Podcast
Questions and Answers
A patient presents with excessive salivation. Which term accurately describes this condition?
A patient presents with excessive salivation. Which term accurately describes this condition?
- Xerostomia
- Dysgeusia
- Ageusia
- Ptyalism (correct)
A patient reports a persistent sensation of a lump in their throat, but no organic cause is found during examination. What term best describes this sensation?
A patient reports a persistent sensation of a lump in their throat, but no organic cause is found during examination. What term best describes this sensation?
- Achalasia
- Dysphagia
- Odynophagia
- Globus (correct)
A patient is diagnosed with bulimia nervosa. Which compensatory behavior is most characteristic of this disorder?
A patient is diagnosed with bulimia nervosa. Which compensatory behavior is most characteristic of this disorder?
- Compulsive consumption of non-food items
- Persistent lack of appetite
- Recurrent binge eating followed by purging (correct)
- Refusal to maintain a healthy body weight
A patient complains of bad breath. What is the proper medical term for this condition?
A patient complains of bad breath. What is the proper medical term for this condition?
A patient reports difficulty initiating a swallow, along with nasal regurgitation and coughing. Which type of dysphagia is most likely?
A patient reports difficulty initiating a swallow, along with nasal regurgitation and coughing. Which type of dysphagia is most likely?
A patient presents with dysphagia primarily affecting solids. Which of the following is a likely structural cause?
A patient presents with dysphagia primarily affecting solids. Which of the following is a likely structural cause?
In evaluating dysphagia, which initial investigation is typically recommended for patients with esophageal symptoms?
In evaluating dysphagia, which initial investigation is typically recommended for patients with esophageal symptoms?
What is the term for the forceful expulsion of gastric contents through the mouth?
What is the term for the forceful expulsion of gastric contents through the mouth?
A patient reports effortless appearance of gastric contents into the mouth, without nausea. What term describes this?
A patient reports effortless appearance of gastric contents into the mouth, without nausea. What term describes this?
Which of the following is a common gastrointestinal cause of vomiting?
Which of the following is a common gastrointestinal cause of vomiting?
A patient presents with metabolic alkalosis due to persistent vomiting. What electrolyte abnormality is also likely to be present?
A patient presents with metabolic alkalosis due to persistent vomiting. What electrolyte abnormality is also likely to be present?
Heartburn is a diagnostic symptom of which condition?
Heartburn is a diagnostic symptom of which condition?
A patient experiences upper abdominal discomfort, early satiety, and postprandial fullness. Which term best describes these symptoms?
A patient experiences upper abdominal discomfort, early satiety, and postprandial fullness. Which term best describes these symptoms?
Which of the following is NOT considered an alarm symptom in patients presenting with dyspepsia?
Which of the following is NOT considered an alarm symptom in patients presenting with dyspepsia?
According to the guidelines for uninvestigated dyspepsia, what is the initial step for patients over 55 or those with alarm symptoms?
According to the guidelines for uninvestigated dyspepsia, what is the initial step for patients over 55 or those with alarm symptoms?
What is the primary difference between hematemesis and melena?
What is the primary difference between hematemesis and melena?
Bleeding originating proximal to which anatomical landmark is classified as upper gastrointestinal bleeding?
Bleeding originating proximal to which anatomical landmark is classified as upper gastrointestinal bleeding?
What is the term used to describe lower GI bleeding characterized by the passage of bright red blood per rectum?
What is the term used to describe lower GI bleeding characterized by the passage of bright red blood per rectum?
A patient with known esophageal varices develops upper GI bleeding. What is the most likely cause of bleeding in this patient?
A patient with known esophageal varices develops upper GI bleeding. What is the most likely cause of bleeding in this patient?
A patient has bleeding that remains unexplained after a normal upper endoscopy and colonoscopy. What term best describes this type of bleeding?
A patient has bleeding that remains unexplained after a normal upper endoscopy and colonoscopy. What term best describes this type of bleeding?
A patient presents with abdominal distension caused by increased abdominal girth over several months. What is the most likely cause?
A patient presents with abdominal distension caused by increased abdominal girth over several months. What is the most likely cause?
Which of the following conditions is most closely associated with excessively noisy bowel sounds (borborygmi)?
Which of the following conditions is most closely associated with excessively noisy bowel sounds (borborygmi)?
A patient reports frequent passage of small volumes of stool with rectal urgency. What term describes this condition?
A patient reports frequent passage of small volumes of stool with rectal urgency. What term describes this condition?
Which of the following is an inflammatory condition of the intestine characterized by diarrhea containing blood and mucus?
Which of the following is an inflammatory condition of the intestine characterized by diarrhea containing blood and mucus?
Which of the following criteria defines constipation based on bowel movement frequency?
Which of the following criteria defines constipation based on bowel movement frequency?
A patient with long-standing opioid use reports constipation. Which of the following is the most likely cause?
A patient with long-standing opioid use reports constipation. Which of the following is the most likely cause?
What is the most common cause of variceal bleeding?
What is the most common cause of variceal bleeding?
A patient experiences altered bowel habits, abdominal discomfort, and flatulence that is relieved by defecation. He most likely has:
A patient experiences altered bowel habits, abdominal discomfort, and flatulence that is relieved by defecation. He most likely has:
Which of the following is considered a medical cause when considering a diagnosis for abdominal pain?
Which of the following is considered a medical cause when considering a diagnosis for abdominal pain?
A known alcoholic presents with abdominal pain, vomiting, and elevated amylase and lipase levels. Which of the following diagnoses is most likely?
A known alcoholic presents with abdominal pain, vomiting, and elevated amylase and lipase levels. Which of the following diagnoses is most likely?
