abdominal Complaint II Flashcards
what is the order for the physical exam for an abdominal exam
1) Inspection
2) Auscultation
3) Percussion
4) Palpation
What to write on soap note if everything in the abdomen is okay?
Abd-Soft, NT/ND, BS+x4, no HSM
what is constipation and how can it be categorized?
it is a symptom not a disease!
blockage of bowel movements or difficulty to move bowel
Tools to categorize constipation is the
- Rome III criteria
- Bristol stool scale
What is the Rome Criteria
for determining constipation, patient must have at least 2 of the following symptoms over the preceding 3 months
- Fewer than 3 bowel movements/week
- Straining
- Lumpy or hard stools
- Sensation of incomplete defacation
- Manuel maneuvering required to defecate
What is the Bristol stool scale
A way for patients and physicians can agree on the look and feel of feces, so they are on the same page when describing bowel movements
- Types 1-7
- 3 and 4 are the most normal
- 1 is super hard pebbles
- 7 is watery
Associated symptoms with constipation and what are the concerning symptoms that may warrant urgent evaluation
- Abdominal bloating
- Low back pain
- Tenesmus
- Pain on defecation
Serious symptoms:
- Rectal bleeding
- Abdominal pain
- Inabillity to pass flatus
- Vomiting
When performing an Anorectal exam what should you be looking for?
- Perianal excoriation
- Skin tags
- Anal fissure
- Prolapse during straining
- Anorectal masses
- Tone of internal anal sphincter
- Presences of gross blood or occult bleeding
- Presents of fectal impactation
What are some lifestyle modifications for constipation
- Increase fiber in diet
- increase water in diet
- Use the bathroom right away when have the urge
- Increae excersise
- Schedule some uninterrupted time eveeryday to do a BM
what is the convenient angle to have legs at to poop?
35 degrees close to chest
what is the difference between diarrhea and gastroenteritis
Diarrhea has no definition but is runny poop
-most common cause people seek medical attention
but Gastroenteritis
- primary manifestation is diarrhea, nausea, vomiting, and abdominal pain can accompany
- what most people call stomach flu
What are the two big types of viruses that can cause viral gastroenteritis
Norovirus
- uncontrolled vomiting and diarrhea for 12-48 hours
- this is normally the outbreak on a cruise ship
Rotavirus
-kids are normally immunized for this
what are the 3 big bacteria’s that cause bacterial gastroenteritis?
Salmonella
-eating something that is contaminated
C.Difficile
- Most common hospital GI illness
- exposure to antibiotics
E. Coli
-travelars diarrhea
what is the one big Parasitic Gastroenteritis?
giardia
- causes diarrhea (greasy stools), bloating, abdominal crapming, N/V
- most often get from infected water when hiking or camping
What are some drugs that can cause Diarrhea?
- Antibiotics
- Laxatives
- Colchicin
- Quinidine
- Sorbitol
- Proton pump inhibitors
Irritable bowel syndrome manifestations and common presentations
Functional GI disorder and is not the same as inflammatory bowel disease
Manifestations:
- Altered bowel habits
- Abdominal pain
- Abominal bloating/distention
Common:
- Postprandial urgency
- Alternating between constipation and diarrhea
- intractability to laxatives
- defecation improves abdominal pain but doesnt relieve it
