ABDOMINAL
PAIN/GASTROINTESTINAL




VOMIT,
DIARHEA,OR
ANY
OTHER
DISCHARGE

(COLOR,
AMOUNT,BLOOD,
CONSISTENCY,ODOR,DISCHARGE
(CABCOD)



ASSOCIATED
SYMPTOMS/ROS:HPI,RAMPPS,DESCRIPTION,
SUDDEN
OR
GRADUAL,BLOATING,CHANGES

IN
BOWEL,
COLOR
OF
STOOL,
BLOOD
IN
STOOL,CHANGES
IN
URINE,
COLOR
OF
URINE,BLOOD
IN
URINE,

RASH,FIBER
DIET,
FLUIDS,JAUNDICE,(YELLOW
DISCOORATION)
RECENT
USE
OF
ANTIBIOTICS
OTHER

PAIN,
RE:
TO
FOOD,TYPES
OF
FOOD
THAT
MAKE
IT
WORSE,
BEFORE
OR
AFTER
YOU
EAT,
RELATIONSHIP

TO
CAFFEINE,HX
OF
COLONOSCOPY,BLOOD
TRANSFUSIONS,
HEADACHE,
DIZZYNESS,FEVER,

NIGHTSWEATS,
CHILLS,FATIGUE,CHEST
PAIN,
PALPITATIONS,WEIGHT,
APPETITE,JOINT
PAIN,
BACK

PAIN,TRAVEL
IMMUNIZATIONS,
ALCOHOLE
USE,
(VAGINAL
BLEEDING
,VAGINAL
OR
PENILE
DISCHARGE,

INQUIRE
ABOUT
ABNORMAL
OBGYN
WITH
FEMALES
WITH
ABD
PAIN
AND
STDS.)

PMH:DM,PANCREATITIS,ETOH,AB
SURGERY,HIV

FH:COLON
CANCER



AB
PAIN
RIGHT
SIDE

DD:
PARN
 
 
 
 WORK
UP
 
 
 
 PE:INSPECT
PALPATE

PYELONEPHRITIS
 
 
 RECTAL
EXAM
 
 
 
 HEENT:INS;PAL,MCBUR

APPENDICITIS
 
 
 
 UA/URINE
CUL/BUN/CR

 
 ABD:INSP/AUS/PAL/PER

RENAL
CELL
CARCINOMA
 
 CT
ABD/US
RENAL
 
 
 GUARDIN,REBOUND

NEPHROLITHIASIS
 
 
 
 
 
 
 














CVA,ROVINGS,MURPHY


 
 
 
 
 
 
 
 
 














PSOAS,
OBTURATOR


 
 
 
 
 
 
 
 
 
 CV/PUL:AUS


 
 
 
 
 
 
 
 
 
 EXT:EDEMA/RASH



JAUNDICE

DD:
V
CCAAPP
 
 
 
 WORK
UP

VIRAL
HEPATITIS
 
 
 AST/ALT/T.BILIRUBIN
 
 

CHOLEDOCHOLITHIASIS

 
 CBC/PT/PTT

CHOLANGIOCARCINOMA
 
 US/CT
ABD

ALCOHOLIC
HEPATITIS
 
 
 VIRAL
HEP
SEROLOGY

ACETOMINOPHEN
LIVER
TOX

PRIMARY
BILARY
CIRRHOSIS

PANCREATIC
CANCER



ABD
PAIN
RUQ

DD:
PPHAAGS
 
 
 
 WORK
UP

PANCREATITIS
 
 
 
 RECTAL/PELVIC
 
 
 

PUD
 
 
 
 
 CBC/UA/AST/ALT/BILIRUBIN/AMYLASE/LIPASE

HEPATITIS
 
 
 
 US/ABD,
HIDA
SCAN

ACUTE
CHOLECYSTITIS

ACUTE
CHOLANGITIS

GASTRITIS

SCLEROSING
CHOLANGITIS









ABD
PAIN
RLQ
FEMALE

DD:
NO
RAPE
 
 
 