Following the assessment of a patient with GI symptoms, the doctor recommends a medication to reduce their excessive diarrhea. This step is related to:
Following the assessment of a patient with GI symptoms, the doctor recommends a medication to reduce their excessive diarrhea. This step is related to:
Your patient is experiencing periumbilical pain, which is visceral is nature. What are the sensations sensed by the Gut organs to feel that pain?
Your patient is experiencing periumbilical pain, which is visceral is nature. What are the sensations sensed by the Gut organs to feel that pain?
A 55 year old patient reports black tarry stool. after the primary steps to take during the assessment, which one would follow?
A 55 year old patient reports black tarry stool. after the primary steps to take during the assessment, which one would follow?
The patient reports taking iron supplements due to anemia. Which one the following can be related to taking iron?
The patient reports taking iron supplements due to anemia. Which one the following can be related to taking iron?
What are the non-surgical treatment for nausea?
What are the non-surgical treatment for nausea?
What are the benefit of taking upper endoscopy in the diagnosis of GI disorders?
What are the benefit of taking upper endoscopy in the diagnosis of GI disorders?
What should you consider as a medical cause of abdominal pain?
What should you consider as a medical cause of abdominal pain?
A patient report a recent use of anti-biotics without a medical consult. Which Gl presentation could occurs?
A patient report a recent use of anti-biotics without a medical consult. Which Gl presentation could occurs?
A patient presents with complaints of excessive salivation due to acid regurgitation. Which of the following conditions is most likely contributing to this patient's ptyalism?
A patient presents with complaints of excessive salivation due to acid regurgitation. Which of the following conditions is most likely contributing to this patient's ptyalism?
Dryness of the mouth can be caused by:
Dryness of the mouth can be caused by:
What conditions would be least likely to lead to halitosis?
What conditions would be least likely to lead to halitosis?
A patient's dysphagia is characterized by difficulty initiating a swallow associated with nasal regurgitation. This presentation is most suggestive of which type of dysphagia?
A patient's dysphagia is characterized by difficulty initiating a swallow associated with nasal regurgitation. This presentation is most suggestive of which type of dysphagia?
A 60-year-old male presents with dysphagia primarily affecting solid foods. Based on his age and symptom presentation, which of the following structural abnormalities is the most likely cause?
A 60-year-old male presents with dysphagia primarily affecting solid foods. Based on his age and symptom presentation, which of the following structural abnormalities is the most likely cause?
A young male patient is suspected of having eosinophilic esophagitis. Which piece of the patient's history would lead to this suspicion?
A young male patient is suspected of having eosinophilic esophagitis. Which piece of the patient's history would lead to this suspicion?
A previously healthy patient reports that they find it difficult to swallow cough, choke and have nasal regurgitation. Which diagnosis is more likely to be related to the presentation?
A previously healthy patient reports that they find it difficult to swallow cough, choke and have nasal regurgitation. Which diagnosis is more likely to be related to the presentation?
While evaluating a patient with dysphagia, which initial diagnostic test would allow for both diagnosis and therapeutic intervention?
While evaluating a patient with dysphagia, which initial diagnostic test would allow for both diagnosis and therapeutic intervention?
A patient who is suspected of having achalasia requires a primary test. What investigation would the clinician recommend?
A patient who is suspected of having achalasia requires a primary test. What investigation would the clinician recommend?
A patient describes regurgitation, what statement would be correct?
A patient describes regurgitation, what statement would be correct?
A patient reports vomiting, which examination should be included in the investigation?
A patient reports vomiting, which examination should be included in the investigation?
A patient with a history of bulimia nervosa is experiencing frequent vomiting. Which of the following electrolyte imbalances is most likely to develop?
A patient with a history of bulimia nervosa is experiencing frequent vomiting. Which of the following electrolyte imbalances is most likely to develop?
What is the underlying cause of heartburn?
What is the underlying cause of heartburn?
If you have a patient presenting with dyspepsia, what GI causes should you consider?
If you have a patient presenting with dyspepsia, what GI causes should you consider?
What is the clinical presentation of a patient with dyspepsia?
What is the clinical presentation of a patient with dyspepsia?
What are the alarm symptoms that are related to dyspepsia?
What are the alarm symptoms that are related to dyspepsia?
A 45-year-old patient presents with hematemesis. What characteristics would describe the cause?
A 45-year-old patient presents with hematemesis. What characteristics would describe the cause?
Which of the following is the correct definition of melena?
Which of the following is the correct definition of melena?
A GI bleed that is above the ligament of Treitz is related to?
A GI bleed that is above the ligament of Treitz is related to?
A patient is experiencing the excessive distension of their abdomen with a tightening sound. Which of the following describes this?
A patient is experiencing the excessive distension of their abdomen with a tightening sound. Which of the following describes this?
Excessively noisy bowel sounds could be related to?
Excessively noisy bowel sounds could be related to?
In elderly patients, what kind of diarrhea should you consider might have occurred?
In elderly patients, what kind of diarrhea should you consider might have occurred?
A patient reports that they have bloody stool with mucus and fever what condition is associated with this?
A patient reports that they have bloody stool with mucus and fever what condition is associated with this?
What stool output weight would describe diarrhea?
What stool output weight would describe diarrhea?
When would you consider a cause to be related to Constipation based on frequency?
When would you consider a cause to be related to Constipation based on frequency?
A patient experiencing frequent constipation resulting from a rectocele would classify the cause as which of the following:
A patient experiencing frequent constipation resulting from a rectocele would classify the cause as which of the following:
If a patient's presentation described Lower GIT bleeding, how would it be determined?
