Gastro history

Question 1

What do you need to ask for with nausea and vomiting?

Answer 1

1. Onset – especially in relation to food, maybe infective, could be related to
   oesophageal stricture
2. Quantity
3. Colour - food/bile/blood

Question 2

What do you need to ask for diarrhoea and constipation?

Answer 2

1. Onset and time course – chronic can be sign of malignancy, acute if related to food maybe infective
2. Associated features – fever, weight loss
3. Blood/black stool
4. Pain on defecation
5. Tenesmus
6. Diet
7. Steatorrhoea
8. Urgency/incontinence

Question 3

What do you need to ask for dysphagia?

Answer 3

1. Onset and time course
2. Level of obstruction (where do they feel food getting stuck)
3. Solids/liquids
4. Associated features – heartburn/weight loss/vomiting

Question 4

What do you need to ask for jaundice?

Answer 4

1. Onset (after an alcohol binge, sudden/progressive)
2. Urine/stool colour
3. Associated symptoms – abdo pain/fever/weight loss/ascites/itchiness/fatigue

Question 5

What do you need to ask for in abdominal swelling?

Answer 5

1. Investigate 5Fs – fluid, flatus, fetus, fat, faeces
2. Dragging/heavy feeling in abdomen in women should raise suspicion of
   ovarian Ca

Question 6

What general symptoms should you always ask about?

Answer 6

1. Weight loss
2. Fever
3. Lethargy

Question 7

What do you check in resp review?

Answer 7

1. cough

2. SOB

Question 8

What do you check with CVS review?

Answer 8

1. chest pain
2. palpitations
3. oedema

Question 9

What do you check with neuro review?

Answer 9

1. falls
2. blackouts
3. headache
4. mood
5. weakness
6. seizures

Question 10

What do you check with GU review?

Answer 10

1. dysuria
2. haematuria
3. testicular pain/lumps

Question 11

What must you ask about in gastro PMHx?

Answer 11

1. Previous jaundice
2. Previous endoscopies
3. Rheumatological/neurological conditions may be associated with dysphagia

Question 12

What must you ask in gastro DHx?

Answer 12

1. Many medications can cause liver disease (e.g. paracetamol, antibiotics agents, methotrexate)
2. Specific medications can cause gastritis/ulcers (e.g. NSAIDs

Question 13

What must you ask in gastro FHx?

Answer 13

1. liver disease

2. cancer

Question 14

What must you ask in gastro SHx?

Answer 14

1. Occupational history
2. Smoking history
3. Travel History
4. Alcohol history
5. Illicit drug use
6. Sexual history may be appropriate