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OSCE > Abdominal Exam > Flashcards

Abdominal Exam Flashcards

1
Q

Clubbing

A

Cirrhosis
IBD
Coeliac’s

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2
Q

Leukonychia

A

Hypoalbuminaemia (liver disease, nephrotic syndrome, malabsorption/malnutrition)

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3
Q

Koilonychia

A

IDA

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4
Q

Palmar erythema

A

Hyperdynamic circulation due not increased oestrogen in chronic or severe acute liver disease
Also- pregnancy, thyrotoxicosis, RA, drug-induced

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5
Q

Dupuytren’s contracture

A

Familial

Cirrhosis (particularly alcoholic)

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6
Q

Flapping tremor (asterixis)

A 
Ask patient to hold out their hands in front of them extended at the wrist for 30s
Hepatic encephalopathy (grade >or-2)
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7
Q

Pulse

A

e.g. increased in hypovolaemia (GI bleeding/shock) or anaemia

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8
Q

Jaundice of skin

A

Liver disease

Cholestasis

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9
Q

Slate-gray appearance

A

Haemochromatosis

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10
Q

Hyperpigmentation

A

Addison’s disease

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11
Q

Mucosal pallor of conjunctiva

A

Anaemia

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12
Q

Jaundice of sclera

A

Liver disease

Cholestasis

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13
Q

Red sclera

A

Anterior Uveitis (IBD)

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14
Q

Corneal arcus

A

Hypercholesterolaemia in cholestasis (significant only if <50)

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15
Q

Kayser-Fleisher rings

A

Wilson’s disease

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16
Q

Xanthelasma

A

Hypercholesterolaemia in cholestasis

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17
Q

Angular stomatitis

A

Severe anaemia (iron/ B12)

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18
Q

Ulcer’s

A

Crohn’s disease

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19
Q

Breath- fetor hepaticus

A

Sweet feculent smelling breath

Late sign in liver failure and hepatic encephalopathy

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20
Q

Breath- ketosis

A

Sickly sweet ‘pear drop’ smelling breath

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21
Q

Breath- uraemia

A

Fishy smelling breath

22
Q

Breath- bowel obstruction

A

Feculent smelling breath

23
Q

Glossitis

A

Vitamin B12/folate deficiencies

24
Q

Macroglossia

A 
Amyloidosis
Acromegaly
Hypothyroidism
Down syndrome
Malignancy
25
Q

Oral candidiasis

A

Immunosuppression

Poor oral hygiene

26
Q

Virchow’s node

A

Troisier’s sign for intra-abdominal malignancy

27
Q

Spider naevi

A

Found in distribution of SVC (face, neck, arms, upper trunk)
>5 is pathological
If pressed will refill from the centre
Due to increased oestrogen in chronic or severe acute liver disease

28
Q

Gynaecomastia

A

Due to increased oestrogen in liver disease

29
Q

Distension- 5 Fs

A 
Fluid
Fat
Flatus
Foetus
Faeces
30
Q

Caput medusae

A

Portal hypertension

31
Q

Peristaltic waves

A

Normal (thin, fit, young individuals) or bowel obstruction

32
Q

Striae

A

Teenagers
Obesity
Pregnancy
Ascites

33
Q

Stomas

A

Typically colostomies in LIF and ileostomies and urostomies in RIF

34
Q

Skin discolouration in pancreatitis

A

Cullen’s sign- umbilicus and surrounding skin

Gray-Turner’s sign- flanks

35
Q

Hernias

A

Observe cough impulse

36
Q

Roving’s sign

A

Pain in RIF>LIF when palpating LIF

37
Q

Appendicitis

A

Local peritonitis in RIF

Positive Rovsing’s sign

38
Q

Murphy’s sign

A

Local peritonitis in RUQ

39
Q

Acute cholecystotitis

A

positive murphy’s sign

40
Q

If degree of extension below costal margin in liver palpation is more than 2cm, there is

A

Hepatomegaly

41
Q

Smooth liver edge

A

Hepatomegaly

42
Q

Irregular liver edge

A

HCC

43
Q

Tenderness when palpating gallbladder

A

Hepatitis

Cholecystitis

44
Q

Liver pulsatility

A

Tricuspid regurgitation

45
Q

Tender RUQ

A

Murphy’s sign- acute cholecystitis

46
Q

Palpable gallbladder but not tender/no pain but jaundice present

A

Courvoisier’s law- likely pancreatic cancer or cholangiocarcinoma, rather than related to gallstones

47
Q

Bilaterally enlarged kidneys

A

Polycystic kidneys

Amyloidosis

48
Q

Unilaterally enlarged kidney

A

Renal tumour

49
Q

Tinkling bowel sound

A

Bowel obstruction

50
Q

Absent bowel sound for at least 3 minutes

A

Paralytic ileus

Peritonitis

51
Q

Pedal oedema

A

Hypoalbuminaemia

52
Q

Further tests

A

Offer to check Hernial orifices (e.g. signs of bowel obstruction)
Examine external genitalia (referred pain from e.g. testicular torsion)
Perform a DRE (e.g. suspicion of GI bleeding)

OSCE (15 decks)

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