Gastrointestinal

Question 1

What are the symptoms of GI disorders?

Answer 1

• Abdominal pain
• Dysphagia
• Odynophagia
• Melena
• Epigastric pain with radiation to the back
• Affected by food
• Early satiety with weight loss
• Constipation
• Diarrhea
• Fecal Incontinence
• Arthralgia
• Referred shoulder pain
• Psoas abcess
• Tenderness over Mcburney’s point

Question 2

What are some characteristics fo abdominal pain?

Answer 2

• visceral and referred
• Pain anterior and posterior at the same level

Question 3

What happens to a person who has dysphagia and what should you consider a possible cause?

Answer 3

Food gets stuck or caught in the esophagus. Check medications (could slow down esophogeal motility)

Question 4

What is melena and what indicates where the disorder is ?

Answer 4

Melena is black, tarry stools due to intestinal bleeding. the higher up in the GI the darker the stool

Question 5

Why would a person get full very fast and still lose weight?

Answer 5

There is possibly a blockage or a space occupying lesion

Question 6

What would you want to know about a person who is constipated?

Answer 6

Diet, fiber, Meds (narcotics)

Question 7

What FUPs would you ask a person with diarrhea?

Answer 7

FUPs regarding diet and meds (antibiotics)

Question 8

What is the problem with Clostridium difficile (c-diff) and what activity do you have to be careful doing with a patient?

Answer 8

C-diff is becoming more prevalent and more difficult (resistant to antibiotics). Be careful when walking patient

Question 9

What are the 3 types of arthralgia?

Answer 9

• Asymmetric- difficult to differentiate between musculo-skeletal
• Migratory- moves from joint to joint
• Oligoarticular-few joints (<4; 6 months history with no mechanism or explanation)

Question 10

What type of patients have arthralgia?

Answer 10

Crohn’s disease (25%)

Question 11

What is Kehr’s sign and what does it mimic?

Answer 11

Referred pain to the left shoulder due to blood or air in the abdominal cavity, asocciated with trauma. There may also be some rebound tenderness in the abdomen. Kehr’s mimcs a heart attack

Question 12

What are tests for Psoas abcess, what are test positions (if indicated) and what is considered positive?

Answer 12

1. Heel tap-pain with tapping heel or equivalent response is pain when hitting a bump in the car or ambulence
2. Single-leg hop- unilateral pain is positive
3. Psoas muscle test- Pt. flexes hip, then therapist palpates psoas through abdominal wall. positve= ab pain in right quadrant
4. Obturator test-Pt flex hip,knee,holding ankle, IR and ER of hip. Positive= lower quadrant or pelvic pain with IR

Question 13

T/F Psoas abscess requires an immediate referral

Answer 13

True

Question 14

What is positive for tenderness over McBurney’s point, what does it suggest, and why is it minimally reliable?

Answer 14

• Positive= rt lower quadrant pain
• Suggests appendicitis
• needs to be inflamed to positive
• see bottom of pg 340

Question 15

What are signs of GI disorders and what do they indicate?

Answer 15

• Jaundice- liver absorption issues
• Skin lesions- Malabsorption problem
• Temperaure- fever indicates infecton
• Positive for appendicitis or abcess (requires immediate referal)
• Unusual BP and HR accompanied by ab pain-splenic rupture

Question 16

What characterstics are associated with Peptic ulcer?

Answer 16

• can be caused by meds such as NSAIDS and antibiotics (10% from NSAIDS)
• Light-headedness and nausea= bleeding ulcer (require immediate physician referral)

Question 17

What is Diverticular disease?

Answer 17

Broad variety of symptoms: cramping, bloody stools, left lower abdominal pain and tenderness, left pelvic pain

Question 18

What are signs and symptoms of Appendiciitis (pg 340)?

Answer 18

Right lower quadrant or flank pain, rebound tenderness, nausea, fever, vomitting, right thigh or groin pain, Positive hop test

Question 19

What are signs and symptoms for acute and chronic pancreatitis?

Answer 19

Acute- nausea, vomitting, malaise, weakness, jaundice, bluish discoloration of the abdomen

Chronic- History of alcohol abuse, Upper (left) abdominal/epigastic pain that raidiates to the back, flatulence, constipation

Question 20

What are the 2 conditions grouped under Inflammatory bowel disease and what are their symptoms?

Answer 20

• Crohn’s disease-inflammation of GI tract (distal ileum), diarrhea, constipation, fever, rectal bleeding,night sweats, skin lesions, uvetis, arthritis, migratory arthralgias. Onset-young adults, adolescents
• Ulcerative colitis- ulceration of the GI tract (colon) so most common symptom is GI bleeds. Same symptoms and onset as Crohn’s

Question 21

What are signs and symptoms for pancreatic carcinoma?

Answer 21

upper abdominal/epigastic pain may radiate to the back, light colored stools, constipation, jaundice

Question 22

What are signs and symptoms for irritable bowel syndrome?

Answer 22

Painful abdominal cramps, constipation, diarrhea, N&V, anorexia, flatuelence, foul breath

Question 23

what are signs and symptoms for colorectal cancer?

Answer 23

Rectal bleeding, hemorrhoids, abdominal, back and pelvic pain, changes in bowel patterns

Question 24

Risk factors for patients with colorectal cancer

Answer 24

High red meat consumption, overweight, acohol, tobacco, family hx, hx of polyps, >age 50

Question 25

What are diagnostic test for GI disorders?

Answer 25

• Endoscopy
• CT or MRI
• Colonoscopy

Question 26

What is cause for a physican’s referral?

Answer 26

1. Chronic Laxative use
2. Eye lesions accompany joint inflammation- inflammatory bowel disease
3. Prolonged NSAID use with symptoms of peptic ulcer
4. Atypical pain pattern not reproducible with STTE and history of Cancer