51 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
Gastroenteritis : Stomach and intestinal inflammation (flu) • Usually due to a viral infection of the intestines but can be caused by food or drug allergy/foodborne infection Appendicitis : Inflammation of the appendix that occurs in adolescents and young adults • Usually requires surgery • Differential diagnosis: Crohn’s, perforated ulcer, gallbladder attack, kidney infection, ovarian cyst, ectopic pregnancy, right lower lobe pneumonia • Signs and symptoms ○ Peri-umbilical lower right quadrant pain • McBurney’s point: Located by palpating for tenderness between anterior superior iliac spine (ASIS) and umbilicus while client is supine ○ Must rule out iliopsoas abscess that can be associated with appendicitis/peritonitis ○ Can refer pain to obturator also ○ Rebound tenderness • Iliopsoas abscess: Can be facilitated by appendicitis ○ + Psoas sign: Pain on passive extension of right hip with patient lying on left side Inflammatory Bowel Disease : Refers to two inflammatory conditions • Ulcerative Colitis (UC) : Inflammation of the inner lining of colon and rectum ○ Increases risk of colon cancer ○ Signs and symptoms ■ Diarrhea, from only a few episodes to very frequently throughout the day (blood and mucus may be present) ■ Abdominal pain/cramping that usually ○ Reduced appetite ○ Nausea/vomiting ○ Low-grade fever
• Crohn’s Disease (CD) : Inflammatory disease that attacks the terminal end of small intestine and colon most commonly ○ Slow and nonaggressive ○ Joint pain, no permanent joint deformity ○ Symptoms same as UC • Both UC and CD have unknown etiology: Unable to distinguish foreign from self- antigens; the body can’t regulate mucosal immune response, causing damage to this tissue Inflammatory Bowel Syndrome (IBS) : Functional motility disorder of small/large intestine; interferes with digestion and absorption • Most common GI disorder • Aggravated by stress, fatigue, or intake of fatty content • Signs and symptoms ○ Chronic and frequent diarrhea/ constipation, usually accompanied by pain ○ Abdominal pain or tenderness: Long back pain ○ Intermittent pain following meals, relieved by bowel movement ○ Abdominal fullness, gas, bloating ○ Loss of appetite, nausea, vomiting ○ Emotional distress/depression • Common therapies ○ Lifestyle modification: Diet, alcohol intake, stress reduction ○ Drugs: Antacids, laxatives, antidiarrheals, antibiotics, histamine antagonists Diverticulosis : Ballooning secondary to weak colon wall • Usually benign • Symptoms: Mild discomfort, flatulence, constipation, or diarrhea Diverticulitis : Infection/microperforations of wall • Can be due to non-steroidal anti- inflammatory drugs (NSAIDs) • Symptoms: Pelvic pain, bloody stools, nausea/vomiting, fever
disappears after a bowel movement ■ Abdominal sounds (a gurgling or splashing sound heard over the intestine) ■ Fever ■ Weight loss
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