9: Peds GI Assessment

Question 1

Pain with deep inspiration while examiner has fingers hooked under rib cage.

Answer 1

Murphy’s Sign

Question 2

3 conditions that cause high-pitched, frequent bowel sounds.

Answer 2

1. Early peritonitis
2. Gastroenteritis
3. Intestinal obstruction

Question 3

If a child has increased ammonia levels, what might be the cause?

Answer 3

Liver disease

Question 4

When would a protuberant abdomen not be alarming?

Answer 4

Toddlers are pot-bellied by nature.

Question 5

RUQ sausage-shaped mass with RLQ empty space.

Answer 5

Dance’s Sign

Question 6

What 4 things do you check for hydration status?

Answer 6

1. Oral mucosa
2. Skin turgor
3. Absence of tears
4. Urinary output

Question 7

Patient lies on left side. Flexion and extension of right leg induces abdominal pain.

Answer 7

Psoas Sign

Question 8

What are normal percussion sounds for the abdomen?

Answer 8

• Tympany over abdomen.
• Dullness along right costal margin and 1-3 cm below costal margin of liver.

Question 9

Light abdominal palpation assesses what?

Answer 9

1. Tenderness
2. Lesions
3. Muscle tone
4. Turgor

Question 10

How long must bowel sounds be absent to be considered absent?

Answer 10

5 minutes

Question 11

Tenderness on gentle pressure at a point on the right side of the abdomen two-thirds of the way from the navel to the bony prominence on the front of the hip.

Answer 11

McBurney’s Sign

Question 12

V/D and abdominal pain need careful assessment b/c they can quickly lead to what?

Answer 12

Dehydration

Question 13

What are 4 GI red flags?

Answer 13

1. Bilious/bloody vomit
2. Mucousy/bloody stools
3. Recent travel
4. High fever

Question 14

Increased abdominal pain as the patient tries to raise the right leg up against the hand of the examiner pushing down against the thigh.

Answer 14

Psoas Sign

Question 15

Pain occurs upon release of palpation.

Answer 15

Rebound tenderness (Blumberg’s Sign)

Question 16

Increased abdominal pain when patient stands on tip toes and falls onto heels.

Answer 16

Markle Sign

Question 17

Increased abdominal pain when coughing.

Answer 17

Dunphy’s Sign

Question 18

2 conditions that can cause absence of bowel sounds for >3 minutes.

Answer 18

1. Peritonitis
2. Intestinal obstruction

Question 19

Palpation of the LLQ causes pain in the RLQ.

Answer 19

Rovsing’s Sign

Question 20

What is a red flag for mental status?

Answer 20

Lethargy and listlessness (can occur rapidly in peds)

Question 21

Deep abdominal palpation assesses what 3 organs?

Answer 21

1. Liver
2. Spleen
3. Kidneys

Question 22

Flex hip with knee bent. Internal rotation of hip causes abdominal pain.

Answer 22

Obturator Sign