GI Red Flags, part 1 -Answer Orthostatic hypotension
• Weight loss
• Iron deficiency anemia
• New onset pain
• Age over 50
• Early satiety
• Palpable mass
• Fever
Murphy's sign -Answer pain with palpation of the RUQ during inspiration, indicative of
cholecystitis
Dunphy's sign -Answer increased abdominal pain with coughing
Markle's sign -Answer (heel jar): pt raises up on tip toes and lets self down allowing
heels to hit floor, jarring the body- this sign is positive if abdominal pain occurs-
associated with peritoneal irritation & appendicitis
Cullen sign -Answer bruising around umbilicus (pancreatitis or ectopic pregnancy)
Grey Turner's sign -Answer discoloration over the flanks suggesting intra-abdominal
bleeding.
Obturator sign -Answer RLQ on internal rotation of right thigh indicative of appendicitis
Psoas sign -Answer RLQ pain with extension of right thigh indicative of appendicitis
rebound tenderness -Answer a sign of inflammation of the peritoneum in which
increased pain is elicited by the sudden release of the fingertips pressing on the
abdomen.
McBurney's point -Answer A point on the right side of the abdomen, about two-thirds of
the distance between the umbilicus and the anterior bony prominence of the hip
GI Red Flags, Part II -Answer Change in bowel habits
, • Fecal incontinence
• Melena/coffee ground emesis
• Guaiac positive stools
• Dysphagia
• Odynophagia
• Long-term NSAID use
• Persistent hoarseness
GI Red Flags, Part III -Answer Chest pain
• Smoker of history of smoking
• History of heavy ETOH use
• Failure to improve with treatment
• Pain out of proportion to exam
• Abdominal distention
• Increase LFT/jaundice
• Abnormal physical exam
Categories of GI Dysfunction -Answer Disorders of motility
• Infection
• Malabsorption syndromes
• Impairment of digestion, absorption, and
nutrition
Congenital malformations and genetic
syndromes
• Metabolic disorders
• Behavioral problems
• Injuries and trauma
• Food intolerances
History -Answer Family history of GI disease
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