Other symptoms + history Flashcards
Other symptoms - nausea/vomiting (3)?
Small bowel obstruction,
inferior MI (irritates diaphragm -> vomiting)
Boerhaaves perforation is precipitated by forceful vomiting.
Other symptoms fever (3)?
suggests infection (viral hepatitis or pneumonia) or inflammation (peritonitis).
Other symptoms dyspepsia/waterbrash?
the constellation of symptoms including heartburn, retrosternal discomfort and bitter taste is likely to be GORD.
Other symptoms change in stool?
pale = bile isn’t reaching bowel,
steatorrhoea = poor digestion of fat, usually due to pancreatic exocrine insufficiency or long standing biliary disease
Other symptoms cough?
basal pneumonia,
A more chronic cough with epigastric pain suggests GORD where the refluxed stomach acid irritates the vocal cords.
PMH biliary disease?
gallstone disease is prone to reoccur and have complications like pancreatitis, acute cholecystitis or ascending cholangitis.
PMH peptic ulcer disease?
perforated
PMH GORD?
high rate of recurrence
PMH vascular disease?
increased risk of MI and mesenteric ischaemia (can be acute or chronic).
Risk factors for chronic mesenteric ischaemia are smoking, hypertension, DM, hypercholesteroleamia, family hist of cardiovascular disease.
Drug history peptic ulcer risk (4)?
NSAIDs, steroids, bisphosphonates, salicytes.
Drug history acute pancreatitis risk (4)?
sodium valproate, steroids, thiazides, azathioprine.
family history?
For cardiovascular risk and there are some very rare hereditary causes of acute pancreatitis.
Social history?
Acute pancreatitis can be caused by binge drinking or chronic alcohol abuse.
Smoking is a risk factor for peptic ulcer disease and vascular causes of epigastric pain.
