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MD3002 GI/GU/Renal > History Taking: Abdomen > Flashcards

History Taking: Abdomen Flashcards

1
Q

What is the order of taking a medical history (including at which point you would ask GI questions)?

A
  • introduction
  • patient ID
  • consent
  • presenting complaint
  • history of presenting complaint (where you ask GI questions)
  • past medical history
  • drug history and allergies
  • family history
  • social history
  • systems enquiry
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2
Q

What would you ask in the systems enquiry of a medical history?

A
  • CVS: chest pain, palpitations
  • RS: shortness of breath, cough
  • endocrine: lumps in the neck, weight changes
  • MSK: pain/stiffness in joints, muscles or back
  • CNS: headaches, funny turns
  • GU: changes in waterworks
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3
Q

What are some mouth symptoms of a GI problem?

A
  • bad breath (halitosis)
  • dry mouth (xerostomia)
  • altered taste (dysgeusia)
  • foul taste (cacogeusia)
  • cracked painful lips (stomatitis)
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4
Q

What can be causes of bad breath (halitosis)?

A
  • gingivitis
  • dental infection
  • pharyngeal infection
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5
Q

What are some important questions to ask about pain?

A
  • SOCRATES
  • does it stop them doing anything
  • can they lie still or are they writhing around?
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6
Q

What are the 9 regions of the abdomen from top to bottom?

A
  • R/L hypochondriac region and epigastric region
  • R/L lumbar region and umbilical region
  • R/L iliac fossa and hypogastric region
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7
Q

What is colicky pain?

A

Pain that peaks in intensity and varies

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8
Q

What are common associated symptoms of a GI issue?

A
  • sweating/fevers
  • vomiting/nausea
  • diarrhoea
  • urinary symptoms
  • vaginal bleeding/discharge
  • weight loss
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9
Q

What are common exacerbators of GI pain?

A
  • eating/not eating
  • movement/lack of
  • position
  • exercise
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10
Q

What are common relievers of GI pain?

A
  • eating/not eating
  • vomiting/opening bowels
  • movement/lack of
  • position
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11
Q

What are some causes of weight gain?

A
  • fluid gain (cardiac failure, liver disease, nephrotic syndrome)
  • hypothyroidism
  • depression
  • increased energy input/output ratio
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12
Q

What are some causes of unexplained weight loss?

A
  • malignancy
  • malabsorption
  • metabolic disease
  • psychiatric causes
  • malnutrition
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13
Q

GORD

A

gastro-oesophageal reflux disease

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14
Q

What can exacerbate heartburn and reflux?

A
  • food
  • lying flat
  • bending forwards
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15
Q

What is dyspepsia (indigestion), what makes it worse and what are the associated symptoms?

A
  • pain/discomfort centered in upper abdomen
  • exacerbated by food
  • associated with nausea, belching and bloating
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16
Q

What is odynophagia, what makes it worse and what are the causes?

A
  • pain on swallowing
  • exacerbated by hot fluids
  • causes: oesophageal ulcers, oesophagitis, oesophgeal candidiasis
17
Q

What is dysphagia?

A
  • difficulty in swallowing
  • NOT globus (lump in throat)
  • obstruction during passage of food
  • always requires further investigation
18
Q

Questions to ask about dysphagia

A
  • where do they feel it sticking?
  • intermittent/progressive?
  • solids/liquids?
  • associated symptoms
  • pain
  • complete obstruction?
  • regurgitation?
19
Q

What are associated symptoms of upper GI bleeding and common causes?

A
  • haematemesis (vomiting blood)
  • melaena (passage of black tarry stools - red flag) - bleed
  • gastric/duodenal ulcer (50%)
  • gastric erosions (15-20%)
20
Q

What are the associated symptoms of lower GI bleeding and common causes?

A
  • fresh blood

- haemorrhoids/anal fissure/ diverticular disease

21
Q

What is painless jaundice a sign of?

A

carcinoma of the head of the pancreas

22
Q

Questions to ask about jaundice?

A
  • duration
  • associated symptoms
  • travel
  • consumption of shellfish
  • blood transfusion
  • alcohol
  • changes in meds
  • IV drug use
  • unprotected sex
23
Q

Constipation causes

A
  • diet/dehydration
  • painful anal conditions
  • immobility
  • medication
  • hypothyroidism
  • colonic/rectal carcinoma
  • neuro
  • hypercalcaemia
  • irritable bowel syndrome
24
Q

Diarrhoea causes

A
  • diet
  • stress
  • infection
  • inflammation
  • endocrine
  • malabsorption
  • medication
  • irritable bowel syndrome
25
Q

Upper GI red flags

A
  • dysphagia
  • evidence of blood loss
  • unexplained weight loss
  • upper abdo mass
  • unexplained back pain
  • painless jaundice
  • persistent vomiting
  • unexplained iron deficiency anaemia
  • unexplained worsening dyspepsia without other symptoms (over 55)
  • new onset GI pain (over 55)
26
Q

Lower GI red flags

A
  • bleeding (rectal bleeding with no cause/in stool)
  • changes in bowel habit (persistent esp if looser stools)
  • mass (right sided or palpable rectal mass)
  • unexplained iron deficiency anaemia
  • history of lower GI cancer

MD3002 GI/GU/Renal (64 decks)

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