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
2
Q
What would you lookg for in the hands on abdo examination?
A
- Flapping tremor
- Nails
- Palms
- Joints
3
Q
What might asterixis indicate?
A
- Hepatic encephalopathy
- CO2 retention
4
Q
What might leuconycia indicate?
A
Hypoalbuminaemia
5
Q
What might koilonychia indicate?
A
Iron deficiency
6
Q
What would palmar erythema potentially indicate?
A
Hyperdynamic circulation due to increased oestrogen levels in liver disease/pregnancy
7
Q
What are causes of dupuytren’s contracture?
A
- FH
- Alcohol
- Liver disease
- Anti-epileptics
- DM
- Peyronies disease
- Ledderhose disease
- Garrod’s disease
8
Q
What would you look at in the face in a GI exam?
A
- Eyes
- Mouth
9
Q
What would scleral icterus indicate?
A
Jaundice - liver disease
10
Q
What would periorbital xanthelasma potentially indicate?
A
Hypercholesterolaemia in cholestasis
11
Q
What might conjunctival pallor indicate in a GI exam?
A
Anaemia - gi malabsorption, bleeding
12
Q
What might angular somtatits/glossitis indicate?
A
B12/iron deficiency
13
Q
What might feculant breath odour indicate?
A
Obstruction
14
Q
What might fruity breath odour indicate?
A
Ketoacidosis
15
Q
What might a sweet breath odour indicate?
A
Portal hypertension
16
Q
What might you look at in the neck and torso in a GI examination?
A
- Neck
- Front/back of chest
17
Q
What might the presence of virkow’s node indicate?
A
Potentially gastric malignancy
18
Q
What would would you look for on the chest in a GI exam?
A
- Spider naevi
- Gynaecomastia
- Loss of hair
19
Q
What might spider naevi/gynaecomastia/hair loss indicate?
A
Increased oestrogen in liver disease
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
21
Q
What are causes of abdominal distention?
A
- Fluid
- Flatus
- Fetus
- Faeces
- Fat
22
Q
What might the presence of striae indicate?
A
- Pregnancy
- Cushing’s syndrome
23
Q
What would you check for on superficial palpation of the abdomen?
A
- Tenderness
- Guarding/rigidity
- Rebound tenderness
24
Q
What would you check for on deep palpation of the abdomen?
A
- Masses
- Deep tenderness
- Rovsigs
- Murphy’s sign
25
What are causes of hepatomegaly?
* **Mets/HCC**
* **Hepatitis**
* **RVF**
* **Leukaemia**
* **Lymphioma**
* **Fatty liver**
* **Alcoholic liver disease**
* **Budd-chiari**
* **EBV**
* **Sarcoidosis**
* **Amyloidosis**
26
What are causes of splenomegaly?
* **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
What are causes of massive splenomegaly?
3 Ms
* Chronic **M**yeloid leukaemia
* **M**alaria
* **M**yelofibrosis
28
What are causes of hepatosplenomegaly?
* **Any cause of chronic liver disease**
* **Leukaemia**
* **Lymphoma**
* **Myeloproliferative disease**
* **Acute viral hepatitis**
* **CMV/EBV**
* **Malaria**
* **Amyloidosis**
* **SArcoidosis**
29
How would you distinguish a kidney froma spleen?
* **Cannot get above it**
* **Spleen is notched**
* **Not ballotable**
* **Moves down with inspiration**
30
What would a tympanic abdomen indicate?
Presence fo flatus
31
What would percussion tenderness indicate?
Peritonitis
32
What would tinkling bowel sounds indicate?
Bowel obstruction
33
What might absent bowel sounds indicate?
Paralyti ileus/peritonitis
34
What might an abdominal aortic bruit indicate?
AAA
35
What might a renal bruit indicate?
Renal artery stenosis
36
What would you check for in the legs in a GI exam\>
Pitting oedema - hypoalbuminaema
37
What would you do in addition to a GI examination?
* **PR**
* **Orifices**
* **Genitalia**
38
What are signs of chronic liver disease?
