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Examination findings > Abdominal exam signs > Flashcards

Abdominal exam signs Flashcards

1
Q

What are causes of finger clubbing?

A
  • Cyanotic heart disease
  • Lung causes
    • Abscess
    • Bronchiectasis
    • CF
    • Don’t say COPD
    • Empyema
    • Fibrosis
    • TB
    • Mesothelioma
  • UC/Crohn’s
  • Bronchogenic carcinoma
  • Biliary Cirrhosis
  • Infective endocarditis (subacute)
  • Neoplasms
  • GI malabsorption
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2
Q

What would you lookg for in the hands on abdo examination?

A
  • Flapping tremor
  • Nails
  • Palms
  • Joints
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3
Q

What might asterixis indicate?

A
  • Hepatic encephalopathy
  • CO2 retention
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4
Q

What might leuconycia indicate?

A

Hypoalbuminaemia

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5
Q

What might koilonychia indicate?

A

Iron deficiency

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6
Q

What would palmar erythema potentially indicate?

A

Hyperdynamic circulation due to increased oestrogen levels in liver disease/pregnancy

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7
Q

What are causes of dupuytren’s contracture?

A
  • FH
  • Alcohol
  • Liver disease
  • Anti-epileptics
  • DM
  • Peyronies disease
  • Ledderhose disease
  • Garrod’s disease
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8
Q

What would you look at in the face in a GI exam?

A
  • Eyes
  • Mouth
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9
Q

What would scleral icterus indicate?

A

Jaundice - liver disease

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10
Q

What would periorbital xanthelasma potentially indicate?

A

Hypercholesterolaemia in cholestasis

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11
Q

What might conjunctival pallor indicate in a GI exam?

A

Anaemia - gi malabsorption, bleeding

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12
Q

What might angular somtatits/glossitis indicate?

A

B12/iron deficiency

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13
Q

What might feculant breath odour indicate?

A

Obstruction

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14
Q

What might fruity breath odour indicate?

A

Ketoacidosis

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15
Q

What might a sweet breath odour indicate?

A

Portal hypertension

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16
Q

What might you look at in the neck and torso in a GI examination?

A
  • Neck
  • Front/back of chest
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17
Q

What might the presence of virkow’s node indicate?

A

Potentially gastric malignancy

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18
Q

What would would you look for on the chest in a GI exam?

A
  • Spider naevi
  • Gynaecomastia
  • Loss of hair
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19
Q

What might spider naevi/gynaecomastia/hair loss indicate?

A

Increased oestrogen in liver disease

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20
Q

What might you look for on inspection of the abdomen?

A
  • Scars
  • Distention/asymmetry
  • Striae
  • Spider naevi
  • Umbilical/incisional/spiglean hernias
  • Movement on respiration
  • Obvious pulsation
  • Distended abdominal veins
  • Stomas
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21
Q

What are causes of abdominal distention?

A
  • Fluid
  • Flatus
  • Fetus
  • Faeces
  • Fat
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22
Q

What might the presence of striae indicate?

A
  • Pregnancy
  • Cushing’s syndrome
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23
Q

What would you check for on superficial palpation of the abdomen?

A
  • Tenderness
  • Guarding/rigidity
  • Rebound tenderness
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24
Q

What would you check for on deep palpation of the abdomen?

A
  • Masses
  • Deep tenderness
  • Rovsigs
  • Murphy’s sign
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25
Q

What are causes of hepatomegaly?

A
  • Mets/HCC
  • Hepatitis
  • RVF
  • Leukaemia
  • Lymphioma
  • Fatty liver
  • Alcoholic liver disease
  • Budd-chiari
  • EBV
  • Sarcoidosis
  • Amyloidosis
26
Q

What are causes of splenomegaly?

A
  • Leukaemia
  • Lymphoma
  • Myeloproliferative disease
  • Haemolysis diseases - spherocytosis
  • Haematopoetic diseases - myelofibrosis,
  • Response to infection - IE, HIV, Malaria, Glandular fever
  • Cirrhosis
  • Splenic vein obstruction
  • Budd-chiari
27
Q

What are causes of massive splenomegaly?

A

3 Ms

  • Chronic Myeloid leukaemia
  • Malaria
  • Myelofibrosis
28
Q

What are causes of hepatosplenomegaly?

A
  • Any cause of chronic liver disease
  • Leukaemia
  • Lymphoma
  • Myeloproliferative disease
  • Acute viral hepatitis
  • CMV/EBV
  • Malaria
  • Amyloidosis
  • SArcoidosis
29
Q

How would you distinguish a kidney froma spleen?

A
  • Cannot get above it
  • Spleen is notched
  • Not ballotable
  • Moves down with inspiration
30
Q

What would a tympanic abdomen indicate?

A

Presence fo flatus

31
Q

What would percussion tenderness indicate?

A

Peritonitis

32
Q

What would tinkling bowel sounds indicate?

