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Z Year3 Clinical Examinations > Abdominal Examination 2 > Flashcards

Abdominal Examination 2 Flashcards

1
Q

What do you look for on the axillae?

A
  1. acanthosis nigricans

2. hair loss

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2
Q

What is acanthosis nigricans?

A

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

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3
Q

What is acanthosis nigricans associated with?

A
  1. benign
  2. insulin resistance
  3. GI malignancy (stomach cancer)
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4
Q

What is loss of axillary hair associated with?

A
  1. iron deficiency anaemia

2. malnutrition

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5
Q

What do you look for in the eyes?

A
  1. conjunctival pallor
  2. jaundice
  3. corneal arcus
  4. xanthelasma
  5. Kayser-Fleischer rings
  6. Perilimbal injection
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6
Q

What could conjunctival pallor suggest?

A

underlying anaemia

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7
Q

What would corneal arcus in under 50years suggest?

A

hypercholesterolaemia

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8
Q

What is xanthelasma associated with?

A

hypercholesterolaemia

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9
Q

What are kayser-fleischer rings?

A

dark rings that encircle the iris

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10
Q

What are kayser-fleischer rings assoicated with?

A

Wilson’s diases (abnormal copper processing by the liver, resulting in accumulation and deposition in various tissues (including the liver causing cirrhosis)

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11
Q

What is perilimbal injection?

A

inflammation of the area of conjunctiva adjacent to the iris

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12
Q

What is perilimbal injection a sign of?

A

sign of anterior uveitis, which can be associated with inflammatory bowel disease

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13
Q

What do you look for in the mouth of a patient?

A
  1. angular stomatitis
  2. glossitis
  3. oral candidasis
  4. aphthous ulceration
  5. hyperpigmented macules
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14
Q

What can cause angular stomatitis?

A

iron deficiency (e.g. gastrointestinal malignancy, malabsorption)

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15
Q

What is glossitis?

A

smooth erythematous enlargement of the tongue

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16
Q

What is glossitis associated with?

A

iron, B12 and folate deficiency (e.g. malabsorption secondary to inflammatory bowel disease).

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17
Q

What is oral candidasis associated with?

A

immunosuppression

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18
Q

What is aphthous ulceration?

A

round or oval ulcers occurring on the mucous membranes inside the mouth

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19
Q

What is aphthous ulceration associated with?

A
  • benign (stress, mechanical trauma)
  • iron, B12, folate deficiency
  • Crohn’s disease
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20
Q

What are hyperpigmented macules a sign of?

A

athognomonic for Peutz-Jeghers syndrome

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21
Q

What is Peutz-Jeghers sydnromes?

A

autosomal dominant genetic disorder that results in the development of polyps in the gastrointestinal tract

22
Q

When is Virchow’s node felt?

A

metastatic intrabdominal malignancy (gastric cancer)

23
Q

What do you look for on the patient’s chest?

A
  1. spider naevi
  2. gynaecomstia
  3. hair loss
24
Q

What are spider naevi?

A

skin lesions that have a central red papule with fine red lines extending radially caused by increased levels of circulating oestrogen

25
Q

What pathology is spider naevi found in?

A
  1. liver cirrhosis (more than 5)

2. Normal if pregnancy or on combined pull

26
Q

What is gynaecosmastia?

A

enlargement of male breast tissue caused by increased levels of circulating oestrogen

27
Q

What can cause gynaecosmastia?

A
  1. liver cirrhosis
  2. digoxin
  3. spironolactone
28
Q

What can cause hair loss on abdomen?

A
  1. increased level of circulating oestrogen

2. general malnourishment

29
Q

What are you looking for on abdominal inspection?

A
  1. scars
  2. abdominal distension
  3. caput medusa
  4. striae (strech marks)
  5. hernias
  6. Cullen’s sign
  7. Grey-Turner’s sign
30
Q

What can abdominal distension be caused by?

A
  1. fat
  2. fluid
  3. flatus
  4. faeces
  5. fetus
  6. fucking big mass
31
Q

What is caput medusae?

A

engorged paraumbilical veins associated with portal hypertension

32
Q

When may you see caput medusae?

A

liver cirrhosis

33
Q

When may you see striae?

A
  1. ascites
  2. intrabdominal malignancy
  3. Cushing’s syndrome
  4. obesity
  5. pregnancy
34
Q

How can you see hernias?

A

ask the patient to cough and observe for any protrusions through the abdominal wall (e.g. umbilical hernia, incisional hernia)

35
Q

What is Cullen’s sign and what does it mean?

A

bruising of the tissue surrounding the umbilicus associated with haemorrhagic pancreatitis (a late sign)

36
Q

What is Grey-Turner’s sign? What does it mean?

A

bruising in the flanks associated with haemorrhagic pancreatitis (a late sign)

37
Q

If a stoma is present what do you comment on?

A
  1. location
  2. contents
  3. consistency of stool
  4. spout
38
Q

What stomas are usually in the left iliac fossa?

A

colostomies

39
Q

What stomas are usually in the right iliac fossa?

A

ileostomies and urostomies

40
Q

What can the contents of stomas be?

A
  1. stool (colostomy or ileostomy)

2. urine (urostomy)

41
Q

What are the different consistency of stool in a stoma?

A
  1. liquid (ileostomy)

2. solid (colostomy)

42
Q

Which stomas have a spout?

A

ileostomies and urostomies (not colostomies)

43
Q

What condition has rebound tenderness?

A

non-specific but peritonitis e.g. appendicitis

44
Q

When may patient be guarding?

A

peritonitis (appendicitis and diverticulitis)

45
Q

What is Rovsing’s sign?

A

palpation of the left iliac fossa causes pain to be experienced in the right iliac fossa

46
Q

What is Rovsing’s sign shown for?

A

unreliable - appendicitis but best indicates peritoneal inflammation of any cause affecting the left and/or right iliac fossa.

47
Q

If you find a mass during palpitation what do you mention?

A
  1. Location
  2. size and shape
  3. consistency
  4. mobility
  5. pulsatility
48
Q

If you can feel the liver edge what should you comment on?

A
  1. degree of extension below the costal margin

2. consistency of live

49
Q

What does it mean if the costal margin is greater than 2cm?

A

hepatomegaly

50
Q

What would a nodular consistency of the liver edge suggest?

A

cirrhosis

51
Q

What would hepatic tenderness suggest?

A

hepatitis or cholecystitis (as you may be palpating the gallbladder)

52
Q

What is pulsatile hepatomegaly associated with?

A

tricuspid regurgitation

Z Year3 Clinical Examinations (33 decks)

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