 WORK
UP

NEPHROLITHIASIS
 
 
 CBC/UA/URINE/CERVICAL
CULTURE

OVARIAN
TORSION
 
 
 PELVIC
EXAM/PELVIC
US

RUPTURED
OVARIAN
CYST
 
 URINE
HCG

APPENDICITIS
 
 
 
 RECTAL
EXAM

PID
 
 
 
 
 CT
ABD/US
ABD/AXR

ECTOPIC
PREGNANCY





ABD
PAIN
RLQ
M/F

DD:
C
DANG
 
 
 
 WORK
UP

CROHNS
DS
 
 
 
 RECTAL/CBC

DIVERTICULITIS

 
 
 US
ABD/CT
ABD/AXR

ACUTE
APPENDICITIS
 
 
 ELECTROLYTES

NEPHROLITHIASIS

GASTROENTERITIS





ABD
PAIN
LUQ

DD:
KIDNEY
RAPPSS
 
 
 WORK
UP

KIDNEY
STONE
 
 
 
 RECTAL

RIB
FRACTURE
 
 
 
 CBC/ELECTROLYTES

ANGINA
 
 
 
 CHEST
XRAY

PNEUMONIA
 
 
 
 CT/US
ABD

PERFORATED
PEPTIC
ULCER

SPLENIC
RUPTURE

SPLENIC
INFARCT



ABD
PAIN
LLQ

DD:
A
GASTRO
DUCC
 
 
 WORK
UP

ABSCESS
 
 
 
 SAME
AS
LUQ

GASTROENTERITIS

DIVERTICULOSIS

ULCERATIVE
COLITIS

CELIAC
SPRUE

CROHNS
DISEASE





ABD
PAIN
UMBILICAL

DD:
I
CCC
EG
 
 
 
 WORK
UP

IBS
 
 
 
 
 RECTAL/PELVIC

CROHNS
DS
 
 
 
 URINE
HCG/CBC/ELECTROLYTES

CELIAC
DS
 
 
 
 CT
ABD/PELVIS

CHRONIC
PANCREATITIS
 
 STOOL
FOR
OVA
AND
PARASITES

ENDOMETRIOSIS

GI
PARASITIC
INFECTION

ADB
PAIN
EPIGASTRIC

DD:
CC
GAP
MMAP
 
 
 WORK
UP

CHRONIC
PANCREATITIS
 
 RECTALEXAM

CHOLECYTITIS
 
 
 
 CBC/
AMYLASE
/LIPASE

GERD,GASTRITIS
 
 
 AST/ALT/T.
BILIRUBIN/BUN/CR

ACUTE
PANCREATITIS,

 
 
 UPPER
ENDOSCOPY/CT/US
ABD

PEPTIC
ULCER
DS.
 
 
 ECG/ELECTROLYTES

MALLORY
WEISS
TEAR

MESENTRIC
ISCHEMIA

AAA

PANCREATIC
CANCER



ABD
PAIN
GENERAL/CRAMP

DD:
MD
MAGIC

 
 
 WORK
UP

MESENTRIC
ISCHEMIA
 
 
 RECTAL/CBC/ELECTOLYTES

DIVERTICULITIS

 
 
 CHEST
XRAY/ABD
XRAY/CT
ABD

MI
 
 
 
 
 ECG/CPK‐MB

ACUTE
PANCREATITIS
 
 
 BARIUM
ENEMA

GASTROENTERITIS
 
 
 AMYLASE/LIPASE/LACTATE

ILEUS

CHOLECYTITIS



(NASEUA
&VOMIT):
ABD
ASSOCIATED
AND
THESE
QUESTIONS,
PLEASE
DESCRIBE
THE
VOMIT,
HOW

MANY
TIMES,COLOR
OF
VOMIT,
BLOOD
IN
VOMIT,COLOR
OF
BLOOD,
CABCOD,HEARTBURN,
COUGH,

RELATION
TO
LIQUIDS
OR
CAFFEINE,
DIZZYNESS,AB
PAIN,PREG,
FOOD
POISENING,
RECENT
EAT
NEW

FOODS
OR
AT
A
RESTAURANT,STIFF
NECK,
VERTIGO,
NUMB
OR
WEAKNESS,HEADACHE,
D,C,FATIGUE,

CHEST
PAIN
SOB,WITH
OR
WITHOUT
FOOD)


