Gastro PCP presentations

Question 1

Vomiting:

Quality

Answer 1

Blood
Mucus
Bile-stained

Question 2

What’s the word for vomiting blood?

Answer 2

Haematemesis

Question 3

Vomiting:

Time

Answer 3

Normal stuff
+
Relationship to meal time
& Morning vomiting

Question 4

Vomiting:

Context

Answer 4

New medications
Sick contacts
Travel
Pregnancy

Question 5

Vomiting

Associated features

Answer 5

Nausea
MI things
Gastro things
Pregnancy things
Dehydration things (as a result of vomiting)

Question 6

“MI things” associated features

Answer 6

Chest pain

Sweating

Question 7

“Gastro things” associated features

Answer 7

Diarrhoea
Fever
Abdo pain
Vommiting

Question 8

“Dehydration things” associated features

Answer 8

Headache
Thirst/dry mouth
Decreased urination

Question 9

“Pregnancy things” associated features

Answer 9

Amenorrhoea

Breast changes

Question 10

Dysphagia:

What are the important two things to determine?

Answer 10

Where it gets stuck - oropharyngeal vs oesophageal

Solids only or solids & liquids

Question 11

Dysphagia:

Associated features

Answer 11

Odynophagia
Coughing
Choking
Reflux
Loss of appetite
Tremors (Parkinson's)
Cancer things

Question 12

“Cancer things” associated features

Answer 12

Weight loss
Loss of appetite
Fever
Night sweats

Question 13

Dysphagia:

FHx

Answer 13

Neuromuscular problems (Parkinson's, MS)
Cancer

Question 14

What the word for loss of peristalsis in oesophagus?

Answer 14

Achalasia

Question 15

Diarrhoea:

Quality

Answer 15

How watery
Blood
Mucus
Steatorrhoea (difficulty flushing)

Question 16

Diarrhoea:

Severity

Answer 16

Volume

Question 17

Diarrhoea:

Context

Answer 17

1. Contact
2. Travel
3. Strange food
4. Meds / ABs

Question 18

Diarrhoea:

Associated features

Answer 18

Gastro things
Malabsorptive things
Dehydration things (as a consequence)
Weight loss (as a consequence)

Question 19

Define acute diarrhoea

Answer 19

A few days

Question 20

Define persistant diarrhoea

Answer 20

2-4 weeks

Question 21

Define chronic diarrhoea

(cf chronic cough)

Answer 21

4+ weeks

Cough: 8+ weeks

Question 22

Constipation:

Context

Answer 22

Diet (low fibre)
Medications (codeine)
Immobility

Question 23

Constipation:

Associated features

Answer 23

Abdo pain
Rectal bleeding
Cancer things
Hypothyroid things

Question 24

Constipation:

FHx

Answer 24

Cancer

Question 25

Rectal bleeding: | Quality

Answer 25

Colour | Mixing

Question 26

What's the word for black, tarry stools?

Answer 26

Melaena

Question 27

Why is malaena black?

Answer 27

The blood is oxidised by gut bacteria

Question 28

Would can bright rectal bleeding indicate?

Answer 28

Blood from rectum: | Anal fissure, haemorrhoids

Question 29

What can dark red rectal bleeding indicate

Answer 29

Bleeding from large intestines

Question 30

Alcohol: | Broad framework

Answer 30

``` Quantitative Circumstances/triggers Dependence Harm Quitting ```

Question 31

Alcohol: | Quantitative questions

Answer 31

Do you drink How often Type & how much on a typical day How often they have 4+ drinks

Question 32

Alcohol: | Dependence questions

Answer 32

Hard to stop once you've started Unmet obligations Morning drinking

Question 33

Alcohol: | Harm questions

Answer 33

``` Injuries Blackouts Guilt 3rd party concern Financial, legal, social harm ```

Question 34

Alcohol: | Quitting questions

Answer 34

Current motivation Previous attempts Previous tequniques

Question 35

Jaundice: | Context

Answer 35

``` Alcoholism Travel / vaccination Tattoos / piercings IVDU Unprotected sex ```

Question 36

Jaundice: | Associated features

Answer 36

Pee (dark) Poo (pale) Puritis Pain Cirrhosis things Malaria or sickle cell things Gallstone things (pain is extreme and intermittent)

Question 37

"Cirrhosis things"

Answer 37

Oedema / ascites Bruising Gynaecomastia/amennorhoea ?