Gastrointestinal History and Physical Exam PDF

Gastrointestinal History and Physical Exam Gastrointestinal System History and Physical Exam Adriana Pollak-Lazzaro, D.O. Gina Miller, M.D. Frances Spiller, D.O. Conflict of Interest Disclosure Gastrointestinal History...

Gastrointestinal History and Physical Exam Gastrointestinal System History and Physical Exam Adriana Pollak-Lazzaro, D.O. Gina Miller, M.D. Frances Spiller, D.O. Conflict of Interest Disclosure Gastrointestinal History and Physical Exam In relation to this presentation, the speaker has no financial or other conflicts of interest that need to be disclosed. Objectives List and discuss the HPI history components in a patient presenting with a painful vs non‐painful gastrointestinal complaint Gastrointestinal History and Physical Exam Discuss some important associated symptoms to consider in a patient presenting with a gastrointestinal complaint List and discuss the following history taking elements of the gastrointestinal problem focused encounter: past medical & surgical history, medications & allergies, family history, and social history List and explain the performance of physical exams done in a gastrointestinal problem focused encounter (see study guide in PowerPoint) Identify and interpret normal vs abnormal findings of gastrointestinal specialty exams, including their indication and use for developing a differential diagnosis Discuss humanistic skills as they relate to a gastrointestinal problem focused encounter  FOM 7 CMR Grades 14% of your FOM 7 Block Grade will come from CMR activities Gastrointestinal History and Physical Exam The table below delineates the activities and associated points: Date CMR Activity Point Value 1/15/25 Hospital Rounds Activity SOAP Note 5 points 2/5/25 & 2/6/25 Mock Hospital Rounds 25 points 20 points Endocrine SP Encounter SOAP note 2/12/25 & 2/13/25 Clinical Competency Exam (CCE) 25 points 150 Points Total: OSCE: 50 points for each SP encounter (100 points total) 2/24/25 & 2/25/25 2 SP Encounters 50 points for graded SOAP 1 Graded SOAP Note note (only one SOAP note will be graded) Suture and Knot Tying Competency The Suture and Knot Tying Competency will take place on Gastrointestinal History and Physical Exam March 5-6, 2025 (during Conference Week) You are responsible for all the techniques that we covered in the Fall: o Holding the instruments correctly o Two-handed knot-tying o One-handed knot-tying o Instrument tie o Simple interrupted suture o Vertical mattress suture o Horizontal mattress suture o Subcuticular running suture o Subcuticular interrupted suture  Jaundice Inspection Gastrointestinal History and Physical Exam Differential Diagnosis of Abdominal Pain (by location) Gastrointestinal History and Physical Exam Physical Examination Inspection Contour Gastrointestinal History and Physical Exam  Flat  Rounded  Scaphoid  Protuberant (Obesity, etc.)  Gravid (Pregnant) Distention Asymmetry (visible on inspection)  Masses  Hernias  Enlarged organ Skin Abnormalities  Rashes/Lesions  Scars  Striae  Bruising  Erythema  Jaundice Dilated Veins (caput medusae) Visible Pulsations Physical Examination Inspection Gastrointestinal History and Physical Exam Sample documentation (expected): Non- distended, no scars or rashes noted. Sample documentation (abnormal): Distended with periumbilical bruising noted.  Inspection Physical Examination Gastrointestinal History and Physical Exam Physical Examination Auscultation Auscultate in all 4 quadrants on skin to assess bowel motility Gastrointestinal History and Physical Exam Types of bowel sounds:  Normoactive-high pitched gurgling sounds (approx. 5-34 sounds/minute)  Hyperactive-loud, gurgling, frequent bowel sounds (increased, > 34 sounds/minute)  Hypoactive-soft infrequent bowel sounds (decreased,