Gall stones
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This document discusses gall stones, listing various risk factors such as age, sex, pregnancy, oral contraceptives, family history, obesity, rapid weight loss, diabetes, and certain medical conditions. It describes the typical clinical presentation of gall stones as severe pain in the upper right abdomen that may refer to the right shoulder or back, accompanied by nausea and vomiting. Diagnosis involves ultrasound, MRCP, and blood tests checking CBC, CRP, bilirubin, and liver enzymes. Frequently asked questions concern whether there is inflammation, the type and size of stones, evaluating the bile ducts, and complications like pancreatitis.
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1. Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain or discomfort and altered bowel habits without detectable structural abnormalities.
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Autoimmune factors
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Mr. S has been diagnosed with Crohn's disease based on his symptoms of diarrhea, fever, abdominal pain, weight loss, food intolerance, and anemia. He has undergone partial resection of his bowel and is recovering. Due to his unintended 15.7% weight loss and malnutrition, he requires increased calorie, protein, and fluid intake to aid his recovery. A low fiber diet is recommended initially to reduce abdominal pain. Close monitoring of his food intake and symptoms through a food diary will help evaluate his nutritional status and identify any foods that may trigger symptoms as he gradually resumes normal eating.
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Sarah is a 45-year-old female who presents with abdominal pain localized to her epigastric and right upper quadrant that worsened after eating. She has a history of similar pain episodes and comorbidities of diabetes and hypercholesterolemia. On examination, she has tenderness in her epigastric and right upper quadrants with a positive Murphy's sign. Imaging reveals findings consistent with acute cholecystitis. She is started on antibiotics and supportive care and recommended for a laparoscopic cholecystectomy to treat her acute cholecystitis.
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2) A thorough history and physical exam is important to determine if the cause is intrahepatic or extrahepatic. Clues to each are provided.
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This document outlines the approach to obstructive jaundice, including causes, examination, investigations, and management. It discusses evaluating a patient's history and symptoms to determine if jaundice is present and if it is obstructive or hemolytic in nature. Potential causes of obstructive jaundice are categorized as intraluminal, mural, extra luminal, malignant, or benign. Key physical exam findings and investigations like blood tests, imaging, and biopsies are described to confirm the diagnosis, identify the cause, stage the disease, and assess the patient's status. The document concludes with discussing preoperative management and the goals of surgical intervention to cure the disease, relieve symptoms, and improve quality of life.
Abdominal Examination
This document provides an overview of abdominal examination techniques and findings. It discusses approaching gastrointestinal symptoms, performing a general physical exam, and specifically examining the abdomen through inspection, auscultation, percussion, and palpation. Key areas of the abdomen that can be examined include the liver, spleen, kidneys, gallbladder, and pancreas. Specific examination findings are outlined that may indicate various gastrointestinal conditions. The importance of thorough abdominal exams to evaluate symptoms and guide diagnosis is emphasized.
Approach to a patient with dyspepsia
This document discusses the approach to a patient presenting with dyspepsia. It defines dyspepsia and outlines its common causes such as food intolerances, gastrointestinal disorders, drugs, and systemic diseases. The importance of taking a thorough history is emphasized to determine underlying conditions like peptic ulcer disease, GERD, hepatobiliary disease, or irritable bowel syndrome. Physical exam and initial tests can rule out alarming causes. Treatment involves lifestyle changes, antacids, anti-secretory drugs, H. pylori eradication for ulcers, and prokinetics or antidepressants for functional dyspepsia. Endoscopy is recommended for older patients or those with alarming symptoms.
Hepato&spleenomegaly
- Places fingers over the lower ribs on the left side
- Asks patient to take a deep breath
You:
- Percuss over the assistant's fingers
- Dullness indicates splenic enlargement crossing
the midline
Positive Nixon's sign suggests splenomegaly.
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hypertension guidelines.pptx management in ;peadiatrics
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Gall stones
- 2. Risk factors • Age • Sex • Pregnancy • Oral contraceptives and estrogen replacement therapy • Family history and genetics • Obesity • Rapid weight loss • Diabetes mellitus • Serum lipids • Serum bilirubin • Cirrhosis • Gallbladder stasis • Other drugs • Decreased physical activity • Crohn's disease • Hemolysis
- 3. Clinical presentation • Typical – Severe pain, Intermittent and recurrent upper abd mainly rt hypochondrium, refered to Rt shoulder and/or back – Nausea, vomiting, fever • Atypical – NCCP, epigastric pain, reflux and Heart burn • Murphy’s sign on clinical examination
- 4. Diagnosis • Ultrasound • MRCP • Lab – CBC – CRP – Bilirubin, ALT,AST
- 9. FAQ • Inflammation or no Inflammation (silent stones)? • Type of stones or number and size? • CBD stones, MRCP or ERCP? • GS pancreatitis • Non calcular cholecystitis • GB polyps • GB dyskinesia
- 10. GS ilieus