606 BIOMEDICINE ,ĂŶĚŬŽĨKƌŝĞŶƚĂůDĞĚŝĐŝŶĞ;ϰƚŚĚŝƚŝŽŶͿ

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%2:(/ &+$1*(6 PRESENTATION POSSIBLE PATHOLOGY MELENA (BLACK, TARRY) Upper GI bleed (loss of > 150-200 mL of blood) BLACK, NONͲSTICKY Iron, bismuth salts (Pepto-Bismol), black licorice BLOODͲRED Colon-rectal tumor, colon diverticulitis, hemorrhoids PALE ↓Fat absorption from small bowel, pancreatic disease SILVERY Pancreatic cancer PENCILͲTHIN, RIBBON STOOLS Distal colon/anal cancer

%2:(/ 3$7+2/2*< INFLAMMATORY BOWEL (Crohn's or Ulcerative Colitis) IRRITABLE BOWEL COLON/RECTAL CANCER z Joint arthralgia z Effects females in early adulthood z Hemorrhoids z Skin lesions (ankles, shins) z Stress related z Rectal bleeding z Light sensitivity z Variable/intermittent S&S z Back pain referred to LEs z ↓Pain with gas/BM (Bowel Movement) z Abdominal cramps z Change in bowel patterns z Anemia due to blood loss z & z Nausea & vomiting z Wt loss z z Weight loss z Clubbing of fingers z Change in bowel patterns z Fatigue & dyspnea due to iron def. z Fever z Foul breath z Red/mahogany stools z Rectal bleeding z (+) Psoas test

$33(1',&,7,6 SIGNS & SYMPTOMS DIFFERENTIAL DIAGNOSIS z G LQ pain, (+) McBurney's point z ↓Hemoglobin z pain into G thigh/testicle z ↓Hematocrit z Nausea, vomiting, night sweats z Change in fingernail beds z Guarding of rectus abdominis z Pale skin color z (+) Psoas sign z Fatigue z (+) z ↓DBP z Low-grade fever z (+) Rebound tenderness z Position of relief: tense with FB or lie down with both knees to chest

8/&(56 z Hx of NSAID use of presence of H. pylori infection z Dull gnawing/burning into midline T6-12 & radiating suprascapula z Antacids provide temporary relief z Nausea, coffee-grounds vomitus z Bloody or black-tarry stools (melena) z May have weeks of remission GASTRIC DUODENAL 30-60 min after a meal Epigastric cramping 2-3 hrs after a meal G UQ Localized tenderness G of midline

+(3$7,7,6 GENERALIZED SIGNS & SYMPTOMS z Nausea z -skin & eyes z Vomiting z pain z Low-grade fever/chills z Dark urine z Loss of appetite z Light-colored stools z Lethargy TYPE INCUBATION TRANSMISSION CAUSE A 15-50 days Fecal-oral (does not develop into chronic hepatitis) Contaminated milk, water, shellfish, unsanitary conditions Blood or body fluids infants = carriers (can 50-180 days Contaminated needles, transfusion B become chronic) C 20-90 days Blood or body fluids (can become chronic) Transfusion D 25-75 days Blood or body fluids Occurs in presence of Hep B, IV drug use E 15-60 days Fecal-oral Contaminated milk, water, shellfish G Unknown Blood or body fluids Transfusion, IV drug use

Digestive System ;ĐͿ,<ŝŵ͕ĐƵƉƵŶĐƚƵƌĞDĞĚŝĂ͘ĐŽŵ