A

Bowel obstruction

33
Q

What might absent bowel sounds indicate?

A

Paralyti ileus/peritonitis

34
Q

What might an abdominal aortic bruit indicate?

A

AAA

35
Q

What might a renal bruit indicate?

A

Renal artery stenosis

36
Q

What would you check for in the legs in a GI exam>

A

Pitting oedema - hypoalbuminaema

37
Q

What would you do in addition to a GI examination?

A
  • PR
  • Orifices
  • Genitalia
38
Q

What are signs of chronic liver disease?

A
  • Hepatomegaly
  • Haemorrhoids
  • Caput medusae
  • Clubbing
  • Leuconychia
  • Palmar erythema
  • Dupuytrens crontracture
  • Spider naevi
  • Gynaecomastia
  • Loss of exillary hair
  • Distended abdomen/ascites
  • Splenomegaly
39
Q

What are signs of liver decompensation?

A
  • Asterixis/confusion - encephalopathy
  • Coagulation disorder
  • Jaundice
  • Ascites
40
Q

What might be the cause of chronic liver disease signs in an afro carribean?

A

Sarcoidosis

41
Q

What might signs of chronic liver disease in someone with slate greay pigmentation/features of diabetes indicate?

A

Haemochromatosis

42
Q

What might signs of chronic liver disease in an IVDU or someone with tatoos indiate?

A

Hepatitis C

43
Q

What might someone with xanthelasma and signs of chronic liver disease ahve?

A

PBC

44
Q

What might someone with signs of chronic liver disease and emphysema have?

A

A1-antitrypsin

45
Q

What is the following scar, and what are the indications for this type of surgical incision?

A

Rutherford morrison scar

  • Kidney transplant
  • Colonic resection
  • Caecostomy
  • Left side - sigmoid colostomy
46
Q

Name these two incisions, and indications for their use?

A

Appendicetomy

  • More horizontal - lanz
  • Oblique - gridiron mcburneys
47
Q

What is the following, and what are indications for its use?

A

Midline laparotomy

  • Most open abdominal operations
48
Q

What is the following incision, and what are indications for its use?

A

Paramedian laparotomy

  • Spleen, kidney and adrenal operations
49
Q

What is the following incision, and what are indications for its use?

A

Kocher’s incision

  • Gallbladder and biliary tract operations
50
Q

What is the following incision, and what are indicaitons for its use?

A

Mercedez benz modification

  • Diaphragmatic hernias
  • Chevron indications
51
Q

What is the following incision, and what are indications for its use?

A

Rooftop/chevron incision

  • Gastrectomy
  • Oesophagectomy
  • Bilateral adrenalectomy
  • Hepatic resection
  • Liver transplant
  • Pancreatic transplant
52
Q

What is the following incision, and what are indications for its use?

A

Pfannensteil incision

  • Caesarean
  • Pelvic/bladder/prostate surgery
53
Q

What are signs of cause of hepatomegaly?

A
  • Signs of chronic liver disease
  • Lymphadenopathy - lymphoma
  • Peripheral oedema/raised JVP - RVF
54
Q

What are signs of causes of splenomegaly?

A
  • Hand deformity - RA
  • Signs of chronic lvier disease
  • Pale conjunctiva - leukamia, myeloproliferative disease, haemolytic anaemia
  • Lymphadenopathy
55
Q

What are features of ADPKD you might see on abdo exam?

A
  • AV fistula
  • Hypertension
  • Pale conjunctiva
  • Flank scars
  • Bilateral ballotable kidneys
  • Hepatomegaly
56
Q

What might be signs of someone with a liver transplant being on immunosuppression?

A
  • Tremor - calcineurin inhibitors
  • Cushingoid/brusiing - steroids
  • Skin lesions/excisions - immunosuppression
57
Q

What are features of a combined kidney/pancreas transplant?

A
  • LIF scar - renal graft
  • RIF scar - pancreas graft
  • Smooth mass underlying LIF scar - transplanted kidney
58
Q

What might you find in someone with polycythaemia in GI exam?

A
  • Dusky cyanosis
  • Hypertension
  • Facial plethora
  • Splenomegaly
59
Q

What might you find on GI exa of someone with PBC?

A
  • Middle aged woman
  • Jaundice
  • Skin hyperpigmentation
  • Excoriations
  • Xanthelasma
  • Hepatomegaly
  • Signs of chronic lvier disease
60
Q

how would you assess renal graft functionality?

A
  • Flap/excoriations
  • Active marks in AV fistula
  • Pale conjunctiva
  • Fluid retention
61
Q

How would you assess pancreatic graft functionality on GI exam?

A
  • Fingertip glucose monitoring marks
  • Insulin injection marks
62
Q

How would you characterise a mass/lump?

A
  • Site
  • Size
  • Shape
  • Contours
  • Consitency
  • Colour
  • Temperature
  • Tenderness
  • Transillumination

Examination findings (23 decks)

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