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21 Cards in this Set
- Front
- Back
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Symptoms of constipation |
-straining -excessive hard stools -unproductive urges -infrequency -feeling of incomplete evacuation |
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Name 5 obstructing lesions |
-colon CA -stricture -diverticular disease -inflammatory bowel disease -foreign body |
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When do you look for obstructing lesions? |
With recent onset constipation |
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What is one thing that rules out mechanical obstruction? What does this suggest? |
Hard stool in the vault and it suggests impaired emptying of the rectal vault |
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What is the most common cause for a change in stool caliber |
tight sphincter rather than "apple core" lesion |
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What clinical findings in regard to lifestyle contribute to constipation? |
-lack of exercise -low intake of fluids -low intake of dietary fiber |
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Dark pigmentation of the colonic mucosa on anoscopy suggest what? |
surreptitious laxative abuse with anthraquinone laxatives such as caster oil or senna |
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What is an anascopy? |
Examination using a small, rigid, tubular instrument called an anascope or anal speculum to evaluate problems in the anal canal |
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What drugs or types of drugs are associated with constipation? |
-chronically used laxatives -opiates -iron -Ca+ or aluminum containing antacids -Ca+ channel blockers -anticholinergic medications such as tricyclic antidepressants |
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Constipation is a common presenting somatic manifestation associated with... |
altered mood and cognition, and other "vegetative" signs |
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Clinical findings of irritable bowel syndrome |
-longstanding hx of abd cramps followed by bowel movements, bloating, flatulence, and constipation beginning in young age -excessive nonpropulsive contractions produce small, hard "rabbit pellet" stools -symptoms increase with psychological stress |
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Clinical findings of pelvic floor dysfunction When should you suspect this? |
-vaginal or perineal pressure needed to assist in evacuation -suspect when there is prolonged or excessive straining before elimination |
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Clinical findings of hypothyroidism |
-Constipation is seldom the main symptom -fatigue, wt. gain, cold intolerance -enlarged thyroid -course hair -loss of lateral eyebrows -delayed relaxation of ankle reflexes |
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When do you suspect hypokalemia |
-suspect in pt taking diuretics or chronically using laxatives |
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Clinical findings of colon CA |
->50 years -May have family hx -Recent onset of constipation, a change in stool caliber, or rectal bleeding (including occult blood) |
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Clinical findings of anorectal pathology |
-inflammed or thrombosed hemorrhoids -fissures -strictures -proctitis |
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Clinical findings of megacolon |
-abdominal distention with empty rectal vault -psychogenic form associated with encopresis (soiling at night) -atonic, hugely dialated colon |
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Clinical findings of mechanical obstruction |
-lack of passage of stool or air -vomiting (esp. w/ small bowel obstruction) -visible peristalsis with loug borborygmi, progressive abdominal distention and severe, colicky abd pain |
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Clinical findings of spinal cord pathology |
-constipation is caused by colonic dilation -associated w/ multiple sclerosis, tabes dorsalis, or spinal cord tumors -may be suggested by decreased anal sensation with an absent anal reflex or a flaccid anal sphincter |
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Clinical findings of hypercalcemia |
-serum Ca+ >12 usually -CNS effects present |
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Clinical findings of scleroderma |
-constipation is associated with dysphagia and tight, shiny skin |
