The Abdomen without notes 2018rev(1).pptx

Men ask older men do you have trouble starting your

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Men Ask older men, “Do you have trouble starting your stream?” “Do you have to stand close to the toilet to void?” “Is there a change in the force or size of your stream, or straining to void?” “Do you hesitate or stop in the middle of voiding?” “Is there dribbling when you’re through?” 25
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ABNORMAL SYMPTOMS ASSOCIATED WITH THE URINARY TRACT 26 Suprapubic Pain Bladder disorders (i.e. infection) Dysuria, Urgency, or Frequency Infection or irritation of either the bladder or urethra Dysuria pain on urination or difficulty urinating (voiding) Urgency: intense and immediate desire to void Frequency: needing to urinate more often than usual. Polyuria/Nocturia Polyuria : significant increase in a 24-hour urine volume. Exceeding 3L (NL amt. 2.5L/D) Nocturia: urinary frequency at night Involuntary loss of urine: occurs with coughing, sneezing, laughing or lifting.
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ABNORMAL SYMPTOMS ASSOCIATED WITH THE URINARY TRACT (CONT.) 27 Hematuria Blood in urine Kidney or Flank Pain (Ureteral Colic) At or below the posterior costal margin near the CVA. May radiate anteriorly towards the umbilicus Its visceral & typically it is dull. Ureteral pain is usually severe and colicky, Originating at the CVA and radiating around the trunk Fever, Chills and Hematuria
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HEALTH PROMOTION AND COUNSELING: EVIDENCE AND RECOMMENDATIONS 28 Screening for ETOH abuse CAGE questionnaire ETOH Use Disorder Identification Test Risk Factors for Hepatitis A, B, & C Hepatitis A (HAV)-fecal/oral route Hepatitis B (HBV)-sexually transmitted Hepatitis C (HCV)-IV drug abuse, tattooing, blood transfusion, Screening for Colon Cancer Colorectal cancer is the 3 rd most common cancer in both men and women. More than 90% occur after age 50
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ALCOHOL ABUSE 29 Signs of Unhealthy ETOH use: h/o pancreatitis Family h/o ETOH use Prior DUI charges Hepatosplenomegaly or ascites on exam Alcohol addition is highly correlated to: Fatal car accidents Suicide, depression, and other mental disorders Family disruption Violence Cirrhosis Stroke GI malignancies
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HEPATITIS A 30 Transmission Fecal/Oral Children: they are asymptomatic Prevention Immunization for all children at age 1 yr Immunization for at risk groups Travelers Male-Male Partners IV drug abuse & Illicit Drug use Patients with chronic liver dz For Immediate Protection Household contacts & Travelers: Immune Serum globulin-within 2 wks before contact & before travel. Soap & water handwashing.
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HEPATITIS B 31 Transmission Mother-to-Child Sexual Intercourse IV Drug Use Patient-to-Healthcare Worker Transplant recipient Blood Transfusion Prevention Immunization Donor Testing Adverse Outcome Cirrhosis, Hepatocellular Carcinoma (Liver CA) High Risk Groups Multiple sex partners Exposure to blood Pts in high risk settings Primary care and specialty settings Occupational exposure settings
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HEPATITIS C 32 Transmission Repeated exposure to infected blood Blood transfusion prior to 1993 Rarely transmitted sexually Prevention
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