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Clerkship - Vomiting, Diarrhea, Constipation

VOMITING

  1. Discuss in general, the differential diagnosis for a patient with emesis.  Consider timing and character of the emesis and associated abdominal pain.  Contrast etiologies in infants, children and adults.
  2. Describe the clinical presentation and etiologies of gastric outlet obstruction.
  3. Discuss the diagnosis and management of obstructive ulcer disease.
  4. Describe the signs and symptoms of small bowel obstruction.
  5. Describe the common etiologies of mechanical small bowel obstruction.
  6. Discuss the potential complications and management of small bowel obstruction.
  7. Outline the initial management of a patient with mechanical small bowel obstruction, including laboratory tests and x-rays.
  8. Contrast the presentation and management of partial vs. complete small bowel obstruction.
  9. Differentiate the signs, symptoms and radiographic patterns of paralytic ileus and small bowel obstruction.

DIARRHEA

  1. Discuss the differential diagnosis of diarrhea in adults.  Consider chronicity, absence or presence of blood and associated pain.  Consider infectious causes.
  2. Describe the presentation and potential complications of ulcerative colitis and Crohn’s disease.
  3. Contrast the pathology, anatomic location and pattern, cancer risk and diagnostic evaluation of ulcerative colitis and Crohn’s disease.
  4. Discuss the clinical manifestations, risk factors, diagnosis and management of pseudomembranous colitis.
  5. Outline the risk factors, presentation, diagnosis and management of ischemic colitis.

CONSTIPATION

  1. Discuss the potential etiologies of constipation in adults and children.  Consider chronic vs. acute.
  2. Describe the clinical presentation and etiologies of large bowel obstruction.
  3. List the diagnostic methods utilized in the evaluation of potential large bowel obstruction, including contraindications and cost effectiveness.
  4. Outline the diagnosis and management of colonic volvulus, diverticular stricture, fecal impaction and obstructing colon cancer.

PREVENTION

  1. Indications for and methods of screening for colorectal carcinoma.
  2. Use of surveillance endoscopy in ulcerative colitis.

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