Gastro PCP presentations Flashcards
Vomiting:
Quality
Blood
Mucus
Bile-stained
What’s the word for vomiting blood?
Haematemesis
Vomiting:
Time
Normal stuff
+
Relationship to meal time
& Morning vomiting
Vomiting:
Context
New medications
Sick contacts
Travel
Pregnancy
Vomiting
Associated features
Nausea MI things Gastro things Pregnancy things Dehydration things (as a result of vomiting)
“MI things” associated features
Chest pain
Sweating
“Gastro things” associated features
Diarrhoea
Fever
Abdo pain
Vommiting
“Dehydration things” associated features
Headache
Thirst/dry mouth
Decreased urination
“Pregnancy things” associated features
Amenorrhoea
Breast changes
Dysphagia:
What are the important two things to determine?
Where it gets stuck - oropharyngeal vs oesophageal
Solids only or solids & liquids
Dysphagia:
Associated features
Odynophagia Coughing Choking Reflux Loss of appetite Tremors (Parkinson's) Cancer things
“Cancer things” associated features
Weight loss
Loss of appetite
Fever
Night sweats
Dysphagia:
FHx
Neuromuscular problems (Parkinson's, MS) Cancer
What the word for loss of peristalsis in oesophagus?
Achalasia
Diarrhoea:
Quality
How watery
Blood
Mucus
Steatorrhoea (difficulty flushing)
Diarrhoea:
Severity
Volume
Diarrhoea:
Context
- Contact
- Travel
- Strange food
- Meds / ABs
Diarrhoea:
Associated features
Gastro things
Malabsorptive things
Dehydration things (as a consequence)
Weight loss (as a consequence)
Define acute diarrhoea
A few days
Define persistant diarrhoea
2-4 weeks
Define chronic diarrhoea
(cf chronic cough)
4+ weeks
Cough: 8+ weeks
Constipation:
Context
Diet (low fibre)
Medications (codeine)
Immobility
Constipation:
Associated features
Abdo pain
Rectal bleeding
Cancer things
Hypothyroid things
Constipation:
FHx
Cancer
Rectal bleeding:
Quality
Colour
Mixing
What’s the word for black, tarry stools?
Melaena
Why is malaena black?
The blood is oxidised by gut bacteria
Would can bright rectal bleeding indicate?
Blood from rectum:
Anal fissure, haemorrhoids
What can dark red rectal bleeding indicate
Bleeding from large intestines
Alcohol:
Broad framework
Quantitative Circumstances/triggers Dependence Harm Quitting
Alcohol:
Quantitative questions
Do you drink
How often
Type & how much on a typical day
How often they have 4+ drinks
Alcohol:
Dependence questions
Hard to stop once you’ve started
Unmet obligations
Morning drinking
Alcohol:
Harm questions
Injuries Blackouts Guilt 3rd party concern Financial, legal, social harm
Alcohol:
Quitting questions
Current motivation
Previous attempts
Previous tequniques
Jaundice:
Context
Alcoholism Travel / vaccination Tattoos / piercings IVDU Unprotected sex
Jaundice:
Associated features
Pee (dark)
Poo (pale)
Puritis
Pain
Cirrhosis things
Malaria or sickle cell things
Gallstone things (pain is extreme and intermittent)
“Cirrhosis things”
Oedema / ascites
Bruising
Gynaecomastia/amennorhoea
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