If a patient's presentation described Lower GIT bleeding, how would it be determined?
If a patient has obscure bleeding in their GIT, what does this mean?
If a patient has obscure bleeding in their GIT, what does this mean?
A patient that you are treating that has abdominal pain is asked a few questions, which of the following is included in the history taking of abdominal pain?
A patient that you are treating that has abdominal pain is asked a few questions, which of the following is included in the history taking of abdominal pain?
A female patient explains that she is experiencing pain and reports that she has endometriosis. Which type of GYN cause is the presentation related to?
A female patient explains that she is experiencing pain and reports that she has endometriosis. Which type of GYN cause is the presentation related to?
A patient presents with a history of bulimia nervosa and exhibits erosion of dental enamel, along with concerns about cardiac arrhythmias. What underlying electrolyte disturbance is most likely contributing to these clinical findings?
A patient presents with a history of bulimia nervosa and exhibits erosion of dental enamel, along with concerns about cardiac arrhythmias. What underlying electrolyte disturbance is most likely contributing to these clinical findings?
A patient with a history of chronic alcohol abuse presents with symptoms of flatulence, abdominal distension, and frequent episodes of explosive diarrhea. Further evaluation reveals steatorrhea. Which of the following conditions is the most likely underlying cause of these symptoms?
A patient with a history of chronic alcohol abuse presents with symptoms of flatulence, abdominal distension, and frequent episodes of explosive diarrhea. Further evaluation reveals steatorrhea. Which of the following conditions is the most likely underlying cause of these symptoms?
An elderly patient with a history of cardiovascular disease is admitted with severe constipation. Medications include a beta-blocker, diuretic, and calcium channel blocker. Which medication is most likely contributing to their constipation?
An elderly patient with a history of cardiovascular disease is admitted with severe constipation. Medications include a beta-blocker, diuretic, and calcium channel blocker. Which medication is most likely contributing to their constipation?
A patient with cirrhosis develops sudden, painless hematemesis. After initial resuscitation, which intervention is most critical in the acute management of this patient?
A patient with cirrhosis develops sudden, painless hematemesis. After initial resuscitation, which intervention is most critical in the acute management of this patient?
A patient with a history of Crohn's disease presents with increased abdominal pain, diarrhea, and signs of dehydration. A CT scan reveals a localized perforation with an associated abscess in the ileum. What is the most appropriate next step in management?
A patient with a history of Crohn's disease presents with increased abdominal pain, diarrhea, and signs of dehydration. A CT scan reveals a localized perforation with an associated abscess in the ileum. What is the most appropriate next step in management?
A patient presents with a long history of NSAID use for chronic arthritis. They report recent onset of melena. After initial stabilization, which diagnostic procedure is most appropriate to identify the source of bleeding?
A patient presents with a long history of NSAID use for chronic arthritis. They report recent onset of melena. After initial stabilization, which diagnostic procedure is most appropriate to identify the source of bleeding?
A patient presents with fevers, abdominal pain, and frequent bloody diarrhea. Stool studies reveal the presence of Clostridioides difficile toxin. Which of the following factors would be the strongest indication for initiating oral vancomycin over oral metronidazole?
A patient presents with fevers, abdominal pain, and frequent bloody diarrhea. Stool studies reveal the presence of Clostridioides difficile toxin. Which of the following factors would be the strongest indication for initiating oral vancomycin over oral metronidazole?
A patient presents with a history of end-stage renal disease and complains of persistent nausea and vomiting. Serum electrolyte abnormalities are present, including hyperkalemia and metabolic acidosis. Which of the following is the most likely cause of the patient's nausea and vomiting?
A patient presents with a history of end-stage renal disease and complains of persistent nausea and vomiting. Serum electrolyte abnormalities are present, including hyperkalemia and metabolic acidosis. Which of the following is the most likely cause of the patient's nausea and vomiting?
A patient presents with chronic diarrhea, weight loss, and abdominal cramping. Initial investigations, including colonoscopy and stool studies, are unremarkable. However, the patient admits to frequent use of over-the-counter laxatives. What is the most likely cause of the patient's symptoms?
A patient presents with chronic diarrhea, weight loss, and abdominal cramping. Initial investigations, including colonoscopy and stool studies, are unremarkable. However, the patient admits to frequent use of over-the-counter laxatives. What is the most likely cause of the patient's symptoms?
A patient with a confirmed diagnosis of achalasia presents with increasing dysphagia, regurgitation and weight loss. Which of the following findings warrants the strongest consideration for progression to esophageal cancer?
A patient with a confirmed diagnosis of achalasia presents with increasing dysphagia, regurgitation and weight loss. Which of the following findings warrants the strongest consideration for progression to esophageal cancer?
A patient presents with abdominal pain localized to the periumbilical region. Which type of pain is associated with the distension, stretch and contraction to the gut organs?
A patient presents with abdominal pain localized to the periumbilical region. Which type of pain is associated with the distension, stretch and contraction to the gut organs?
A patient reports frequent episodes of heartburn that worsen when lying down, along with a chronic cough and new-onset asthma. Which pathophysiological mechanism is most likely contributing to the asthma?
A patient reports frequent episodes of heartburn that worsen when lying down, along with a chronic cough and new-onset asthma. Which pathophysiological mechanism is most likely contributing to the asthma?
A patient presents with persistent dyspepsia despite trials of PPI therapy and negative testing for H. pylori. Which of the following findings would be most suggestive of functional dyspepsia rather than organic disease?
