GI Assessment

Question 1

Correct order for examination

Answer 1

• Inspection
• Auscultation
• Percussion
• Palpation

Question 2

RUQ

Answer 2

Liver, Lung, gallbladder, duodenum, R adrenal, R kidney, portions of colon

Question 3

RUQ Associated Illnesses

Answer 3

• Liver issues
• Lower Lobe PNA
• Duodenal Ulcer
• Cholecystitis

Question 4

RLQ

Answer 4

Appendix, ovary, kidney/ureter, ileum, ascending colon, bladder, spermatic cord

Question 5

RLQ Associated Illnesses

Answer 5

• appendicitis
• ovarian issues
• Ectopic pregnancy
• Renal stones
• GI issues

Question 6

LUQ

Answer 6

Spleen, stomach, Aorta, Colon, Lung, pancreas, L adrenal

Question 7

LUQ Associated Symptoms

Answer 7

• Ruptured spleen
• Gastric Ulcer
• AA
• LLL PNA
• perf’d colon

Question 8

LLQ

Answer 8

Sigmoid colon, ovary, kidney/ureter, kidney, bladder, spermatic cord

Question 9

LLQ Associated Illnesses

Answer 9

• Ovary issues
• Ectopic pregnancy
• Renal stones
• GI issues

Question 10

Periumbilical Associated Illnesses

Answer 10

• Obstruction
• Pancreatitis
• Early appendicitis
• Mesenteric Thrombosis
• AA
• Diverticulitis

Question 11

Epigastric Associated Illnesses

Answer 11

• Peptic Ulcer
• Acute Pancreatitis
• Biliary Colic
• MI

Question 12

Suprapubic Associated Illnesses

Answer 12

• Urinary retention
• Ruptured ectopic Pregnancy
• Ovarian Cyst
• Cystitis

Question 13

General Abdominal Pain, Associated Illnesses

Answer 13

• bacterial peritonitis
• DKA
• Addison’s
• Hypercalcemia
• lead toxicity
• porphyria

Question 14

Gallbladder

Answer 14

stores bile from the liver, responds to CCK from duodenum, secretes into cystic duct –> common bile duct, maintains alkaline pH in SI, emulsifies fats

Question 15

Pancreas

Answer 15

produces digestive juices,empties into duct of wirsung (pancreatic duct, runs the length), empties into duodenum; also produces insulin and glucagon

Question 16

Spleen

Answer 16

filters blood, manufactures WBCs

Question 17

GI Changes in Pregnancy

Answer 17

• increased urinary symptoms
• Linea nigra
• Diastasis recti
• Striae
• Constipation
• GERD
• Gallstones
• Pyelonephritis

Question 18

GI changes in Older Adults

Answer 18

• decreased motility
• epithelial atrophy –> decreased enzymes and protection
• Decreased liver size
• increased gallstones and cholesterol

Question 19

Causes of Abdominal Distension w/o Pain

Answer 19

• Hypokalemia
• Hypothyroid
• Narcotics

Question 20

Vertical Liver Span

Answer 20

6-12cm

5th intercostal space

Question 21

Indicates Liver Enlargement

Answer 21

palpation of liver 2-3cm below costal margin

Question 22

Site of Spleen Percussion

Answer 22

Midaxillary, slightly posterior; 6th-9th rib (if any)

Question 23

HPI Abdominal Pain

Answer 23

-OLDCARTS
-Relationship to menstruation, urination, defecation, food or alcohol, time of day
-Stools
Medications

Question 24

HPI Diarrhea

Answer 24

• OLDCARTS

- Associated with fevers/chills, weight loss, incontinence, certain foods, timing, stress, medications

Question 25

HPI Constipation

Answer 25

• OLDCARTS

- Associated with diet changes, medications

Question 26

Colon Cancer Risk Factors

Answer 26

• > 50 years
• family hx –> polyps, colon CA, FAP, HNPCC, Turcot syndrome, peutz-jeghers syndrome, MUYTH-associated polyposis
• hx of polyps, IBDs, FAP, HNPCC
• African American
• Diet low in fiber, high in red meat, processed meats
• Obesity
• smoking
• inactivity
• heavy alcohol use
• T2DM

Question 27

Appropriate BMI

Answer 27

18.5-24.9

Question 28

Obesity BMI

Answer 28

30 or greater

Question 29

Newborn Head Circumference

Answer 29

33-35 cm OR 13-14 inches