PMH:
PUD,
REFLUX
DS,LIVER
DS



VOMIT
W/WO
BLOOD

DD:
HUGED
PEGGE
 
 
 WORK
UP
 
 
 
 PE:
SEE
ABD

HYPERCALCEMIA
 
 
 CBC
W/DIFF,ELECTRO
 
 
 W/N,V
MUST

UTI
 
 
 
 
 UPPER
GI
ENDOSCOPY
 
 
 CHECK
THROAT,

GASTRIC
ULCER

 
 
 PT/INR
 
 
 
 
 MOUTH,NOSE

EROSIVE
ESOPHAGITIS
 
 
 BUN/CR

DUODENAL
ULCER
 
 
 LIVER
FUNC
TEST

PUD
 
 
 
 
 AST/ALT
TOTAL
AND
DIRECT
BILIRUBIN

ESOPHOGITIS

GASTRITIS

GI
MALIGNANCY

ESOPHAGEAL
VARICES













(DIARRHEA&CONSTIPATION)
SEE
ABD
ASSOCIATED
SYMPTOMS
ALSO
HPI
AND
RAMPPS,AND
ASK
THE

FOLLOWING
QUESTIONS,
VOLUME,CHANGE
OF
BOWEL
HABITS,DARK
STOOLS,
BLOATING,
TIMES
PER

DAY,
COLOR
OF
STOOL,CONSTIPATED,
BLOOD
IN
STOOL,DECREASED
SENSE
OF
EVACUATION,
N,V,

WEIGHT
APPETITE,
URINARY
PROBLEMS
OR
CHANGES,PAIN
WITH
DEFECATION,




CONSTIPATION
&DIARRHEA

DD:
COCIID
 
 
 
 WORK
UP
 
 
 
 PE:INSPECT/PALPATE

CHRONIC
PANCREATITIS
 
 RECTAL

 
 
 
 HEENT/THYROID

COLORECTAL
CANCER
 
 
 CBC/AST/ALT/T.BILIRUBIN
 
 ABD
FULLEXAM

CELIAC
DS.
 
 
 
 BARIUM
ENEMA
 
 
 EXT/CV/PUL

IBD
 
 
 
 
 CT
ABD/COLONOSCOPY

IBS
 
 
 
 
 CT
PELVIS/AXR

DIVERTICULOSIS
 
 
 



CONSTIPATION

DD:
SHILD
 
 
 
 WORK
UP

SUBSTANCE
ABUSE


 
 
 RECTAL

HYPOTHYROID
 
 
 
 TSH

IBS
 
 
 
 
 URINE
TOX

LOW
FIBER
DIET
 
 
 ELECTROLYTES

DEPRESSION



DIARRHEA

DD:
CHILLI
 
 
 
 WORK
UP

CELIAC
SPRUE
 
 
 
 RECTAL/
CBC

WHIPPLES
DS
 
 
 
 ELECTROLYTES
 

IBS
 
 
 
 
 STOOL

EXAM
 
 
 

LACTOSE
INTOLERANCE

 
 TSH/AST/ALT

LAXATIVE
ABUSE
 
 
 CT
ABD/AXR/COLONOSCOPY

INFECTIOUS
DIARRHEA



DIARRHEA

DD:
HII
TIPP
 
 
 
 WORKUP

HYPERTHYROID‐
 
 
 TSH

INFECTIOUS
DIARRHEA‐

 
 STOOL
FOR
OVA
AND
PARASITES

IBD‐
 
 
 
 
 COLONOSCOPY

TRAVELERS
DIARRHEA‐



 
 ELECTROLYTES

IBS‐
 
 
 