A patient presents with persistent dyspepsia despite trials of PPI therapy and negative testing for H. pylori. Which of the following findings would be most suggestive of functional dyspepsia rather than organic disease?
A patient is being evaluated for recent onset dyspepsia. Which of the following symptoms would be considered an alarm feature, necessitating prompt endoscopic evaluation?
A patient is being evaluated for recent onset dyspepsia. Which of the following symptoms would be considered an alarm feature, necessitating prompt endoscopic evaluation?
A 70-year-old patient presents with several weeks of progressive dysphagia. The patient reports that the dysphagia is worst with solid foods. History includes smoking and alcohol use. Which diagnosis is most likely?
A 70-year-old patient presents with several weeks of progressive dysphagia. The patient reports that the dysphagia is worst with solid foods. History includes smoking and alcohol use. Which diagnosis is most likely?
A patient presents with symptoms suggesting oropharyngeal dysphagia. Which of the following is the most specific clinical feature that differentiates oropharyngeal from esophageal dysphagia?
A patient presents with symptoms suggesting oropharyngeal dysphagia. Which of the following is the most specific clinical feature that differentiates oropharyngeal from esophageal dysphagia?
A young adult presents with intermittent dysphagia to solids. The episodes are non-progressive and often occur when eating quickly or when consuming large bites of food. What is the most likely diagnosis?
A young adult presents with intermittent dysphagia to solids. The episodes are non-progressive and often occur when eating quickly or when consuming large bites of food. What is the most likely diagnosis?
A patient is diagnosed with eosinophilic esophagitis (EoE). What is the most important aspect of the patient's history that leads to the diagnosis?
A patient is diagnosed with eosinophilic esophagitis (EoE). What is the most important aspect of the patient's history that leads to the diagnosis?
A patient is being evaluated for dysphagia and undergoes upper endoscopy. During the procedure, the endoscopist notes resistance in the lower esophagus and significant dilation proximal to this area. What condition is most likely?
A patient is being evaluated for dysphagia and undergoes upper endoscopy. During the procedure, the endoscopist notes resistance in the lower esophagus and significant dilation proximal to this area. What condition is most likely?
A patient presents with nausea, vomiting and early saity, what is the next step to ask during the evaluation?
A patient presents with nausea, vomiting and early saity, what is the next step to ask during the evaluation?
A person has vomiting what investigation would you perform?
A person has vomiting what investigation would you perform?
A patient presenting to the clinic has a chief complaint related to altered bowel habits. Considering the lower GI, which of the following would describe their presentation?
A patient presenting to the clinic has a chief complaint related to altered bowel habits. Considering the lower GI, which of the following would describe their presentation?
A 55 year old patient reports difficult act, which of the following relates to the presentation?
A 55 year old patient reports difficult act, which of the following relates to the presentation?
You are obtaining a history on a patient complaining of Abdominal Pain. During collection of your data, what questions would you ask?
You are obtaining a history on a patient complaining of Abdominal Pain. During collection of your data, what questions would you ask?
You have a patient that reports visceral pain due to the Gut organs. What type of pain is described when reporting well localized and sharp pain??
You have a patient that reports visceral pain due to the Gut organs. What type of pain is described when reporting well localized and sharp pain??
A 40 year old patient has pain during their cycle associated with their fallopian tubes. They also report that this has been happening for some time. What is the likely cause?
A 40 year old patient has pain during their cycle associated with their fallopian tubes. They also report that this has been happening for some time. What is the likely cause?
A patient presents with postprandial fullness, belching and nausea. The clinicians suspects the patient has dyspepsia due to liver causes. Which of the following is associated with liver causes related to halitosis?
A patient presents with postprandial fullness, belching and nausea. The clinicians suspects the patient has dyspepsia due to liver causes. Which of the following is associated with liver causes related to halitosis?
A patient has noisy bowel sounds in the gut due to:
A patient has noisy bowel sounds in the gut due to:
A patient presents to you reporting a painful mouth. How is this characterised?
A patient presents to you reporting a painful mouth. How is this characterised?
A patient reports dry mouth, which causes would you investigate?
A patient reports dry mouth, which causes would you investigate?
A patient reports an increased sensation to defecate. What lower GI symptom should you start considering?
A patient reports an increased sensation to defecate. What lower GI symptom should you start considering?
A patient reports abdominal distension over several months. Which consideration should you investigate?
A patient reports abdominal distension over several months. Which consideration should you investigate?
Which finding in a patient presenting with upper GI bleeding is most indicative of a more proximal source of bleeding rather than a distal one?
Which finding in a patient presenting with upper GI bleeding is most indicative of a more proximal source of bleeding rather than a distal one?
Following an episode of hematemesis, a patient exhibits signs of shock. After initiating intravenous fluids, what is the most crucial next step in the immediate management?
Following an episode of hematemesis, a patient exhibits signs of shock. After initiating intravenous fluids, what is the most crucial next step in the immediate management?
When taking a history on someone complaining about abdominal pain, what do you ask?
When taking a history on someone complaining about abdominal pain, what do you ask?
Medical causes for abdominal pain are
Medical causes for abdominal pain are
During the evaluation of an obscure lower GI bleed. Which diagnostic evaluations will be perfomed after resuscitation and an upper endoscopy?
During the evaluation of an obscure lower GI bleed. Which diagnostic evaluations will be perfomed after resuscitation and an upper endoscopy?
Which conditions might results in constipation?
Which conditions might results in constipation?
A patient with a history of Bulimia Nervosa is reporting enamel erosion for dental reasons and also have cardiac arrhythmia. What is the most probable deficiency?
A patient with a history of Bulimia Nervosa is reporting enamel erosion for dental reasons and also have cardiac arrhythmia. What is the most probable deficiency?
