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PCM2 Midterm > Abdominal Exam 2 > Flashcards

Abdominal Exam 2 Flashcards

1
Q

Normal Findings of Abdominal Exam

A

Flat, Non-distended, normoactive bowel sounds heard throughout, tympanic throughout, soft, no masses, nontender, no HSM

Abd-soft, NT/ND, BS=$, no HSM

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2
Q

Abnormal Findings of Abdominal Exam

A

distended, round, obese, scaphoid, hyperactive/hypoactive/ diminished bowel sounds throughout, tenderness to palpation, rebound, guarding, rigid, palpable mass, special test: +

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3
Q

GERD signs and sx:

A

normal findings:

  • heart burn: retrosternal sensation after eating or lying supine
  • regurgitation: effortless return of gastric contents into pharynx
  • dysphagia: occurs in about 30% of Gerd Patients
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4
Q

Atypical sx associated with GERD

A

-coughing, wheezing
-horseness, sore throat
otitis media
non-cardiac chest pain
enamel erosion

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5
Q

Lifestyle modifications for GERD

A
  • lose weight
  • avoid known triggers: chocolate, citrus, tomato based products, peppermint, coffee
  • avoid large meals
  • wait 3 hours after a mean before lying down
  • elevate the head by 8 inches
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6
Q

Medications/ Therapies for GERD

A

antacids, H2 receptor antagonists

PPIs

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7
Q

Constipation

A

most common digestive complaint in teh US
**Symptom not a disease

categorized by:
Rome 3 criteria
Bristol Stool Scale

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8
Q

Rome Criteria

A

Must have experienced at least 2 of the following sx over preceding 3 months

  • fewer than 3 bowel movement/ week
  • straining
  • lumpy or hard stools
  • sensation of incomplete defecation
  • manual maneuvering required to defecate
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9
Q

Bristol Stool Scale

A

look and feel of feces

Types 1-7
Types 3 and 4 are as close to normal as possible…formed and easy to pass

–patients of types 1 and 2 are more likely to complain of constipation

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10
Q

Type 1 bristol Stool Scale

A

-separate hard lumps

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11
Q

Type 7 Bristol Stool Scale

A

–watery, no solid pieces

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12
Q

Constipation Physical Exam

A

abdomen exam
pelvic exam for females
anorectal exam

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13
Q

Constipation: Abdomen Exam

A

distention or masses may indicate colonic stools or tumors
large abdominal wall hernias may interfere with generation of intra-abdominal pressure required with initiation of defecation

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14
Q

Pelvic Exam (Constipation)

A

palpated posterior vaginal all at rest and while straining to check for internal prolapse or rectocele

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15
Q

Things to look for with Anorectal Exam

A 
perianal excoriation "chronic skin picking"
skin tags, hemorrhoids
anal fissure
prolapse during straining
anorectal masses
tone of internal anal sphincter
presence of gross blood or occult bleeding
presentation of fecal impaction
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16
Q

Lifestyle Modification for constipation

A

increase fiber in diet
increase water in diet
use the bathroom right when you have the urge
increase exercise including walking
schedule unintterupted time every day for BM

17
Q

Diarrhea

A

no universal definition

18
Q

Gastroenteritis

A

non-specific term
primary manifestation is diarrhea but nausea, vomiting, diarrhea, abdominal pain accompany

usually caused by infectious agent
mostly viral, follow by some bacterial and parasites

19
Q

Viral Gastroenteritis

A

Norovirus

Rotavirus

20
Q

Norovirus

A

sudden onset of uncontrolled vomiting 12-48 hours after exposure

-more vomiting than diarrhea
resolves 36 hours after symptom onset
*cruise ship

21
Q

Rotavirus

A

they will have had it by age 5 if not immunized
prior to immunization 55-70k hospitalization
—severe dehydration

22
Q

Bacterial Gastroenteritis

A

Salmonella
C.Diff
E.Coli

23
Q

Salmonella

A

bacterial gastroenteritis

  • eat contaminated
  • onset 12-36 hours after contaminated food
24
Q

C. Difficile

A

bacterial gastroenteritis

  • most common hospital acquired GI illness
  • exposure to antibiotics
25
Q

E Coli.

A

food, water, person-person transmission

most common cause of travelers diarrhea starts within 5 days and lasts 2 weeks

26
Q

Giardia

A

Parasitic Gastroenteritis
causes diarrhea with stools that float, bloating, abdominal cramping,

person-person, animals to humans, FO route, infected water

27
Q

Drug Associated causes of diarrhea

A 
antibiotics; alters normal flora
laxatives
clochicin
quinidine
sorbitol
PPI
28
Q

IBS

A

doesnt equal IBD

  • altered bowel habits
  • abdominal pain
  • abdominal bloating, distention
  • post prandial urgency
  • alternating between constipation and diarrhea with one dominating
  • intractability to laxatives
  • defecation improves abdominal pain but doesn’t relieve it
29
Q

Diarrhea associated Sx

A

nausea, vomiting, abdominal cramping, abdominal bloating, fever

30
Q

Malabsorptive stools

A

white/bulky,

small bowel pathology

PCM2 Midterm (8 decks)

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