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Year 6 > Abdominal Examination > Flashcards

Abdominal Examination Flashcards

1
Q

What can cause palmar erythema?

A

Chronic liver disease
+
Normal finding in pregnancy

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2
Q

What is Koilonychia?

A

Spoon-shaped nails

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3
Q

What is Leukonychia?

A

Whitening of the nail bed

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4
Q

What causes Koilonychia?

A

Iron deficiency anaemia e.g. malabsorption in Crohn’s

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5
Q

What causes Leukonychia?

A

Hypoalbuminaemia e.g. from end stage liver disease, or protein-losing nephropathy

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6
Q

What are the causes of clubbing in abdo exam?

A
  1. IBD
  2. Coeliac disease
  3. Liver cirrhosis
  4. Lymphoma of the GI tract
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7
Q

How long do the arms need to be out to check for asterixis?

A

30 seconds

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8
Q

What are the possible causes of asterixis?

A
  1. Heptatic encephalopathy (due to hyperammonaemia)
  2. Uraemia secondary to renal failure
  3. Co2 retention secondary type 2 resp failure
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9
Q

What is Dupuytren’s contracture?

A

Thickening of the palmar fascia

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10
Q

What are the RF for developing Dupuytren’s contracture?

A 
Genetics 
Excessive alcohol use 
Increasing age 
Male gender
Diabetes
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11
Q

What is acanthosis nigricans?

A

Darkening (hyperpigmentation) and thickening (hyperkaratosis) of the axillary skin

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12
Q

What is associated with acanthosis nigricans?

A 
Benign (in dark-skinned people
Insulin resistance (T2DM) 
GI malignancy (most commonly stomach cancer)
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13
Q

What causes axillary hair loss?

A

Iron deficiency anaemia

Malnutrition

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14
Q

What can angular stomatitis mean in abdo exam?

A

GI malignancy

Malabsorption

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15
Q

What causes glossitis?

A

Iron deficiency
B12 deficiency
Folate deficiency
e.g. from malabsorption secondary to IBD

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16
Q

What are aphthous ulcers?

A

round or oval ulcers on the mucous membranes inside the mouth

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17
Q

What causes aphthous ulcers?

A
  1. benign e.g. due to stress or mechanical trauma
  2. iron, b12, folate def
  3. Crohn’s disease
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18
Q

What is the importance of Virchow’s node?

A

It receives lymphatic drainage from the abdominal cavity and therefore is one of the first clinical signs of metastatic intra-abdominal malignancy (most commonly gastric cancer)

19
Q

Where is Virchow’s node?

A

Left supraclavicular fossa

20
Q

What is the importance of the right supraclavicular lymph node in abdo exam?

A

It receives lymphatic drainage from the thorax and so can indicate metastatic oesophageal cancer

21
Q

What causes spider naevi?

A

high circulating levels of oestrogen (same for gynaecomastia)

  • Liver cirrhosis
  • normal finding in pregnacy
  • COCP
22
Q

How many spider naevi are need to be more inclined to a pathological cause such as liver cirrhosis?

A

> 5

23
Q

What medications cause gynaecomastia?

A

Spironolactone

Digoxin

24
Q

What is Cullen’s sign?

A

Bruising of the tissue surrounding the umbilicus associated with haemorrhagic pancreatitis

25
Q

What is Grey tuner’s sign?

A

bruising in the flanks assocaited with haemorrhagic pancreatitis

26
Q

If a stoma is present what should you assess?

A
  1. Location
  2. Contents
  3. Consistency of stool
  4. Spout r
27
Q

What is rebound tenderness?

A

When you press down slowly but release rapidly, you get pain

28
Q

What is rebound tenderness associated with?

A

Peritonitis e.g. appendicitis

29
Q

What is guarding?

A

Involuntary tension inthe abdo muscles on palpation

30
Q

What is guarding associated with?

A

Peritonitis e.g. appendicitis and diverticulitis

31
Q

What is Rovsing’s sign?

A

Palpation of the LIF causes pain on the RIF

32
Q

If a mass is found on deep palpation what characteristics should you assess?

A 
Location 
Size and shape 
Consistency 
Mobility 
Pulsatiliy (vascular pathology e.g. AAA)
33
Q

What are causes of hepatomegaly?

A

Hepatitis
Malignancy: HCC or mets
PBC
Metabolic: Wilsons and haemochromatosis

34
Q

How do you elicit Murphy’s sign?

A

Position fingers at the right costal margin in the mid-clavicular line at the liver’s edge and ask the patient to take a deep breath in
- if the patient suddenly stops mid-breath due to pain - then it is positive

35
Q

What does Murphy’s sign detect?

A

Cholecystitis

36
Q

What are the causes of splenomegaly?

A
  1. Portal HTN secondary to liver cirrhosis
  2. Haemolytic anaemia
  3. Congestive HF
  4. Splenic metastases
  5. Glandular fever
37
Q

What are causes of enlarged kidneys?

A 
Bilateral 
1. PKD 
2. Amyloidosis 
Unilateral 
1. Renal tumour
38
Q

When you palpate the aorta how should your hands move in healthy individuals and how do they move in AAA?

A

Healthy - superiorly (upwards towards the head)

AAA - they move outwards - it is an expansile mass

39
Q

What 3 types of bowel sounds are there?

A

Normal
Tinkling
Absent

40
Q

What does tinkling vs absent bowel sounds suggest?

A 
Tinkling = osbtruction 
Absent = ileus (loss of peristaltic motion of the bowel)
41
Q

What are causes of ileus?

A

Electrolyte abnormalities

Recent abdo surgery

42
Q

How long do you need to assess for to conclude absent bowel sounds?

A

3 minutes

43
Q

How do you complete an abdo exam?

A
  1. Check Hernial orifices (if there are signs of bowel obstruction)
  2. DRE (if suspect GI bleeding)
  3. Examine the external genitalia
44
Q

Why do you examine the external genitalia in abdo exam?

A

To rule out testicular torsion which can be referred abdo pain
To rule out Indirect inguinal hernia

Year 6 (18 decks)

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