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Year 3 > Abdominal Examination > Flashcards

Abdominal Examination Flashcards

1
Q

Why do you ask the patient in an abdominal examination to lift the head of the bed?

A

Difficult for patients with peritonitis

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2
Q

What is Koilonychia?

What does it indicate?

A

Spoon shaped nailes

Seen in Iron-deficiency anaemia

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3
Q

What is Leukonychia?

What does it indicate?

A

Whitening of Nailbed

Indication of Hypoalbuminaemia

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4
Q

Which GI conditions might cause Clubbing?

A
  • IBD
  • Coeliac Disease
  • Liver cirrhosis
  • Lymphoma of the GI tract
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5
Q

What is A)Dupuytren’s Contracture?

What is it associated with?

A

: thickening of the palmar fascia, eventually resulting in contracture deformities of the fingers and thumb

Associated with -Alcohol related chronic liver disease

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6
Q

What is Palmar Erythema?

What is it associated with?

A

Associated with high Oestrogen

Chronic liver disease

•Normal finding in pregnancy

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7
Q

What are possible causes for Asterixis?

A
  • REsp Failure: CO2 retention
  • Kidney failure : Uraemia
  • Liver Failure: Hepatic encelopathy
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8
Q

What is an AV fistula? What does it indicate?

A

Ateriovenous fistula = connection between artery and vein

  • created in patients on haemodialysis
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9
Q

What is Acanthosis Nigricans?

What are possible causes?

A

darkening (hyperpigmentation) and thickening (hyperkeratosis) of the axillary skin

Can be

  • benign
  • Due to Insulin resistance
  • GI malignancy
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10
Q

What are Excoriation marks?

What might they indicate in an Abdnominal Examination

A

Eg. scratchmarks on arms

due to itching/pruritis – underlying cholestasis – obstructive/cholestatic jaundice - deposition of bile salts in skin leading to itching

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11
Q

What are possible GI reasons for Hairloss (e.g. at chest, arms)?

A
  1. Liver disease –> High Oestrogen
  2. Iron Deficiency Anaemia, Malnutrition
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12
Q

Why do you check the JVP in an abdominlal exam?

A

To check the fluid status

  • e.g. overload in liver failure
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13
Q

What is an important Lymphadenopathy in an GI examination?

A

Virchow’s node: Lymphnode at left supraclavicular fossa

  • Troisier’s sign if palpable
  • Might indicate Metastatic intraabdominal malignancy (mostly. gastric cancer)
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14
Q

How do you call the sign if Virchows node can be palpated?

A

Troisier’s sign

(lymphnode at left suproclavicular fossa)

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15
Q

What are possible GI reasons for Glossitis?

A

B12, Folate deficiency

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16
Q

What are possible GI reasons for Angular Stomatitis?

A

Unspecific, might indicate IBD

17
Q

Which GI conditionn is Pigmentation of the Mouth associated with?

A

GI polyps and malignancies

18
Q

Which GI conditions are Aphthous ulcers in the mouth associated with?

A

Typically benign, can be associated with iron,/folate/B12 deficiency or Crohn’s Disease.

19
Q

What are Spider Naevi an indication of ?

A

High Oestrogen

  • Normal in Pregnancy
  • Might be sing of Liver cirrhosis
20
Q

What are possible reasons for Abdominal Distensions?

A

F at

F luid

F atulence

F aecies

F Foetus

F ulminal Mass

21
Q

What might Abdominal pulsations indicate?

A
  • Aortic Aneurism
  • Normal pulsation in lean people
  • Tranmission due to pancreatic/gastric tumor
22
Q

What is Cullens sign?

A

Bruising around the umbillicus due to haemorrhagic pancreatitis

23
Q

What si Grey-Turners sign?

A

Sign of haemorrhagic pancreatitis

Bleeding into the falciform ligament

24
Q

What is Rebound tenderness a sign of?

A

This is a non-specific, unreliable clinical sign that can, in some cases, be associated with peritonitis (e.g. appendicitis

25
Q

Which characteristics of an abdominal mass should you describe?

A
  • location
  • size
  • consistency
  • mobility
  • pulsatility
26
Q

In Hepatomegaly: What would smooth vs irregular surface/edges indicate?

A
  • Carcinoma/ Metastisice
  • cirrhosis
  • cysts
  • (and many more)
27
Q

What are causes for an tender liver at abdominal palpation?

A
  • hepatitis
  • rapid liver enlargement (right heart failure, Budd-Chiari)
  • hepatocellular carcinoma (HCC)
  • hepatic abscess
  • biliary obstruction/ cholangitis
28
Q

What are possible reasons for a pulsatile liver?

A
  • tricuspid regurgitation
  • hepatocellular carcinoma
  • vascular abnormalities
  • aortic transmission
29
Q

What are possible causes for hepatomegaly?

A

Many

  • alcoholic liver disease
  • liver cirrhosis
  • hepatitis - viral, autoimmune
  • malignancy
  • Right heart failure
  • Haematological disorders (lymphoma, leukemia etc.)
30
Q

What are possible reasons for Splenomegaly?

A

Many

  • Haematological disorders
  • Portal Hypertension
  • Certain Infections
  • Rheumatological conditions
    *
31
Q

How would you percuss shifting dullness in an abdominal examination?

What does it indicate?

A

An indication of Ascitis

Percuss: umbilical region –> left or right flank

Resonant changes to dull

Roll onto their side (30 seconds)

Repeat percussion over same area

If ascites present: note will change from dull to resonant

32
Q

What abnormal findings do you listen for in auscultation of Bowel Sounds?

A

Auscultate at 2 Positions

  1. High pitched bowel sounds
    1. Bowel obstructions
  2. Abscent
    1. Ileus
    2. Peritonitis
  3. Bruits
    1. AAA
    2. RAS
    3. Hepatic neoplasm and alcoholic hepatitis
33
Q
A

Year 3 (52 decks)

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