Module 9 Abdominal & Male GU Flashcards
1
Q
GI Common Concerns
A
- Abdominal Pain — Acute and Chronic
- Indigestion, N/V
- Loss of appetite and early satiety
- Difficult or painful swallowing
- Change in bowel function
- Diarrhea, constipation
- Jaundice
2
Q
Urinary & Renal Common Concerns
A
- Suprapubic pain
- Difficulty urinating, dysuria, frequency, urgency, hesitancy, decreased stream
- Excessive urination
- Urinary incontinence
- Hematuria
- Flank pain & Uretral colic
3
Q
Acute/Emergent Abdominal Pain
-Quick Hx
A
- Gather hx while performing exam
- Important information
- Location
- Onset and progression
- Character of the pain
- Associated symptoms
- Medications
- Recent surgery
- Recent travel
- LMP
4
Q
Acute/Emergent Abdominal Pain
-Rapid Assessment
A
- Inspection —FIRST
- Auscultation
- Percussion
- Palpation
5
Q
Acute/Emergent Abdominal Pain
-Labs?
A
- CMP, CBC, Amylase & Lipase
- U/A — Urine HCG for F of childbearing age**TEST
- EKG for those >/= 50 years and/or CAD risk (DIABETES
6
Q
Acute/Emergent Abdominal Pain
-Clinical Pearls
A
- Pain BEFORE Vomiting = Acute Surgical Abdomen
- Pain AFTER Vomiting = Acute medical abdomen
- Do not medicate and mask Sx’s
- Peritonitis = High fever, lethargy and chills — Call 911
- Pain exaggerated w/ movement — PERITONITIS
- Restless, writhing patient — renal or biliary colic
7
Q
Acute/Emergent Abdominal Pain
-Clinical Pearls 2
A
- Cancer is a common cause of abdominal pain in elderly patients **TEST
—Elderly patients have UNCOMMON causes of abdominal pain - Abdominal pain w/out associated symptoms is RARELY a serious problem
- Location of pain is one of the BEST TESTS for determining Dx
8
Q
SUDDEN Onset Abdominal Pain
-Causes?
A
- Perforated Ulcer
- Mesenteric infarction
- Ruptured AAA
- Ovarian torsion or ruptured cyst
- Ruptured Ectopic Pregnancy — Get urine HCG
- Acute MI
9
Q
RAPID onset Abdominal Pain
-Causes
A
- Strangulated hernia
- Vólvulos
- Intussusception
- Acute pancreatitis
- Biliary colic
- Diverticulitis
- Ureteral & Renal colic
10
Q
GRADUAL onset Abdominal Pain
-Causes
A
- Appendicitis
- Strangulated hernia
- Chronic Pancreatitis
- Peptic Ulcer Dz
- Inflammatory bowel disease
- Cystitis & Urinary retention
- Prostatitis & Salpingitis
11
Q
Non-Urgent/Chronic Abdominal Pain
-Systems to Assess with GI complaints?
A
- Cardiovascular**TEST
- Respiratory
- Musculoskeletal
- GU
12
Q
Non-Urgent/Chronic Abdominal Pain
-HPI 7 Dimensions
A
- Timing of pain
- Description of pain — Boring, stabbing, burning, cramping, waxing/waning, colic, shearing/tearing
- Point to the pain
- Rate pain 1-10
- Aggravating factors — meds or food?
- Alleviating factors — Meds or food?
- Accompanying symptoms — Fairly thorough ROS w/ GI complaint
13
Q
Non-Urgent/Chronic Abdominal Pain
-Gastric vs Peptic Ulcer
A
- Gastric Ulcer — Food makes it Worse
2. Peptic Ulcer — Food makes it better
14
Q
Non-Urgent/Chronic Abdominal Pain
-ROS
A
- HEENT — HA, Jaw pain, throat pain, Dysphonia, Odynophagia (Pain w/ eating; REFER ASAP)
- CV — CP SOB, Dyspnea on exertion, orthopnea, palpitations, tachycardia, tachypnea L shoulder/Jaw pain Syncope
- Respiratory — SOB, cough, wheezing, pain w/ inspiration
- Abdomen — N/V/D/C, pain, anorexia, Dysphagia, BM’s melena
- GU —Dysuria, hematuria, pelvic pain
- Musculoskeletal — Pain w/ movement; pain reproducible w/ palpation; pain over ligament insertion
15
Q
Non-Urgent/Chronic Abdominal Pain
-Important Subjective Information
A
- Repeated UTI’s that don’t have significant findings on culture — Think Interstitial Cystitis — Antibiotics don’t treat under lining problem
