abd SPE Flashcards
how do you check for ascites
shifting dullness fluid wave
how do you check for gallbladder issue
murphys- pressure when you press on gallbladder illicits enough pain to stop breathing
how do you check for ventral hernia
ask pt to raise head and shoulders off table
order of abdominal exam
inspect auscultate percuss palpate
peritoneal signs
guarding, rigidity, rebound tenderness
how do you check for appendicitis
psoas obturator rosvings
when eval acute diarrhea, what is the main focus
volume status and complications
when eval acute diarrhea, what do you focus on for the vitals
temp/ fever HR BP (incl orthostatic)
when eval acute diarrhea, what do you focus on for the skin exam
turgor
when eval acute diarrhea, what do you focus on HEENT
mucous membranes- eyes, mouth
when eval acute diarrhea, what do you focus on- abdominal exam
distention bowel sounds tenderness peritoneal signs masses
when eval acute diarrhea, what do you focus on- rectal exam
tenderness stool guaiac perianal dz
when eval acute diarrhea, what do you focus on- neuro exam
mental status
GI hx
- abdominal pain
- nausea/ vomiting (+ volume)
- hematemesis
- diarrhea
- stool changes-
- type
- color
- blood in stool
- hematochezia
- melena
- constipation
- gas/ flatulence
- indigestion/ heartburn/ reflux
- appetitie change
- food intolerance
- hernia/ hemorrhoid
- jaundice/ dark
- urine itching
how to do rectal exam
- tell pt- I’m now going to examine the anal region (inspect), spread butt cheeks
- looking for fissures/ hemorrhoids
- lube finger
- inform pt you’ll be inserting finger into rectum
- do 180 sweep in both directions around rectum to check for lesions
- remove finger and check for stool for blood
what are the DDX for diarrhea
infectious
emotional stress
meds
IBS
IBD- crohns/ ulcerative colitis
celiac
lactose intolerance
HIV
HIV sxs
general- fever, night sweats, fatigue/ malaise, weight loss
joints- arthralgias
mouth- oral hairy leukoplakia, thrush
skin- kaposis sarcoma, molluscum, dermatophyte infestation, kaposis sarcoma
UC sxs
bloody diarrhea, rectal bleeding
LLQ/ peri-umbilical pain
constipation
sclerosing cholangitis
more BM means more severe
fever, fatigue, anorexia, N/V, arthralgias, erythema nodosum, granuloma pyoderma, uveitis, irisitis,
celiac sxs
diarrhea
steatorrhea
gas
bloating
weight loss
abdominal pain
constipation
downs/autoimmune dz
crohns sxs
smoking
bimodal
aphthous ulcers, night time diarrhea, RLQ pain/ mass
fever, fatigue, anorexia, N/V, arthralgias, erythema nodosum, granuloma pyoderma, uveitis, irisitis
more lesions/ inflammation means more severe
recurrent low abdominal pain
+/- indigestion
+/- chest pain
+/- uterine stuff
IBS
IBS Rome criteria
1+ days/week for months:
abdominal pain w/ 2/3:
- defecation
- change in stool frequency
- change in stool form
