48 topics with brief breakdowns: definitions, key facts, and classroom questions.
This section covers methods of clinical and instrumental examination of the gastrointestinal tract, as well as the semiotics of major gastroenterological diseases. You will journey from basic oral cavity examination, assessment of tongue and pharyngeal changes, to the interpretation of endoscopic images, radiographs, and coprograms.
Special attention is paid to physical examination: techniques of superficial and deep abdominal palpation, percussion, auscultation, and detection of ascites. The special pathology block provides a detailed analysis of key syndromes (dyspepsia, gastrointestinal bleeding, malabsorption) and diseases of the esophagus, stomach, intestines, and pancreas. You will study markers of acute and chronic processes: from GERD and peptic ulcer disease to pancreatitis, Crohn's disease, ulcerative colitis, and gastrointestinal malignancies.
In practical classes and exams, the technique of deep sliding palpation, differential diagnosis in gastrointestinal bleeding syndrome, and the symptoms of peptic ulcer disease and acute pancreatitis are tested most rigorously. A clear understanding of the mechanisms of eructation, vomiting, diarrhea, and constipation will become your reliable foundation for the further study of internal medicine.
Which hormone is responsible for stimulating hydrochloric acid production?
The main stimulator of hydrochloric acid production in the stomach is the hormone gastrin.
What is the "Caput Medusae" sign (Caput Medusae)?
This is a pathological sign characterized by severe dilatation and radial branching of subcutaneous veins around the umbilicus. It occurs due to impaired blood flow in the portal vein (portal hypertension), most often against the background of liver cirrhosis.
Why start from the healthy area during superficial palpation?
To avoid provoking reflex muscle spasm and increasing pain at the very beginning of the examination. The "from healthy to affected" movement allows the patient to get used to the physician's touch.
Why are the fingers inserted specifically during the patient's exhalation?
Upon expiration, physiological relaxation of the anterior abdominal wall muscles occurs, which minimizes reflex resistance and allows deep penetration toward the posterior abdominal wall.
What percussion sound is characteristic of ascites?
In ascites (the presence of free fluid in the abdominal cavity), the percussion sound becomes dull.
Why does the patient turn onto their side during percussion?
This is the positional change method for detecting shifting dullness. Upon turning, free fluid flows downward, and a dull sound appears there, while a tympanic sound appears at the top.
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