 
 RECTAL

PSEUDOMEMBRANEOUS
 
 STOOL
CULTURE
AND
BLOOD
AND
WBC



COLITIS

POISENING
FOOD















DARK
STOOL

DD:
EGGS
PT

ESOPHAGEAL
VARICES

GASTRIC
EROSION

GASTRITIS

STOMACH
CANCER

PUD

THROMBOCYTOPENIA



LOGHT
STOOL

DD:HEPATITIS
ABC
CC
GGS

HEPATITIS
AB
OR
C

CHOLECYSTITIS

CHOLANGITIS

GIARDIA

GALLSTONES

STEATORRHEA





BLOOD
PER
RECTUM
OR
STOOL
SEE
ABD
ASSOCIATED
SYMPTOMS
ALSO
HPI
AND
RAMPPS,BLOOD

BEFORE
DURING
OR
AFTER
DEFECATION,
URGENCY,
SPASM
OF
RECTUM,
MUCOUS
IN
STOOL,FEVER,

CHILLS,
ABD
PAIN,
JOINT
PAIN,
DIET,
FIBER,
FLUID,
CONTACTS,
TRAVEL,
CAMPING,
HIV,
ABD
SURG,
DM,

PANCREATITIS,
ETOH
USE,
DRUG
USE,
COLON
CA,
EASY
BRUISING
OR
BLEEDING,
PRIOR
COLONOSCOPY,

TRAUMA,MEDICATION
SUCH
AS
BLOOD
THINNERS
WARAFAN,ETC,
ETC,
ETC.







BLOOD
PER
RECTUM

DD:
I
HID
UP
AN
 
 
 WORK
UP

ISCHEMIC
BOWEL
 
 
 RECTAL/CBC/
COLONOSCOPY

HEMORHOIDS
 
 
 
 PT/PTT/ELECTROLYTES

INFECTIOUS
DIARRHEA
 
 
 CT
ABDOM/PELVIS/AXR

DIVERTICULAR
BLEED
 
 
 BARIUM
ENEMA

ULCERATIVE
COLITIS

PROCTITIS

ANA
FISSURE

NEOPLASM



OLDER
PERSON
BLOOD
PER
RECTUM

DD:
DAM
IT

DIVERTICULITIS

ANGIODYSPLASIA

MALIGNANT
POLYP

IBD

ISCHEMIC
COLITIS







DYSPHAGIA

ASSOCIATED
SYPTOMS:
SEE
ALSO
ASSOCIATED
SYMPTOMS
FOR
ABD
PAIN
FOR
A
COMPLETE
LIST:

HPI,RAMPPS,DESCRIPTION,
LIQUIDS
OR
SOLIDS,
WHAT
WAS
DIFFICULT
TO
SWALLOW
AT
FIRST
LIQUIDS

OR
SOLIDS,
PROGRESSION,DURATION,
WEIGHT
LOSS,
DROOLING
REGURGITATION,
HEARTBURN,
PAIN

ON
SWALLOWING,
SORE
THROAT,
SOUR
TASTE,
DRY
COUGH,
HOARSENESS,
CHEST
PAIN,
HIV
RISK,

SMOKING,
NUMBNESS,
WEAKNESS,
TINGLING,
SENSATION
CHANGES,
N,V,D,C,
ABD
PAIN,
PAIN
IN

JOINTS,
FATIGUE,
CHILLS,
FEVER,
FOOD
CRAVINGS,
MEDICATIONS.
HOT
COLD
INTOLERANCE,

PALIPITATIONS,
INSOMNIA.



DYSPHAGIA

DD:
SEE
GAME
 
 
 
 WORK
UP
 
 
 PE:
INSPECT/PALPATE

SYSTEMIC
SCLEROSIS
 
 
 CBC/IRON/TIBC

 
 HEENT/MOUTH/THROAT

ESOPHAGEAL
CANCER
 
 
 CXR
 
 
 
 CV/PUL/ABD/SKIN

ESOPHAGITIS
 
 
 
 BARIUM
SWALLOW

GERD
 
 
 
 
 ENDOSCOPY

ACHALASIA
 
 
 
 HIV
ANTIBODY

MV
STENOSIS

ESOPHAGEAL
STRICTURE