GI Assessment Flashcards
Red flag symptoms of GI complaint
syncope, light-headedness, melena, hematochezia, dysphagia, odynophagia, unexplained weight loss
Diagnostic data tx for GI complaint
FOB, H. pylori assessment, CBC, PPI; address lifestyle issues, treat for H. pylori, consider EGD
When to refer to EGD
anemia, FOB, any red flag sxs or findings
PE biliary disease
RUQ colicky pain, associated with nausea radiating to lower ribs and back, positive murphy’s sign
Test of choice for biliary disease
transabdominal US
PE acute cholecystitis/choledocolithiasis
fever, N/V, RUQ pain, may or not be colicky or associated with infection
HIDA scan steps
- radionucleotide injected that collects in the liver and moves to gall bladder
- administer CCK to activate GB to eject bile
- CCK will reproduce sxs
- Sequential imaging to track isotope movement
- failure to visualize GB is positive for obstruction
Scleral icterus
yellowing of sclera due to bilirubin binding to elastin
PE pancreatitis
severe epigastric or periumbilical, N/V, fever, tachycardia, hypotension, epigastric rigid abdomen, ileus
Lab data for pancreatitis
elevated serum amylase and lipase, leukocytosis, proteinuria with granular casts, glycosuria, hyperglycemia, elevated serum bilirubin and BUN
Acute pancreatitis treatment
NPO, pain management, hydration/fluid resuscitation, ID underlying cause
Esophagus chapman point
between rib 2 & 3 parasternally
Stomach chapman point
Left between rib 5-6 and 6-7 at costochondral junction
Pancreas chapman point
Right between ribs 6-7 at costochondral junction
Liver chapman point
right between 5-6 and 6-7 at costochondral junction
Small intestines chapman point
ribs 8-11 b/l at costochondral junction
Gallbladder chapman point
R rib 6-7 at costochondral junction
Constipation definition
less than 3 BM/week OR excessive straining OR hard or dry stools OR sense of incomplete evacuation
Dyspepsia
pain or discomfort center in upper abdomen associated with fullness, early satiety, bloating or nausea
Behavioral model change for gastritis
stop intake of causative agent
Metabolic/energetic model change for gastritis
urea breath test and triple therapy for H. pylori, acid suppression
Respiratory/circulatory model change for gastritis
FOB, eval and treat lymphatic changes
Neurologic model change for gastritis
treat chapman points, eval and treat viscerosomatic findings
Biomechanical model change for gastritis
eval and tx somatic dysfunction
Behavioral model change for GERD
lifestyle modification–elevating head of bed, avoiding cigarettes, alcohol, coffee, peppermint, chocolate, high carbs, large meals
Metabolic/energetic model change for GERD
suppression of gastric acid production, promotility therapy
Respiratory/circulatory model change for GERD
assess for reflux complications such as asthma, hoarseness, and dental erosions
Biomechanical model change for GERD
MSK findings and chapman point tx
Neurologic model for GERD
address PSI and SI to esophagus and stomach, address chapman points
Preferred imaging for diverticulitis
CT with oral and IV contrast
Bowel sounds associated with obstruction
high pitched
Bowel sounds associated with ileus
decreased/absent
Percussion of abdomen
tympany over air-filled viscera, dullness over solid organs and fluid or feces
Expected liver span
6-12 cm at mid-clavicular line on R
Expected spleen span
ribs 6-10 at mid-axillary line on L
Rebound tenderness indicates…
peritoneal inflammation
Percussion sounds of ascites
shifting dullness
Quality of visceral pain
gnawing, burning, aching, cramping
