History-Taking: Digestion and Metabolism

Question 1

8 upper GI symptoms

Answer 1

• Abdominal pain
• Heartburn
• Nausea and vomiting
• Difficulty swallowing (dysphagia)
• Painful swallowing (Odynophagia)
• Vomiting blood (Hematemesis) –> bright red or coffee grounds
• Loss of appetite
• Jaundice

Question 2

Describe dysphagia as a patient may describe it

Answer 2

Food “sticks” or “doesn’t go down right”

Question 3

Causes to consider for dysphagia

Answer 3

Oropharyngeal or neuromuscular

Question 4

Location of problem in dysphagia

Answer 4

Below sternal notch, usually esophageal

Question 5

4 things to consider when a patient has jaundice

Answer 5

Context (travel, medications, acuity)
Color of urine and stool
Pruritus (itching)
Risk factors for hepatitis

Question 6

6 lower GI symptoms

Answer 6

• Abdominal pain
• Change in bowel habits
• Constipation
• Diarrhea
• Bright red blood in the stool (hematochezia)
• Dark and tarry stools (melena)

Question 7

Define acute diarrhea

Answer 7

<2 weeks duration

Question 8

Define chronic diarrhea

Answer 8

≥ 4 weeks duration

Question 9

9 things to consider when a patient has diarrhea

Answer 9

Associated cramping?
Volume
Frequency
Consistency
Mucus, pus, blood, black and tarry??
Tenesmus? (feel like pooping, but no poop)
Day and night?
Greasy/oily or frothy?
Recent antibiotics?

Question 10

2 things to differentiate for abdominal pain

Answer 10

Acute vs. chronic

Upper vs. lower

Question 11

3 patterns of abdominal pain

Answer 11

Visceral
Parietal
Referred

Question 12

2 different anatomical types of abdominal pain

Answer 12

Gastrointestinal

Genitourinary

Question 13

5 basic questions to ask when a patient has abdominal pain

Answer 13

Location
Chronology
Quality
Quantity/severity
Aggravating and alleviating factors

Question 14

5 red flag symptoms

Answer 14

Dysphagia
Recurrent vomiting
Bleeding
Weight loss
Fever or night sweats

Question 15

Second most common cause of cancer death

Answer 15

Colon cancer

Question 16

When is colon cancer diagnosed?

Answer 16

After the onset of symptoms or occult bleeding in the majority of patients

Question 17

What can screening detect for colon cancer?

Answer 17

Asymptomatic early-stage malignancy –> improves mortality

Question 18

Risk factors for colon cancer

Answer 18

Family history (number of family members affected, first-degree relatives, age of onset)

Question 19

2 types of thyroid dysfunction

Answer 19

Hyperthyroidism

Hypothyroidism

Question 20

7 symptoms of hyperthyroidism

Answer 20

Heat intolerance
Sweating
Nervousness
Palpitations
Involuntary weight loss
Muscle weakness +/- tremor
Diarrhea

Question 21

6 symptoms of hypothyroidism

Answer 21

Cold intolerance
Fatigue
Weight gain
Muscle weakness
Dry, coarse skin and/or hair
Constipation

Question 22

How to detect type 2 diabetes in adults

Answer 22

Usually asymptomatic, so requires screening

Question 23

5 symptoms of hyperglycemia

Answer 23

Polyuria
Thirst and polydipsia (excessive thirst)
Nocturia
Blurred vision
Weight loss

Question 24

Symptoms of severe hyperglycemia

Answer 24

Dehydration

Decreased level of alertness