Concepts in GI Assessment Flashcards
What is dyspepsia?
epigastric pain assoc w/ nausea (look for Chapman point for esophagus & stomach)
What should you look for on PE in pt w/ upper GI complaint?
look for signs of anemia (pallor, chelitis, tachycardia, hypotension)
What are some complications of GERD?
asthma, hoarseness, dental erosions
What are important ROS red flag sxs for upper GI complaint?
syncope, light-headedness, melena or hematochezia, dysphagia, odynophagia
When do you refer to EGD?
anemia
+FOB
any red flag symptoms or findings
What is a major red flag sx for upper GI?
unexplained wt loss
What is the workup for a pt w/ upper GI complaint?
Fecal Occult Blood (FOB)
assess for current H pylori infxn
consider CBC if concern for anemia
Radiography is NOT indicated
What is the tx for pt w/ upper GI complaint?
PPI for acid suppression
treat for H pylori
address lifestyle issues
How does biliary dz present?
RUQ colicky pain as stone moves thru common duct some nausea radiates to lower ribs & back \+ Murphy's sign
Test of choice for biliary dz?
Transabdominal US
How does acute cholecystitis or choledocolithiasis present?
fever, N/V, RUQ pain
+/- colicky, +/i infection
presence of stone obstructing cystic duct (may progress to cholangitis)
What is a major PE finding assoc w/ dyspepsia?
SCLERAL ICTERUS (yellowing of sclera b/c deposition of BR)
What are causes of conjugated hyperbilirubinemia?
hepatocellular dysfunction
biliary obstruction
What are signs & sxs of hepatocellular dysfunction?
Non infectious (pruritis, light colored stools, jaundice)
Infectious (constitutional sxs, low grade fever, RUQ pain, jaundice, enlarged liver)
What are signs & sxs of biliary obstruction?
RUQ pain jaundice pruritis dark urine light colored stools *unintentional wt loss (red flag)
What do you assess in pt w/ hyperBR?
assess for ascites (fluid wave)