Abdominal Exam

Question 1

Which type of peptic ulcer gets better with food? Worse?

Answer 1

Better: Duodenal
Worse: Gastric (stomach cancer as well)

Question 2

What is a sister mary joseph nodule?

Answer 2

Palpable nodule bulging into umbilicus as a result of metastasis of a malignant cancer in pelvis or abdomen.

Question 3

What is virchow’s node?

Answer 3

Sentinel, left supraclavicular node indicating cancer

Question 4

What type of abdominal pain is better upon leaning forward?

Answer 4

Pancreatitis

Question 5

Sequelae of chronic pancreatitis?

Answer 5

1. Steatorrhea

2. Diabetes

Question 6

Which abdominal pain radiates toward right should?

Answer 6

1. Biliary colic form gallstones in cystic or common bile duct
2. Acute cholecystitis

Question 7

What does murphy’s sign indicate?

Answer 7

Acute cholecistitis

Question 8

Where is pain from acute diverticulitis experienced?

Answer 8

LLQ from mass effect

Question 9

What are the signs of appendicitis?

Answer 9

1. Rovsing
2. Psoas
3. Obturator

Question 10

What does pain in mcburney’s point indicated?

Answer 10

Apendicitis

Question 11

Where is obstruction if fecal vomit? Bile/mucous?

Answer 11

Fecal: colon
Bile: SI

Question 12

What is obstipation?

Answer 12

Inability to pass stool OR fart

Question 13

What are “high pitched tinkling noises on auscultation” indicative of?

Answer 13

Acute obstruction

Question 14

Where is pain from Crohn’s?

Answer 14

RLQ

Question 15

What are Skip lesions?

Answer 15

Palpable inflammation of ileum seen in crohn’s

Question 16

What is the following indicative of: “I just don’t feel like I can fully empty my bowels and the pain relieves upon defecation”

Answer 16

IBD

Question 17

Main type of stomach cancer?

Answer 17

Adenocarcinoma

Question 18

Where does a peptic ulcer radiate to?

Answer 18

The back

Question 19

What is acute cholecystitis?

Answer 19

Inflammation of gallbladder usually from obstruction of cystic duct by gallstone

Question 20

What pain is relieved by antacids?

Answer 20

GERD

Peptic ulcer

Question 21

What pain is worse on lying down or leaning forward?

Answer 21

GERD

Question 22

What pain is worse with booze, fatty meals and chocolate?

Answer 22

GERD

Question 23

Pain relieved by Ca blockers?

Answer 23

GERD

Question 24

What pain wakes you up at night?

Answer 24

Duodenal ulcer

Question 25

Epigastric pain NOT releived by food or tums?

Answer 25

Cancer

Question 26

What to suspect in acute RLQ pain that temporarily subsides?

Answer 26

Ruptured appendix

Question 27

Pain worse lying on back?

Answer 27

Acute pancreatitis

Question 28

What do steatorrhea and TIIDM indicate?

Answer 28

Chronic pancreatitis

Question 29

What makes hernias more apparent on exam?

Answer 29

Raising head and shoulders while laying on back

Question 30

What is diastasis recti?

Answer 30

Separation of 2 rectus abdominal muscles with abdominal contents forming midline ridge when head and shoulders raised from supine position - Pregnancy, obesity, and lung disease can cause - Not dangerous

Question 31

Prognosis of umbilical hernias in infants?

Answer 31

Spontaneously close in 1 - 2 years

Question 32

Is a small or large incisional hernia more dangerous?

Answer 32

Smaller: I am guess this is because it is more likely to wrap tightly around abdominal contents causing ischemia?

Question 33

Where does epigastric hernia occur?

Answer 33

Linea alba between umbilicus and xiphoid

Question 34

What is a pannus?

Answer 34

Apron of fatty tissue seen in obesity that can drape below the inguinal ligaments

Question 35

Appearance of stomach tumor on percussion?

Answer 35

Dull to percussion with displaced air filled bowel on periphery showing tympany

Question 36

Most common cause of abdominal mass?

Answer 36

Pregnancy

Question 37

How long must you listen to prove absent bowel sounds?

Answer 37

2 minutes

Question 38

What are high pitched tinkling bowel sounds indicative of?

Answer 38

Air in bowel

Question 39

What does hepatic bruit suggest?

Answer 39

Hepatic carcinoma or alcoholic hepatitis

Question 40

What would a venous hum indicated?

Answer 40

cirrhosis

Question 41

Does raising head alleviate deep or superficial abdominal pain?

Answer 41

Deep

Question 42

Presentation of acute salpingitis?

Answer 42

1. Rebound tenderness 2. Rigidity 3. Uteran motion tenderness 4. Maximal above inguinal ligmanets

Question 43

What is riedel's lobe?

Answer 43

Elongated right lobe of liver often seen in tall people | - Not hepatomegaly as volume is normal, just change in shape