Abdominal Exam 2 - Parrott Flashcards
What are “Normal” Findings from an Abdominal Examination?
Flat Nondistended Normoactive bowel sounds Tympanic Soft No masses Nontender No hepatomegaly/splenomegaly/hepatosplenomegaly/organomegaly noted
What are the “Normal” PARROTT STANDARD Abdominal Exam Findings?
Abd - Soft, NT/ND, BS+ x 4, no Hsm
What are some examples of ABNORMAL Abdominal Exam Findings?
Distended Round Obese Scaphoid Hyperactive Hypoactive Tenderness to palpation Rebound Guarding Rigid Palpable mass
What are the 3 TYPICAL signs/symptoms of GERD?
- Heartburn
- Regurgitation
- Dysphagia
- 30% of GERD patients - sensation food stuck in chest.
What are 5 ATYPICAL signs/symptoms of GERD?
- Coughing/wheezing
- Reflex arch of bronchoconstriction - Hoarseness, sore throat
- Otitis media
- Noncardiac chest pain
- Enamel erosion/dental manifestation
What are 5 Lifestyle Modifications suggested for GERD patients?
- Losing weight
- Avoiding triggers
- Chocolate, citrus, tomato based products, etc. - Avoiding large meals
- Wait 3 hours after meal before lying down
- Elevate head of bed by 8 inches
What is the most common digestive complaint in the US? Which two tools are used to describe this complaint?
CONSTIPATION
Two Tools:
- Rome III Criteria
- Bristol Stool Scale
Note: Constipation is a symptom, NOT A DISEASE.
What are the Rome III Criteria for Constipation?
Must experience AT LEAST 2 of following over PAST 3 MONTHS:
- Fewer than 3 bowel movements/week
- Straining
- Lumpy/hard stools
- Sensation of incomplete defecation
- Manual maneuvering required to defecate
- Enema or digital disimpaction
What is the Bristol Stool Scale?
Method of agreeing on “look/feel” of feces when describing bowel movements.
Types 1-2 —> Complain of constipation
Types 3-4 —> Close to normal
Types 5-7 —> Progressing more to watery with no solid pieces
Which 3 Physical Examination entail a total “Constipation” Physical Exam?
- Abdomen Exam
- Pelvic Exam for females
- Anorectal Exam
What is the difference between Skin Tags and External Hemorrhoids?
Skin Tags
- Formed from skin that rub together
External Hemorrhoids
- Vein coming out caused protrusion of skin
What are 5 Lifestyle Modifications for Constipation?
- Increase fiber
- Increase water intake
- Use bathroom right away
- Increase exercise, including walking
- Schedule some uninterrupted time every day for a BM
What are the usual causes of Gastroenteritis?
Viral (50-70%) Bacterial (15-20%) Parasitic (10-15%) Food-borne toxigenic Drug-associated
What are the 2 Big VIRAL Gastroenteritis entities?
- Norovirus
- Uncontrolled vomitting 12-48 hours after exposure
- Vomiting > Diarrhea
- Resolves 36 hours after start
- CASINO or CRUISE SHIP - Rotavirus
- Can lead to severe dehydration
What are the 3 Big BACTERIAL Gastroenteritis entities?
- Salmonella
- Contaminated food
- Onset 12-36 hours after eating food - C. Difficile
- Most common hospital acquired GI Illness
- Exposure to antibiotics - E. Coli
- Food, contaminated water, person to person
- Most common cause traveler’s diarrhea
