GPA - Constipation, Diarrhea, GI bleed, bloody stool Flashcards
Key pe for constipation diarrhea
Thyroid endocrine, abdominal and rectal, pelvic
DDX - Constipation Diarrhea 67 yo m, Alternate diarrhea constipation, small caliber blood in stool x 8 months Wt loss low fiber, hx of colon cancer
Colorectal cancer Irritable bowel syndrome Diverticulitis Celiac dz Parisitic infection Malabsorption
Workup - Constipation Diarrhea 67 yo m, Alternate diarrhea constipation, small caliber blood in stool x 8 months Wt loss low fiber, hx of colon cancer
CBC: electrolytes Colonoscopy Barium enema CT: Abdonminal CMP:
DDX - Constipation Diarrhea
28y Male, Constipation x 3 weeks
eaten junk food x 2 months since mother died
Low fiber diet
Hypothyroid
Depression
Irritable bowel syndrome
Workup - Constipation Diarrhea
28y Male, Constipation x 3 weeks
eaten junk food x 2 months since mother died
Rectal exam
TSH
PHQ-9
DDX - Constipation Diarrhea 30yo F, Alternate constipation and diarrhea abdominal pain releaved by defication Neg nausea, vomit wt loss or blood in stool
Irritable bowel syndrome Crohnes Diverticulitis Celiac disease Chronic pancreatitis malabsorption, lactose GI parasitic infecttion Ulcertave colits
Workup - Constipation Diarrhea 30yo F, Alternate constipation and diarrhea abdominal pain releaved by defication Neg nausea, vomit wt loss or blood in stool
Rectal exam, occult blood
CBC
Stool: ova parasite
CT abdomen
DDX - Constipation Diarrhea
33yo M, Watery diarrhea, vomiting, diffuse abdomenal pain x 24 hours
coworkers are also ill
Infectious diarrhea: gastroenteritis
Food poisoning
Inflammatory bowel disease
Workup - Constipation Diarrhea
33yo M, Watery diarrhea, vomiting, diffuse abdomenal pain x 24 hours
coworkers are also ill
Occult blood, rectal
Stool: ova and parasite, leukocytes
CBC, electrolytes
CT abdomen pelvis
DDX - Constipation Diarrhea 40yo f Watery diarrhea abdominal cramps antibiotics for UTI last week
C.diff: pseudomembranous colitis
Gastroenteritis
food poiiiisoning
IBD
Workup - Constipation Diarrhea 40yo f Watery diarrhea abdominal cramps antibiotics for UTI last week
Stool Leukosites, culture, occult blood
C diff toxin
CBC electrolytes
DDX - Constipation Diarrhea
25yo M
water diarrhea, abdominal cramps
mexico vacation
travelerrs diarrhea giardia amebiasis food poisoning Hepatitis A
Workup - Constipation Diarrhea
25yo M
water diarrhea, abdominal cramps
mexico vacation
Stool: ova parasite, leukosides, occult blood Antigens: giardia, entamoebia CBC, electrlytes, CMP: liver functionn Viral hepatitis serology
DDX - Constipation Diarrhea
30yo F
watery diarrhea, abdominal cramp, bloating
milk aggrivation, fasting makes better
Lactose intolerance Gastroenteritis Malabsorption Celiac disease Irritable bowel disease Irratable bowel syndrome Hyper thyroid
Workout - Constipation Diarrhea
30yo F
watery diarrhea, abdominal cramp, bloating
milk aggrivation, fasting makes better
Rectal and stool exam
Hydrogen breath test
TSH
DDX - Constipation Diarrhea 33yo M watery diarrhea diffuse abdomnial pain, wt loss in past 3 weeks not responded to antibiotics
Crohns disease celiac disease UC Pseudomembranous colitis small bowel lymphoma
Workup - Constipation Diarrhea 33yo M watery diarrhea diffuse abdomnial pain, wt loss in past 3 weeks not responded to antibiotics
Rectal, stool and culture CBC, electrolytes TSH CT abdomen, colonscopy Small bowel series Urinary 5-HIAA
Key PE for Upper GI bleed
Orthostatic hypothension, ENT Heart and lung abdominal Rectal
DDX - upper GI bleed 4YO F coffee ground emesis x 3 days dark tarry stool hx of epigastric pain releived by antacids and fodo
Bleeding peptic ulcer
gastritis
esophageal varices
Gastric cancer
Workup - upper GI bleed 4YO F coffee ground emesis x 3 days dark tarry stool hx of epigastric pain releived by antacids and fodo
CBC Ferritin, TBIC, upper endoscopy Abdominal ultrasound CMP: AST, ALT, biliruben Alk phos H pylori
DDX - Upper GI bleed
40 yo F
Epigastric pain, coffee ground emesis,
hx of RA treated with aspirin, and alcholic
Gastritis (can be bleeding) Bleeding peptic ulcer esophageal varices Gastric cancer Malllory weiss tear
Workup - Upper GI bleed
40 yo F
Epigastric pain, coffee ground emesis,
hx of RA treated with aspirin, and alcholic
CBC, Electrolytes, ast, alt, biliruben alk phos
Endoscopy
barium swallow
Key PE for blood in stiool
Vitals, orthostatics, and rectal examss
ddx - bloody stool
67yo M with blood in stool
wt loss, constipation
Family hx of colon cancer
Colon cancer Hemorrhoids anal fissure Diverticulitis Lower GI bleed IBD
Workup - bloody stool
67yo M with blood in stool
wt loss, constipation
Family hx of colon cancer
Colonoscopy
CBC, electrlytse, AST,ALT, biliruben, ALK phos
CT abdomen
Barium enema
ddx - bloody stool 33 yo R - rectal bleeding diarrhea x 1 week lower abdominal pain, Tenesmus for several months.
IIrritable bowel disease: Ulcerative colitis, Chrones Anal fissure hemorrhoids diverticulosis dysentery
Workup - bloody stool 33 yo R - rectal bleeding diarrhea x 1 week lower abdominal pain, Tenesmus for several months.
CBC, PT, PTT Abdominal x ray Colonscopy CT - abdomen and pelvis barium enema
ddx - bloody stool 58 yo M painless bright red blood chronic constipaiton low fiber
Diverticulosis Anal fissure hemorrhoids angiodysplasia colorectol cancer
ddx - bloody stool 58 yo M painless bright red blood chronic constipaiton low fiber
CBC PT, PTT electrolytes colonscopy CT, abdomen pelvis
