At the completion of this chapter, the learner will be able to:

1.0 Describe the key elements in completing a gastrointestinal history.

1.1. Identify common gastrointestinal symptoms by:
      a. Defining the presenting symptom
      b. Describing the symptom
      c. Identifying important historical features
      d. Identifying related symptoms
      e. Determining differences in presenting symptoms
       f. Describing the cause and mechanism for each symptom
 
2.0 Describe appropriate examination techniques for the abdomen, including:
      a. Inspection
      b. Auscultation
      c. Palpation
      d. Percussion
 
3.0 Correctly examine and identify:
      a. Bowel sounds
      b. Ascites
      c. Liver
      d. Spleen
      e. Abdominal mass
 
LEARNER WORKBOOK

EXERCISE 1
1.0 Match each of the following symptoms with the correct definition:

	Symptom		Definition
1.	Waterbrash	___	a.  Vomited blood
2.	Dysphagia	___	b.  Belching
3.	Ascites	___	c.  Lump in throat
4.	Globus	___	d.  Burning sensation behind the sternum
5.	Hindgut pain	___	e.  The flux
6.	Proctalgia fugax	___	f.   Pain in the epigastric area
7.	Aerophagia	___	g.  Lack or loss of appetite
8.	Heartburn	___	h.  Difficulty in swallowing
9.	Dyspepsia	___	i.   Recurrent abdominal pain
10.	Constipation	___	j.   Increased serum bilirubin levels
11.	Anorexia	___	k.  Accumulation of fluid in peritoneal cavity
12.	Hematemesis	___	l.   Sudden severe pain in the anus
13.	Foregut pain	___	m. Persistent difficult, infrequent, or           incomplete evacuation
14.	Jaundice	___	n.  Pain in the hypogastric area
15.	Hematochezia	___	o.  Flooding of mouth with a clear salty fluid
			p.  Indigestion
			q.  Blood in stool

Answer (definitions found throughout chapter: 1 (o), 2 (h), 3 (k), 4 (c), 5 (n), 6 (l), 7 (b), 8 (d), 9 (p), 10 (m), 11 (g), 12 (a), 13 (f), 14 (j), 15 (q))

EXERCISE 2
2.0 Describe the procedure for completing a gastrointestinal history (a minimum
      of eight factors should be included ).

Answer (introduction, p3, 4)

3.0 List eight signs of malnutrition.

Answer (section 12.3, p25)

4.1 Describe the process for examining the abdomen, including inspection,
      auscultation, palpation, and percussion.

Answer (inspection: section 20.1, p41; auscultation: section 20.2, p43; palpation: section 20.3, p44; percussion: section 20.4, p45)

4.2 Describe the process for examining 1) the liver, 2) the spleen.

Answer (liver: section 20.5, p45; spleen: section 20.6, p46)

4.3 Describe how you would examine the patient if you suspected ascites.

Answer (section 20.7, p47)