Abdominal Exam II Flashcards
what should be included in dictating a normal abd exam?
Flat Nondistended Normoactivebowel sounds heard throughout Tympanic throughout Soft No masses Nontender No hepatomegaly/ splenomegaly/ hepatosplenomegaly/ organomegalynoted
what should be included in dictating a abnormal abd exam?
Distended Round Obese Scaphoid Hyperactive/hypoactive/diminished bowel sounds throughout Tenderness to palpation Rebound Guarding Rigid Palpable mass (would describe area located and size of mass) Special tests positive or negative
what are the three typical Sx of GERD?
Heartburn-Retrosternal sensation of burning or discomfort that usually occurs after eating, when lying supine or bending over.
Regurgitation –Effortless return of gastric and/or esophageal contents into the pharynx.
Dysphagia –Occurs in about 30% GERD pts –sensation that food is stuck, particularly in retrosternal area
what are so atypical sx of GERD?
Coughing and/or wheezing –why?
Hoarseness, sore throat
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
what are the lifestyle modifications associated with GERD?
Losing weight (if overweight) Avoiding known triggers: Chocolate, citrus juice, tomato-based products, etc Avoiding large meals Waiting 3 hours after a meal before lying down Elevating the head of the bed by 8 inches
what is the most common digestive Cx in the US?
Constipation!
which is a Sx, not a disease!!!!
what must a patient experience to meet the Rome III criteria?
Must have experienced 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 defecation • Manual maneuvering required to defecate
what is the bristol stool scale? what is considered normal?
This is a way that patients and physicians can agree on the “look and feel” of feces and the passage of fecal material so that they are on the same page when describing bowel movements.
Types 1 through 7, with types 3 and 4 being as close to “normal” as possible –formed and easy to pass.
Patients who describe predominantly type 1 and 2 are more likely to complain of “constipation.
what are some lifestyle modifications from constipation?
Increase fiber in diet
Increase water in diet
Use the bathroom right away when you have the urge, don’t “hold it.”
Increase exercise, including walking
Schedule some uninterrupted time every day for a BM
define gastroenteritis
Nonspecific term, primary manifestation is diarrhea but nausea, vomiting and abdominal pain can accompany
What most people consider “stomach flu”
what are the two biggies for viral gastroenteritis?
norovirus and rotavirus
describe noravirus
“nora virus in bora bora”
Starts with sudden onset uncontrolled vomiting 12-48 hours after exposure
Usually more vomiting than diarrhea
Resolution about 36 hours after symptoms start
When you hear about an outbreak on a cruise ship or in a casino, this is usually the cause
what are the three biggies of bacterial gastroenteritis?
Salmonella
Eating something contaminated
Onset 12-36 hours after eating contaminated food
C. Difficile
Most common hospital-acquired GI illness
Exposure to antibiotics
E. Coli
Food, water, person-to-person transmission
Most common cause of traveler’s diarrhea –starts within 5 days, lasts 2 wks
what is the parasitic gastroenteritis biggie?
Giardia Causes diarrhea (greasy stools that tend to float), bloating, abdominal cramping, N/V
Transmission person-to-person, animals-to-humans through fecal oral route, most commonly gotten from infected water (campers, hikers, travelers)
what is IBS?
IBS does NOT equal IBD (inflammatory bowel disease) Manifestations: Altered bowel habits Abdominal pain Abdominal bloating/distention
Common:
Postprandial urgency
Alternating between constipation and diarrhea, with one dominating per individual patient
Intractability to laxatives
Defecation improves abdominal pain but doesn’t relieve it