A patient with a history of chronic alcohol abuse is complaining about flatulence, abdominal distension, and frequent diarrhea. These symptoms are related to?
A patient with a history of chronic alcohol abuse is complaining about flatulence, abdominal distension, and frequent diarrhea. These symptoms are related to?
An older patient has sever constipation resulting from cardiovascular disease. Also, the patient is taking Beta-blockers, diuretics, and Calcium Channel Blockers. which drug is more likely cause constipation?
An older patient has sever constipation resulting from cardiovascular disease. Also, the patient is taking Beta-blockers, diuretics, and Calcium Channel Blockers. which drug is more likely cause constipation?
A patient with cirrhosis develops sudden, painless hematemesis. What is the most critical step in this?
A patient with cirrhosis develops sudden, painless hematemesis. What is the most critical step in this?
A patient presenting a history from Crohn's disease is experiencing increased abdominal pain, diarrhea, and signs of dehydration. and CT scan is reveling localized perforation with abscess. Which one you would consider as the most important step?
A patient presenting a history from Crohn's disease is experiencing increased abdominal pain, diarrhea, and signs of dehydration. and CT scan is reveling localized perforation with abscess. Which one you would consider as the most important step?
A patient with a story of NSAID use is reporting recent onset of melena. after stabilization, Which diagnostic procedure is appropriate?
A patient with a story of NSAID use is reporting recent onset of melena. after stabilization, Which diagnostic procedure is appropriate?
A patient presents with fevers, abdominal pain, and frequent bloody diarrhea. the stool work is revealing the presence of Clostridioides difficile toxin. and one the following factors is indicationg oral vancomycin, wich one is?
A patient presents with fevers, abdominal pain, and frequent bloody diarrhea. the stool work is revealing the presence of Clostridioides difficile toxin. and one the following factors is indicationg oral vancomycin, wich one is?
A patient presenst with a history of end-stage renal disease and is complaining about nausea and vomiting. Also, hyperkalemia and metabolic acidosis are present. what could be the most likely cause?
A patient presenst with a history of end-stage renal disease and is complaining about nausea and vomiting. Also, hyperkalemia and metabolic acidosis are present. what could be the most likely cause?
A patient is presenting chronic diarrhea and abdominal cramping. the patient is also admitting to taking laxatives. What is the most likely cause?
A patient is presenting chronic diarrhea and abdominal cramping. the patient is also admitting to taking laxatives. What is the most likely cause?
A patient with achalasia is revealing increasing dysphagia, regurgitation and weight loss. Wisch is the finding for esophageal presentation?
A patient with achalasia is revealing increasing dysphagia, regurgitation and weight loss. Wisch is the finding for esophageal presentation?
A patient reporting abdominal pain in the periumbilical region. Which presentation is associated with pain?
A patient reporting abdominal pain in the periumbilical region. Which presentation is associated with pain?
A patient is experiencing Hearburn when lying down with cough and asthma. Which way the pathophysiological mechanism contributes to asthma?
A patient is experiencing Hearburn when lying down with cough and asthma. Which way the pathophysiological mechanism contributes to asthma?
What would be the most suggestive findings in patient with dyspepsia instead of an organic disease?
What would be the most suggestive findings in patient with dyspepsia instead of an organic disease?
In the evaluation of Dyspepsia what will be considered an alarm feature?
In the evaluation of Dyspepsia what will be considered an alarm feature?
A patient presents a history of smoking and alcohol use with a progressive dysphagia, which diagnose is more likely?
A patient presents a history of smoking and alcohol use with a progressive dysphagia, which diagnose is more likely?
A patient is presenting with symptoms of oropharyngeal dysphagia. What clinical future differentiates from the esophageal?
A patient is presenting with symptoms of oropharyngeal dysphagia. What clinical future differentiates from the esophageal?
A patient has intermittent dysphagia to solids, What is more likely to be the diagnosis?
A patient has intermittent dysphagia to solids, What is more likely to be the diagnosis?
A patient is diagnosed with Eosinophilic esophagitis. What is the most important aspect of the history?
A patient is diagnosed with Eosinophilic esophagitis. What is the most important aspect of the history?
You have a patient who is diagnosed with dysphagia is undergoing an upper endoscopy. what is more likely to find during the procedure?
You have a patient who is diagnosed with dysphagia is undergoing an upper endoscopy. what is more likely to find during the procedure?
After a patient tells you that they are experiencing nausea, vomiting, and early satiety what is you next step?
After a patient tells you that they are experiencing nausea, vomiting, and early satiety what is you next step?
After the evaluation of GIT complain you determined there is a possible alteration of bowel presentation (Lower GI). What do you have to consider to describe?
After the evaluation of GIT complain you determined there is a possible alteration of bowel presentation (Lower GI). What do you have to consider to describe?
A 55 year old patient has report difficult act, which is more likely to be consider during report?
A 55 year old patient has report difficult act, which is more likely to be consider during report?
When taking a history on someone complaining about abdominal pain what is an important consideration?
When taking a history on someone complaining about abdominal pain what is an important consideration?
Which type of pain reports well localized and sharp pain??
Which type of pain reports well localized and sharp pain??
A 40-year-old patient has pain during their cycle is been happening for some time and is associated with their fallopian tubes. What could the cause be?
A 40-year-old patient has pain during their cycle is been happening for some time and is associated with their fallopian tubes. What could the cause be?
A patient is in the clinic with suspected liver origin disease. Which causes is likely to be related to?
A patient is in the clinic with suspected liver origin disease. Which causes is likely to be related to?
