Differentials of Gastroenterology Presenting Complaints

benryan95's version from 2016-05-12 17:47

Section 1

Question Answer
What are ALARMS symptoms in Dysphagia?unexplained Anaemia, Loss of weight (unintentional), Anorexia, Recent onset of progressive symptoms, Melaena or haematemesis, Swallowing difficulty, >55 years old
Name 3 neuromuscular disorders that can cause dysphagiaStroke, Myasthenia Gravis, Motor Neurone Disease
Name 5 obstructive disorvers that can cause dysphagiaBenign oesophageal stricture, oesophageal cancer, oesophageal web, pharyngeal web, external oesophageal compression
Name 3 oesophageal motility disorders that can cause dysphagiaAchalasia, oesphageal spasm, systemic sclerosis
Name 2 causes of dysphagia that do not fit into the other groupsGlobus pharyngeus, tonsillitis
What 4 questions about dysphagia itself should be asked? (STOP)Solids or liquids, Timing, Onset, Progression
Name 10 associated features of dysphagia that are worth asking/thinking aboutFood getting stuck, Halitosis, Lump, Gurgling, Pain, GORD/Dyspepsia, Haematemesis, Bowels, Neuro, Autoimmune, Constittional (Weight Loss)

Section 2

Question Answer
What are ALARMS symptoms in haematemesis?Anaemia, Loss of weight, Anorexia, Recent onset of progressive symptoms, Melaena, Swallowing difficulty
What 7 things are worth asking about with the haematemesis? (O CAT RIB)Onset, Character/Clarify, Amount, Timing, Retching, Indigestion, Bowels
What are 6 common causes of haematemesis?Oesophagitis, Gastric/Duodenal erosis, Bleeding peptic ulcer, Oesophageal varices, Oesophageal/gastric malignancy, Mallory-Weiss tear

Section 3

Question Answer
With regards to O'SOCRATES, what should be asked about in change in bowel habit?Open question, Specify, Onset, Character/colour, Radiation (dark, foul smelling stools), associated features, timing, exacerbating/relieving factors, severity
With regards to BOWELS, what associated factors should be asked about in change in bowel habit?Bloating, Ouch!, Weight loss, exhaustion, Lasting Urge, Swallowing/UGI symptoms
What are some extra-intestinal features that could be considered in change in bowel habit?IBD features - mouth ulcers, fever, painful red eye, joint or back pain. SPinal cord lesion - weakness in legs, difficult to gain an erection? Foreign travel?
Name 3 factors that are likely to cause constipationDiet (lack of fibre), lack of exercise and immobility, mediations (opioids, iron supplements, amitriptyline etc.)
Name 6 causes of change in bowel habitColorectal cancer, IBD, IBS, Gastroenteritis, Diverticular disease, Malabsorption (also overflow diarrhoea after costipation, diabetic autonomic neuropathy, metabolic disturbance)

Section 4

Question Answer
In bleeding from the rectum, what are 8 associated features you would want to ask about? (CATS PAWS)Change in bowel habit, Abroad, Tiredness, Swallowing/UGI symptoms, Pain/itching, Anorexia, Weight los, Systemic Features
Name 8 different causes for PR bleedingAnal fissure, Haemorrhoids, Gastroenteritis, Diverticular disease, Colorectal cancer, IBD, Angiodysplasia, UGI bleed