GI

Question 1

Hx OF PC

What symptoms should you ask about in Hx of PC?

Answer 1

• Appetite/weight change?
• Vomiting/haematemesis?
• Dysphagia/dyspepsia?
• Abdominal distension/pain?
• Jaundice.
• Urinary symptoms?
• Bowel habit (bleeding/mucus PR).
• Systemic.

Question 2

Hx OF PC

What would you ask about in vomiting?

Answer 2

• How frequent?
• What time of day it occurs?
• Colour, smell, quantity.
• Haematemesis? If so fresh or altered?

Question 3

Hx OF PC

What would you ask about in dysphagia?

Answer 3

• Is it continuous/intermittent?
• How long does it last?
• Where does food stick?
• Solids, liquids or both?
• Reflux?
• Nocturnal coughing/dyspnoea.

Question 4

Hx OF PC

What would you ask about in jaundice?

Answer 4

• Colour of urine/stools.
• Hx of gallstones.
• Pain.
• Fever/rigors.
• Itching?

Question 5

Hx OF PC

What would you ask about in altered bowel habit?

Answer 5

• What is normal? What is it now?
• How frequent?
• Any associated abdominal discomfort, urgency, incontinence?
• Appearance (formed? float?).
• PR bleeding, clots, mucus?

Question 6

Hx OF PC

What would you ask about in weight/appetite loss?

Answer 6

• How much weight over how long?
• Have you lost weight intentionally?
• Have you lost your appetite?

Question 7

Hx OF PC

What systemic questions would you ask?

Answer 7

• Fever?
• Night sweats?
• Weight loss?
• Problems with eyes, ulcers, arthritis (IBD).

Question 8

Hx OF PC

Spot diagnosis: what would the Hx of PC for peptic ulcer be?

Answer 8

S = epigastric.
O = acute or gradual, ?remissions.
C = gnawing.
R = into back.
A = ?GI haemorrhage if perforates.
T = 30m-3h.
E = After food (hunger).
S = mild-moderate.

Question 9

Hx OF PC

Spot diagnosis: what would the Hx of PC for cholecystitis be?

Answer 9

S = RUQ.
O = colicky.
C = stabbing, piercing.
R = right scapula/shoulder.
A = vomiting, fever, rigors.
T = 3–24h.
E = fatty foods can make worse.
S = severe.

Question 10

Hx OF PC

Spot diagnosis: what would the Hx of PC for pancreatitis be?

Answer 10

S = epigastric.
O = suddenly.
C = piercing/stabbing/burning.
R = into back.
A = N+V, abdominal distension.
T = ≥24h
E = eating can make worse, sitting upright makes better.
S = very severe.

Question 11

PMH

What would you ask about in PMH?

Answer 11

• Previous GI issues.
• Any surgery.
• Gynae problems if female.
• Hx of jaundice, diabetes.

Question 12

DH

What would you ask about in DH?

Answer 12

• Any regular meications.

- Drugs can have GI effects (NSAIDs + peptic ulcers).

Question 13

SH

What would you ask about in SH?

Answer 13

• Alcohol, smoking, occupation + diet.

- Recent foreign travel.

Question 14

FH

What would you ask about in FH?

Answer 14

• Familial element to some carcinomas.
• Malabsorption syndromes.
• Crohn’s/UC.