 
infectious agents
laxative abuse
colon cancer
IBS
crohn's disease
ulcerative colitis
diabetic enteropathy
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12
Q

Screening questions for constipation and diarrhea

A

 How long have you been constipated?
 When was the last time you had a bowel movement?
 Do you ever have periods of constipation alternating with periods of
diarrhea (a pattern noted in some patients with colon cancer or
diverticulitis)?
 Do you have any associated symptoms, such as malaise, a sensation of
abdominal fullness or bloating, fever, agitation, or altered mental status?
 Recent changes in diet or fluid intake?
 Medication changes?

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13
Q

Dehyrdration due to diarrhea follow up questions

A

 How many episodes do you have each day?
 How long have you had diarrhea?
 Do you ever have periods of diarrhea alternating with periods of constipation?
 Is the diarrhea worse at certain times of the day?
 Do family members or companions have similar symptoms?
 Do you have any associated symptoms, such as fever, chills, nausea, vomiting,
confusion, or abdominal pain or distention?

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14
Q

Possible manifestations of dehydration

A 
rapid breathing
confusion
postural hypotension
rapid pulse ( <100bpm)
irritability
dizziness
headache
increased thirst
skin turgor
capillary refill
darker urine color
dry mouth
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15
Q

Low GI: Hematochezia

A

passage of bright blood-red stools

origin: left side of the colon or anorectal area

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16
Q

screening questions for hematochezia

A

 How long have you noticed bright red blood in your stools?
 Is the red blood mixed within the stools (red streaks) or not?
 Are there any associated symptoms, such as difficulty in initiating bowel
movements or a feeling of lightheadedness or fatigue?

17
Q

Colon carcinoma

A

malignancy in large intestine

origin: polyps in colon (upper) or rectum (lower)

screening questions
 Any unusual shape in stool, pencil-like in diameter or flat, ribbon-like?
 Any blood in your stool, when you go to the bathroom?

18
Q

possible symptoms of colon carcinoma

A 
change in bowel habits
blood in toilet
weakness
constipation
diarrhea
fatigue
rectal bleeding
abdominal pain, cramps, gas
unexplained weight loss

Primary Care PT (10 decks)

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