A patient has noisy bowel sounds due to:
A patient has noisy bowel sounds due to:
A patient that you have is complaining about mouth pain, what is this characterized as?
A patient that you have is complaining about mouth pain, what is this characterized as?
If a patient is reporting Dry mouth, what causes would you like to further investigate?
If a patient is reporting Dry mouth, what causes would you like to further investigate?
If a patient increased sensation to defecate. What symptom would you consider?
If a patient increased sensation to defecate. What symptom would you consider?
During an assessment and the patient reports abdominal distension over several months. Which symptom do you need to consider?
During an assessment and the patient reports abdominal distension over several months. Which symptom do you need to consider?
Flashcards
Ptyalism
Ptyalism
Excessive secretion or flow of saliva.
Xerostomia
Xerostomia
Dry mouth due to reduced saliva production.
Halitosis
Halitosis
Bad breath with an offensive odour.
Dysphagia
Dysphagia
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Odynophagia
Odynophagia
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Globus
Globus
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Hematemesis
Hematemesis
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Melena
Melena
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Hematochezia
Hematochezia
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Dyspepsia
Dyspepsia
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Abdominal Distension
Abdominal Distension
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Borborygmi
Borborygmi
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Diarrhea
Diarrhea
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Dysentery
Dysentery
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Dyschezia
Dyschezia
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Proctodynia
Proctodynia
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Oropharyngeal dysphagia
Oropharyngeal dysphagia
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Esophageal dysphagia
Esophageal dysphagia
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Content of Vomitus
Content of Vomitus
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Vomiting definition
Vomiting definition
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Heartburn
Heartburn
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Upper GI Bleeding
Upper GI Bleeding
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Lower GI Bleeding
Lower GI Bleeding
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Obscure GI bleeding
Obscure GI bleeding
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Occult GI bleeding
Occult GI bleeding
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Visceral pain
Visceral pain
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Parietal pain
Parietal pain
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Content of Vomitus- recent
Content of Vomitus- recent
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Content of Vomitus-lower obstruction
Content of Vomitus-lower obstruction
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Anorexia nervosa (AN)
Anorexia nervosa (AN)
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Bulimia nervosa (BN)
Bulimia nervosa (BN)
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Pica
Pica
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Xerostomia Causes
Xerostomia Causes
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Upper Endoscopy
Upper Endoscopy
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Barium Evaluation
Barium Evaluation
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Inflammatory Pathologic Nature
Inflammatory Pathologic Nature
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Obstructive Pathologic Nature
Obstructive Pathologic Nature
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Ischemic Pathologic Nature
Ischemic Pathologic Nature
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Perforation's Pathologic Nature
Perforation's Pathologic Nature
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Halitosis Causes
Halitosis Causes
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Diagnostic GERD
Diagnostic GERD
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GI Causes of Vomiting
GI Causes of Vomiting
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Non-GI Causes of Vomiting
Non-GI Causes of Vomiting
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Constipation
Constipation
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Constipation Causes
Constipation Causes
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Borborygmi Causes
Borborygmi Causes
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Symptoms of Diarrhea
Symptoms of Diarrhea
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Study Notes
- General Gastroenterology Symptoms include upper GI symptoms, lower GI symptoms and those related to the GI Adenexae
Upper GI Symptoms
- Salivation disorders include Ptyalism (excessive salivation) and Xerostomia (dry mouth).
- Halitosis is the term for bad breath.
- Appetite disorders can manifest as a loss of appetite or polyphagia (excessive eating).
- Dysphagia refers to difficulty swallowing.
- Other symptoms include nausea, eructation (belching), regurgitation, and hiccough.
- Haematemesis is vomiting blood
- Dyspepsia means indigestion
- Abdominal pain may be epigastric.
Lower GI Symptoms
- Distension accompanies Borborygmi (stomach rumbling).
- Diarrhea is frequent, watery stools.
- Dysentery is an infection of the intestines that causes diarrhea containing blood and mucus.
- Tenesmus is the feeling of constantly needing to pass stool.
- Constipation is difficulty emptying the bowels
- Melena refers to black, tarry stools.
- Haematochezia occurs when there is fresh blood in the stool.
- Dyschezia is difficult defecation.
- Proctodynia refers to pain in the rectum.
Symptoms Related to GI Adenexae
- Hepatocellular decompensation
- Vascular decompensation
- Cholestasis
Disorders of Appetite: Increased Appetite
- Diabetes Mellitus (DM)
- Thyrotoxicosis
- Parasitic infestation
- Malabsorption
Disorders of Appetite: Decreased Appetite
- Emotional disturbance/anorexia nervosa (amenorrhea)
- Gastric diseases like acute/chronic gastritis, atrophic gastritis, or stomach cancer
- Metabolic issues like chronic renal failure or liver cell failure
- Chronic infection such as T.B, chronic inflammation, or malignancy
Specific Syndromes of Eating Disorders
- Anorexia nervosa (AN) involves refusing to maintain a healthy body weight due to a fear of weight gain.
- Bulimia nervosa (BN) is recurrent binge eating with compensatory behaviors like purging
- Pica is compulsively craving non-food items or foods lacking nutrition.
Ptyalism
- This condition may be caused by local reflexes.
- Oral infections such as acute necrotising ulcerative gingivitis, oral wounds, dental procedures, and new dentures can trigger Ptyalism.
- Systemic factors include nausea and acid regurgitation (reflux oesophagitis).
- Exposure to toxins like iodine and heavy metals may cause Ptyalism.
- False Ptyalism (drooling) can be psychogenic.
