Gastritis physical examination: Difference between revisions

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{{Gastritis}}
{{Gastritis}}
{{CMG}} {{AE}}
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==Overview==
==Overview==
Patients with Gastritis usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Patients with gastritis may appear pale. Some patients may appear [[Fatigue|fatigued]] and in distress if associated with [[abdominal pain]]. Vital signs generally appear to be normal. When associated with [[gastrointestinal bleed]], vital signs include [[Tachycardia|tachycardia]]. [[Pallor]] may observed in patients presenting with [[melena]] and [[hematemesis]]. On examination of the [[eyes]], [[conjunctival]] [[pallor]] may be observed. [[Halitosis]] may be observed in case of chronic gastritis. Chest tenderness may be present on palpation in case of ''[[Helicobacter pylori]]'' infection associated gastritis. Epigastric [[tenderness]] may be present. Gastritis associated with [[Gastric ulcer|gastric ulcers]] may result in [[blood loss]] and the [[stool test]] may be guaiac-positive.


OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of Gastritis.
OR
The presence of [finding(s)] on physical examination is highly suggestive of Gastritis.
==Physical Examination==
==Physical Examination==


*Physical examination of patients with Gastritis is usually remarkable for:[finding 1], [finding 2], and [finding 3].
Physical examination of patients with Gastritis may include:
*The presence of [finding(s)] on physical examination is diagnostic of Gastritis.
*The presence of [finding(s)] on physical examination is highly suggestive of Gastritis.


===Appearance of the Patient===
===Appearance of the Patient===
*Patients with Gastritis usually appear pale.
*Patients with gastritis may appear pale. Some patients may appear [[Fatigue|fatigued]] and in distress, is associated with [[abdominal pain]].


===Vital Signs===
===Vital Signs===
*[[Tachycardia]]
*Vital signs are usually normal.
*[[Dyspnea]]
*When associated with [[gastrointestinal bleed]], vital signs include:
:*[[Tachycardia]]


===Skin===
===Skin===
*[[Cyanosis]]  
*[[Pallor]] may observed in patients presenting with [[melena]] and [[hematemesis]].
*[[Jaundice]]
* [[Pallor]]
* Bruises
 
<gallery widths=150px>
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
* Abnormalities of the head/hair may include ___
*On examination of the [[eyes]], [[conjunctival]] [[pallor]] may be observed.
* Evidence of trauma
* Icteric sclera
* [[Nystagmus]]  
* Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accomodation / non-reactive to neither light nor accomodation
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae / tragus (anterior to ear canal)
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
* Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
 
===Neck===
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Asymmetric chest expansion / Decreased chest expansion
*[[Breath sounds|Normal vesicular breath sounds]] are observed.
*Lungs are hypo/hyperresonant
*[[Halitosis]] may be observed in case of chronic gastritis.
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds / Distant breath sounds
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
*Chest tenderness upon palpation
*Chest tenderness may be present on palpation in case of ''[[Helicobacter pylori]]'' infection associated gastritis
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*S1 and S2 are normal
*[[Heave]] / [[thrill]]
*[[Friction rub]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope


===Abdomen===
===Abdomen===
*[[Abdominal distention]]
*Epigastric [[tenderness]] may be present.
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*Gastritis associated with [[Gastric ulcer|gastric ulcers]] may result in [[blood loss]] and the [[stool test]] may be guaiac-positive.
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
​​​
*Point tenderness over __ vertebrae (e.g. L3-L4)
{{WH}}
*Sacral edema
{{WS}}
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump
 
===Genitourinary===
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge
 
===Neuromuscular===
*Patient is usually oriented to persons, place, and time
* Altered mental status
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)
 
===Extremities===
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity


[[Category:Medicine]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
 
[[Category:Up-To-Date]]
{{WH}}
{{WS}}

Latest revision as of 21:49, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Overview

Patients with gastritis may appear pale. Some patients may appear fatigued and in distress if associated with abdominal pain. Vital signs generally appear to be normal. When associated with gastrointestinal bleed, vital signs include tachycardia. Pallor may observed in patients presenting with melena and hematemesis. On examination of the eyes, conjunctival pallor may be observed. Halitosis may be observed in case of chronic gastritis. Chest tenderness may be present on palpation in case of Helicobacter pylori infection associated gastritis. Epigastric tenderness may be present. Gastritis associated with gastric ulcers may result in blood loss and the stool test may be guaiac-positive.

Physical Examination

Physical examination of patients with Gastritis may include:

Appearance of the Patient

  • Patients with gastritis may appear pale. Some patients may appear fatigued and in distress, is associated with abdominal pain.

Vital Signs

Skin

HEENT

Lungs

Heart

  • Chest tenderness may be present on palpation in case of Helicobacter pylori infection associated gastritis
  • S1 and S2 are normal

Abdomen

​​​ Template:WH Template:WS

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