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CLINICAL               7        PATIENT PRESENTATIONS RELATED TO THE
          PRESENTATION
                                          GASTROINTESTINAL SYSTEM & NUTRITIONAL HEALTH




             Patient presentations span all relevant age                              The Guide to clinical presentations in this category may
             categories, special populations, and varied                              include, but is not limited to, the following ways in which
             clinical settings.                                                       patients present for osteopathic medical care:


             7.1    JAUNDICE                                                          abdominal conditions, acute or chronic – distention, trauma (blunt or penetrating;
                                                                                      splenic rupture/splenomegaly); abdominal aortic aneurysm; abdominal wall
             7.2    ASCITES
                                                                                      hernias; pulsatile masses • abdominal pain, acute or chronic (localized and
             7.3    ANOREXIA
                                                                                      diffuse/generalized); radiating to extra-abdominal location; infection (eg,
             7.4    NAUSEA, VOMITING, AND HEMATEMESIS
                                                                                      peritonitis, gastroenteritis, appendicitis, mesenteric adenitis); sickle cell crises;
             7.5    DISORDERS OF BOWEL FREQUENCY AND EVACUATION                       mesenteric ischemia • anorectal conditions, including fissures, pain,
                                                                                      hemorrhoids, pruritis ani, encopresis/stool incontinence • ascites due to liver
             7.6    ABDOMINAL PAIN
                                                                                      disease (eg, cirrhosis, portal hypertension), malignancy, congestive heart failure,
             7.7    ABDOMINAL, GASTROINTESTINAL, AND GI TRACT MASSES,
                 CANCERS, AND ORGANOMEGALY                                            renal failure • bleeding, lower or upper gastrointestinal; overt gastrointestinal; in
                                                                                      stool (eg, occult, melena, hematochezia) • bowel conditions, acute or chronic –
             7.8    MELENA/HEMATOCHEZIA/ANORECTAL RECTAL BLEEDING
                 AND PAIN                                                             constipation, flatus, obstruction, intussusception, volvulus, obstipation, ischemic
             7.9    HEARTBURN AND REFLUX                                              bowel; fecal impaction; adhesions; diverticulitis, diverticulosis; ileus, meconium
                                                                                      ileus; gastroparesis; infantile colic; Meckel diverticulum • dental disease and
             7.10 OROPHARYNGEAL AND DENTAL PAIN AND LESIONS
                                                                                      conditions – abscess, gingival abnormalities, periodontal disease • diabetes-
             7.11 ISSUES OF WEIGHT
                                                                                      related conditions (eg, gastroparesis, ketoacidosis) • eating disorders – bulimia;
             7.12 ABDOMINAL TRAUMA                                                    anorexia, including anorexia due to drugs, metabolic disorders, mood disorders;
             7.13 DYSPHAGIA AND ODYNOPHAGIA                                           laxative abuse • esophageal and pharyngeal disorders – epiglottitis, esophagitis,
                                                                                      oropharyngeal or esophageal dysphagia, retropharyngeal abscess, hernia,
             7.14 FOREIGN BODY IN GASTROINTESTINAL TRACT
                                                                                      stricture, varices, Mallory-Weiss syndrome, Boerhaave tear, Barrett esophagus •
             7.15 ABDOMINAL WALL ABNORMALITIES
                                                                                      feeding and nutrition – feeding tubes, total parenteral nutrition • gallbladder
             7.16 PHYSICAL EXAM FINDINGS RELATED TO THE                               conditions – cholecystitis, cholelitihiasis, cholestasis • gastroesophageal
                 GASTROINTESTINAL SYSTEM AND NUTRITIONAL HEALTH
                                                                                      disorders – foreign body (eg, ingested food boluses and non-food items such as
             7.17 LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING                     bones, fruit pits, broken teeth, dental appliances); gastroesophageal reflux
                 RELATED TO THE GASTROINTESTINAL SYSTEM AND
                 NUTRITIONAL HEALTH                                                   disease; gastritis; peptic ulcer disease, Helicobacter pylori • gastrointestinal
                                                                                      disorders – parasites (eg, helminths and protozoa), polyps, stomas •  


        COMLEX-USA MASTER BLUEPRINT                                                                DIMENSION 2     CLINICAL PRESENTATION 7    PAGE 54
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