- Bell's palsy, Parkinson's disease, and stroke can cause drooling
Xerostomia
- It is defined as dryness of the mouth.
- It can be due to dehydration, polyuria from DM or diabetes insipidus, Sjogren syndrome, anticholinergic drugs, uremia, or mouth breathing.
Painful Mouth (Mouth Ulcers)
- Sore lips, tongue & buccal mucosa can be due to iron, folate, or vitamin B12 deficiency.
- Other causes include aphthous ulcers (recurrent painful tiny ulcers), infective stomatitis (candidiasis), inflammatory bowel disease, celiac disease, or collagen vascular diseases like SLE.
Halitosis
- This is defined as bad mouth odour.
- Bad oral hygiene or dental caries can cause Halitosis in the mouth.
- Esophageal malignancy or achalasia can cause Halitosis
- Pyloric obstruction in the stomach can cause Halitosis.
- Liver cell failure (LCF) in the liver can cause Halitosis
- Uremia, DKA, and suppurative lung disease can cause Halitosis
Dysphagia Definitions
- Dysphagia: Difficulty in swallowing
- Odynophagia: Painful swallowing
- Globus: Feeling of lump in the throat without organic cause
Types & Causes of Oropharyngeal Dysphagia
- It involves difficulty in initiating swallowing and is associated with nasal regurgitation.
- Coughing or choking often accompanies it, leading to aspiration pneumonia.
- May be linked to a history of neurological disease, such as a stroke.
- Could be associated with other neurological problems.
- Causes include bulbar palsy, pseudobulbar palsy, myasthenia gravis & myositis.
- Drugs like aminoglycosides can cause this
Types & Causes of Oesophageal Dysphagia
- Does not involve difficulty in initiating swallowing but involves food getting stuck soon after swallowing
- May be associated with reflux or dyspepsia
- Structural causes, which affect solids, include diverticulum, peptic stricture, and carcinoma, or extrinsic compression.
- Motility issues, affecting liquids/solids, include achalasia, distal oesophageal spasm, and nutcracker oesophagus.
Historical Considerations for Dysphagia
- For young male patients, eosinophilic oesophagitis should be a consideration.
- For patients >40 years, Schatzki ring is a likely cause.
- For patients >50 years, oesophageal cancer is more likely .
Questions to Ask About Dysphagia
- What type of food causes issues (liquid or solid)?
- Is the dysphagia intermittent or progressive?
- What associated symptoms are present?
- Early to solids indicates mechanical dysphagia, possibly structural.
- Early to liquids indicates motor dysphagia.
- Rapid progression, especially with weight loss, suggests malignancy.
- Oesophageal rings can cause intermittent solid-food dysphagia.
- Peptic strictures usually have a long-standing history of dysphagia.
- A history of heartburn suggests peptic stricture.
- Initiating a swallow with coughing/choking/hoarseness/nasal regurgitation suggests oropharyngeal dysphagia.
- Laryngeal symptoms with dysphagia indicate neuromuscular disorders.
- Hoarseness after dysphagia could mean involvement of the recurrent laryngeal nerve due to esophageal cancer.
Dysphagia: Investigations to Run
- Upper endoscopy is the primary initial diagnostic and therapeutic for esophageal dysphagia.
- Barium evaluation is more sensitive for subtle esophageal narrowing from mucosal rings.
- Use Barium evaluation if high suspicion for achalasia or proximal esophageal lesions.
- Esophageal biopsy examinations can occur, testing mid and distal samples.
- The diagnosis of eosinophilic esophagitis requires >/= 15 eosinophils per high-power field.
- Esophageal manometry may be indicated.
- Video swallow examination is a technique which allows video recording of the patient swallowing barium mixed solids and liquids, focusing on the pharyngeal phase
Nausea, Retching, Vomiting, & Regurgitation
- Nausea is the unpleasant sensation of being about to vomit with mouth watering.
- Vomiting is forceful expulsion of gastric contents.
- Retching is contraction of abdominal muscles without expulsion of gastric contents.
- Regurgitation is effortless appearance of contents into the mouth, and may be a symptom of gastro-oesophageal reflux or rumination syndrome.
- Vomiting is a synchronous contraction of the diaphragm, intercostal & abdominal muscles that raises intra-abdominal pressure.
- Relaxation of the lower esophageal sphincter leads to forcible expulsion of the gastric contents.
Causes of Vomiting
- GI causes: Gastroenteritis, peptic ulcer, gastric malignancy, paralytic ileus, acute pancreatitis, acute cholecystitis, acute hepatitis, or gastroparesis
- Non-GI: Acute renal failure; neurologic issues; cardiac issues like MI’s
- DKA, Ear problems, Infections
- Hypercalcaemia, hyponatremia and Hyperemesis gravidarum
- Motion sickness, psychogenic issues, bulimia nervosa
Historical Questions for Vomiting
- Assess the content of vomitus and its timing
- Assess for associated symptoms such as fever, myalgias
- Check menstrual cycle for Hyperemesis graviderium of pregnancy
Complications of Vomiting
- Electrolyte and acid-base disorders: Metabolic alkalosis , Hypokalemia, Hypochloremia and Hyponatremia
- MW tears or Esophagitis can occur
- Dehydration
Investigations for Vomiting
- Blood tests: CBC, Urea and electrolytes as well as ABG and Blood glucose
- LFTs and Amylase
- An abdominal X-ray, ECG, abdominal US, and pregnancy test can be done
- CT/MRI can be used specifically for abdominal and brain testing
- May require an upper GI endoscopy.