* **Hepatomegaly**
* **Haemorrhoids**
* **Caput medusae**
* **Clubbing**
* **Leuconychia**
* **Palmar erythema**
* **Dupuytrens crontracture**
* **Spider naevi**
* **Gynaecomastia**
* **Loss of exillary hair**
* **Distended abdomen/ascites**
* **Splenomegaly**
39
What are signs of liver decompensation?
* **Asterixis/confusion** - encephalopathy
* **Coagulation disorder**
* **Jaundice**
* **Ascites**
40
What might be the cause of chronic liver disease signs in an afro carribean?
Sarcoidosis
41
What might signs of chronic liver disease in someone with slate greay pigmentation/features of diabetes indicate?
Haemochromatosis
42
What might signs of chronic liver disease in an IVDU or someone with tatoos indiate?
Hepatitis C
43
What might someone with xanthelasma and signs of chronic liver disease ahve?
PBC
44
What might someone with signs of chronic liver disease and emphysema have?
A1-antitrypsin
45
What is the following scar, and what are the indications for this type of surgical incision?
Rutherford morrison scar
* **Kidney transplant**
* **Colonic resection**
* **Caecostomy**
* **Left side** - sigmoid colostomy
46
Name these two incisions, and indications for their use?
Appendicetomy
* More horizontal - lanz
* Oblique - gridiron mcburneys
47
What is the following, and what are indications for its use?
Midline laparotomy
* Most open abdominal operations
48
What is the following incision, and what are indications for its use?
Paramedian laparotomy
* Spleen, kidney and adrenal operations
49
What is the following incision, and what are indications for its use?
Kocher's incision
* Gallbladder and biliary tract operations
50
What is the following incision, and what are indicaitons for its use?
Mercedez benz modification
* Diaphragmatic hernias
* Chevron indications
51
What is the following incision, and what are indications for its use?
Rooftop/chevron incision
* **Gastrectomy**
* **Oesophagectomy**
* **Bilateral adrenalectomy**
* **Hepatic resection**
* **Liver transplant**
* **Pancreatic transplant**
52
What is the following incision, and what are indications for its use?
Pfannensteil incision
* **Caesarean**
* **Pelvic/bladder/prostate surgery**
53
What are signs of cause of hepatomegaly?
* **Signs of chronic liver disease**
* **Lymphadenopathy** - lymphoma
* **Peripheral oedema/raised JVP** - RVF
54
What are signs of causes of splenomegaly?
* **Hand deformity** - RA
* **Signs of chronic lvier disease**
* **Pale conjunctiva** - leukamia, myeloproliferative disease, haemolytic anaemia
* **Lymphadenopathy**
55
What are features of ADPKD you might see on abdo exam?
* **AV fistula**
* **Hypertension**
* **Pale conjunctiva**
* **Flank scars**
* **Bilateral ballotable kidneys**
* **Hepatomegaly**
56
What might be signs of someone with a liver transplant being on immunosuppression?
* **Tremor** - calcineurin inhibitors
* **Cushingoid/brusiing** - steroids
* **Skin lesions/excisions** - immunosuppression
57
What are features of a combined kidney/pancreas transplant?
* LIF scar - renal graft
* RIF scar - pancreas graft
* Smooth mass underlying LIF scar - transplanted kidney
58
What might you find in someone with polycythaemia in GI exam?
* **Dusky cyanosis**
* **Hypertension**
* **Facial plethora**
* **Splenomegaly**
59
What might you find on GI exa of someone with PBC?
* **Middle aged woman**
* **Jaundice**
* **Skin hyperpigmentation**
* **Excoriations**
* **Xanthelasma**
* **Hepatomegaly**
* **Signs of chronic lvier disease**
60
how would you assess renal graft functionality?
* **Flap/excoriations**
* **Active marks in AV fistula**
* **Pale conjunctiva**
* **Fluid retention**
61
How would you assess pancreatic graft functionality on GI exam?
* **Fingertip glucose monitoring marks**
* **Insulin injection marks**
62
How would you characterise a mass/lump?
* **S**ite
* **S**ize
* **S**hape
* **C**ontours
* **C**onsitency
* **C**olour
* **T**emperature
* **T**enderness
* **T**ransillumination
