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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                                                          Henoch-Schönlein purpura • hernias, direct and indirect – inguinal, abdominal
                                                                                      wall, hiatal, esophageal • Kawasaki disease • lesions, gastrointestinal, including
             7.2    ASCITES
                                                                                      erosions, blisters, white lesions, neoplasms • liver conditions, including fatty liver;
             7.3    ANOREXIA
                                                                                      hepatitis; jaundice, infection-induced (eg, bacterial, parasitic, viral) or neonatal
             7.4    NAUSEA, VOMITING, AND HEMATEMESIS
                                                                                      (prehepatic [physiologic or pathologic], hepatic, or posthepatic
             7.5    DISORDERS OF BOWEL FREQUENCY AND EVACUATION                       hyperbilirubinemia); hepatomegaly; masses; iron storage disorder
                                                                                      (hemochromatosis) • malabsorption conditions, acute and chronic – diarrhea;
             7.6    ABDOMINAL PAIN
                                                                                      celiac diseases; immune or enzyme deficiency (eg, lactase, disaccharidase);
             7.7    ABDOMINAL, GASTROINTESTINAL, AND GI TRACT MASSES,
                 CANCERS, AND ORGANOMEGALY                                            steatorrhea; short-bowel syndrome • mouth disorders (eg, mucous membrane
                                                                                      disorders, such as oral ulcers); tongue abnormalities • muscle strain, abdominal
             7.8    MELENA/HEMATOCHEZIA/ANORECTAL RECTAL BLEEDING
                 AND PAIN                                                             • nausea and vomiting – due to drugs/toxins/poisoning, food allergy, infections;
             7.9    HEARTBURN AND REFLUX                                              hyperemesis gravidarum; pediatric vomiting; with hematemesis from irritable
                                                                                      bowel syndrome, pyloric stenosis, or other systemic cause (eg, uremia, central
             7.10 OROPHARYNGEAL AND DENTAL PAIN AND LESIONS
                                                                                      nervous system and psychiatric conditions) • pancreatitis • tumors, including
             7.11 ISSUES OF WEIGHT
                                                                                      primary and secondary gastrointestinal and abdominal organ malignancies
             7.12 ABDOMINAL TRAUMA
             7.13 DYSPHAGIA AND ODYNOPHAGIA
                                                                                      CONSTITUTIONAL SIGNS AND SYMPTOMS
             7.14 FOREIGN BODY IN GASTROINTESTINAL TRACT
                                                                                      fatigue  • fever  • generalized weakness  • involuntary weight loss  • malaise  •
             7.15 ABDOMINAL WALL ABNORMALITIES
                                                                                      night sweats  • pallor
             7.16 PHYSICAL EXAM FINDINGS RELATED TO THE
                 GASTROINTESTINAL SYSTEM AND NUTRITIONAL HEALTH
                                                                                      PHYSICAL EXAM FINDINGS
             7.17 LABORATORY TEST FINDINGS AND DIAGNOSTIC IMAGING                     abdominal and inguinal palpation, rigidity, tenderness  • abdominal auscultation,
                 RELATED TO THE GASTROINTESTINAL SYSTEM AND
                 NUTRITIONAL HEALTH                                                   bowel sounds  • abdominal percussion  • asterixis  • Cullen sign  • fluid thrill or
                                                                                      wave  • Grey Turner sign  • Murphy sign  • peritoneal signs  •  


        COMLEX-USA MASTER BLUEPRINT                                                                DIMENSION 2     CLINICAL PRESENTATION 7    PAGE 55
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