Treatment for Vomiting
- Treat the cause and dehydration
- Electrolyte imbalance can occur
- Use Anti-emetics such as:
- Antihistminics: cyclizine
- Dopamine antagonists: Metoclopramide, domperidone
- Serotonin antagonists: ondansetron
- Coticosteroids maybe given in severe cases.
Heartburn
- Hot burning retrosternal discomfort that radiates upwards
- Diagnostic of GERD as is Regurgitation of acid producing a sour taste in the mouth called acid reflux
- Increases when lying flat
Dyspepsia
- Defined as upper abdominal discomfort that is commonly associated with early satiety, postprandial fullness, nausea, belching, bloating, and regurgitation
- GI causes: GERD, PUD, acute gastritis, gall stones, functional dyspepsia, Hepatitic Disease and Chronic pancreatitis
- Systemic diseases: DM, renal insufficiency or adrenal insufficiency can cause this condition
- Drugs and Infections can cause it
Clinical Presentations for Dyspepsia
- Dyspeptic and Alarm symptoms should be investigated further
- Dyspeptic symptoms: Upper abdominal pain or discomfort, bloating, early satiety, postprandial fullness, nausea, belching and regurgitation
- Alarm symptoms: Weight loss, anaemia, bleeding, vomiting, dysphagia, abdominal mass and Hx of GIT Malignancy
Upper GI Bleeding
- Bleeding occurs from proximal to the ligament of Treitz, which marks the duodenojejunal junction
- Haematemesis: Vomiting of coffee ground blood
Causes of Upper GI Bleeding
- Variceal bleeding is commonly seen in Egypt and is recurrent
- Can be from Oesophageal and Fundic varices as well as Ectopic duodenal varices
- Non variceal bleeding is caused by peptic ulcers and Gastric/duodenal erosions
- Mallory Weiss tear and Oesophagitis can also cause this along with Esophgeal, gastric, duodenal tumors
Assessment & Management for Upper GI Bleeding
- Assess Haemodynamic stability while excluding non-GI sources of bleeding and any comorbidities
- Treat with fluids, medications and potentially endoscopy
Abdominal Pain - History Taking
- Enquire about onset, location and duration
- Enquire about character as it relates to associated symptoms
- Determine alleviating factors
- Identify severity
Important Questions for Abdominal Pain
- Is Intra-abdominal vs Abdominal wall pain (CAWP : Chronic abdominal wall pain syndrome)?
- If Intra- abdominal pain , is it Visceral, Parietal or Refered?
- Consider the pathologic nature → Inflammatory, Obstructive, Ischemic, Perforation?
- Determine a Most Probable Cause → Medical, Surgical or Gynaecologic?
Types of Pain
- Visceral pain occurs when the gut organs are sensitive to distension, stretch, contraction, and twisting
- Parietal Pain leads to sharp localised pain
- Referred pain may be related to the same innervation
- Psychogenic pain has no organic causes
Potential Medical Causes for Abdominal Pain
- Myocardial infarx and pneumonia
- Pulmonary infarx and aortic dissection
- Pyelonephritis, Diab ketoacidosis
- Acute porphyria
- Sickle cell crisis Tabes dorsalis
Other causes for abdominal pain
- Surgical causes involve: Perforated diverticular disease or appendix as well as acute cholecystitis with bladder perforation
- GYN causes involve: Torsion of ovary, ectopic pregnancy and uterine rupture
Lower GI Symptoms
- Distension and Borborygmi occur
- Bowel habits require examination (Diarrhoea, dysentry , constipation and tenesmus) and Stool Character
- Act Problems: Dyschezia and Proctodynia
Potential Causes for Abdominal Distension
- Fat: slow increase over months/years that is functional
- Flatus: Belching and abdominal distension as well as audible intestinal sounds
- If there is Faeces, you may want to consider subacute obstruction
- For pregnancy or tumor then test fluids
Flatulence - Symptoms and Signs
- Involves increased gas due to aerophagia with increased legume consumption
- Also related to decreased absorption gases
- Has physical signs such as Diffuse protuberance
Borborygmi - Excessively Noisy Bowel Peristalsis Is Due To
- Gut obstruction (pain, constipation, vomiting)
- Gastroenteritis (diarrhoea, nausea, pain)
- Potential allergic reaction to food poisoning
- Toxic enteritis
Diarrhea Key Facts
- An increase in the fluidity, frequency, and/or volume (weight > 250 g) of daily stool output, and decrease stool consistency
- Acute type lasts less than 2-3 weeks, longer is considered the Chronic type
- Pseudodiarrhea includes the frequent passage of small volumes of stool related to IBD
Dysentery Defined
- The inflammatory disorder of the intestine that occurs especially to the colon
- This will result in severe diarrhea that contains blood with an infection
Constipation Explained
- Bowel dysfunction in the form of decreased frequency of bowel movements and/or presence of hard stool
- Based on both symptoms and also frequency (Bowel movements are frequently 3 or less)
Potential Causes of Constipation
- Inadequate fluid or fiber intake along with Impaired colonic motility
- Suppression of defecatory urge and a drugs
- May lead to Structual disorders such as Rectal prolapse and Systemic disease
Lower GI Bleeding
- Bleeding from sites distal to (below) the ligament of Trietz
- Haematochezia leads to marron colour
Lower GI Bleeding Definitions
- Obscure bleeding is GIT bleeding that persists/ recurs without etiology
- This can be related to Colitis, Hemorrhoids, Ulcers or Diverticular disease
- Occult bleeding is presentation of positive fecal occult blood without any visual indication.
- Management requires diagnostics
Lower GI Bleeding Management
- Assess for risk and resuscitate with IV fluids
- Diagnostics can be done such as colonoscopy
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