Abdominal Examination Flashcards
What is macroglossia? Suggest some possible causes.
An unusually enlarged tongue. It can be caused by:
- Amyloidoses
- Acromegaly
- Vascular malformations
- Muscular hypertrophy
A deficiency of which substance can result in glossitis?
Vitamin B12
Other acceptable answers were Vitamins B1-B3 and iron
Why does leukonychia occur? Suggest some conditions which can cause this.
Low albumin:
- Nephrotic syndrome
- Hepatic failure
Suggest some gastrointestinal causes of clubbing.
- Cirrhosis
- Malabsorption
- Inflammatory Bowel Disease
Why is the left supraclavicular node of particular interest in a gastrointestinal examination?
Virchow’s - gastric malignancy commonly metastasises here.
Suggest some conditions which can cause koilonychia (spooning) of the nails.
- Hypochromic anaemia (especially iron deficiency)
- Plummer-Vinson syndrome (dysphagia & oesophageal webs)
What is melena? Suggest five possible causes of melena.
- Peptic Ulcer Disease (really common as they are always bleeding)
- Malignancy (upper GI - will also be getting some haematemesis)
- Gastritis
- Oesophageal varices
- Warfarin & other anticoagulants (in excess)
Suggest some possible reasons for hepatic flap.
- Hepatic failure (build up of ammonia) - hepatic encephalopathy
- Other encepathlopathies
- Wilson’s disease
What are spider naevi? What can they indicate and what level of spider naevi qualifies for further investigation?
Small swollen blood vessels (telangiectasis) found in the region of the SVC, caused by excess oestrogen. They can be a sign of:
- Liver failure/cirrhosis (cannot metabolise ammonia - failure of urea cycle)
- OCP or HRT
Having more than 3 (in clinical practice more than 5) warrants follow up.
Given the way spider naevi form, what other sign in the same area should you look for?
Gynecomastia - spider naevi are caused by an imbalance in the level of oestrogen, as is gynecomastia.
Suggest some possible gastrointestinal causes of palmar erythema?
- Portal hypertension
- Chronic liver disease (cirrhosis, hepatitis)
Suggest four different conditions that could lead to malabsorption.
- Alcohol
- Crohn’s disease
- Ulcerative colitis
- Infective - Whipple’s disease, C. diff
What is dupuytren’s contracture? What type of GI problem could be indicated?
A fixed flexion of the fingers possibly due to liver cirrhosis.
What might visible peristalsis be a sign of?
Intestinal obstruction
Describe the different types of liver edge and
- Craggy/nodular - malignancy (metastases or hepatocellular) or cirrhosis
- Smooth - hepatitis, right-heart failure or fatty liver disease
