Abdominal Examination Qs Flashcards
What should you do at the start of the Abdo exam?
WIPER
What are we looking for on a General Inspection?
- Age
- Younger: IBD
- Older: Chronic Liver Disease - Confusion (Hepatic Encephalopathy)
- Jaundice (Acute Hepatitis,, Cirrhosis, Cholangitis)
- Distention (Ascites, Bowel Obstruction, Organomegaly)
- Cachexia (Muscle loss)
Upon examining the Hands, what signs are we looking for?
- Pallor
- Anaemia/GI Bleeding
- Palmar Erythema (Redness of Heel)
(Chronic Liver Disease/Pregnancy) - Koilonychia (I-D Anaemia, Crohn’s)
- Leukonychia (E-S Liver Disease)
What is the ___ Window test used for?
Schamroth’s
Clubbing
Soft-Tissue Swelling
What pathologies can lead to Asterixis?
- Type 2 Respiratory Disease
- Uraemia (Secondary to Renal Failure)
- Hepatic Encephalopathy
Upon palpating the hands, what should you be feeling for?
- Temperature
- Radial Pulse
- Dupuytren’s Contracture
What is Dupuytren’s Contracture?
Condition where your fingers (mainly ring or pinky) are permanently in a flexed position
Upon examining the arms, what are you looking for?
- Bruising: Cirrhosis (Less Factors made)
- Excoriations: Cholestatic Pruritis
- Needle Track Marks (Drugs)
What is Cholestatic Pruritis and how is it caused?
- Stoppage of Bile Flow into Duodenum
- Too much Unconjugated Bilirubin in the bloodstream
- Bile Salts deposit onto the skin and cause itching
What can you observe in the Axillae?
- Acanthosis Nigricans
(Hyperpigmentation, Hyperkeratosis - T2DM/Stomach cancer) - Hair Loss
(I-D Anaemia and Malnutrition)
What can you observe in the Eyes?
- Conjunctival Pallor (Anaemia)
- Corneal Arcus (Cholesterol buildup)
- Jaundice
- Xanthelasma
- Kayser-Fleischer Rings (Wilson’s due to Copper deposition)
What can you observe in the Mouth?
- Candidiasis (Immunosuppression)
- Central Cyanosis
- Glossitis (B12/B9/B7 Def)
- Hyperpigmented Macules (Peutz-Jegher’s Syndrome)
What can you observe in the Neck?
- Virchow’s Node (Left supraclavicular)
2. Lymphadenopathy
What can you observe in the Chest?
- Spider Naevi (Cirrhosis/Pregnancy)
- Gynaecomastia
(Oestrogen/Spironolactone/Digoxin)
What can cause Abdominal Distention?
- Fat
- Fluid
- Faeces
- Foetus
- Flatus
- Fulminant Mass
What do we call bruising in the flanks?
Grey-Turner Sign
Pancreatitis
What can cause Striae?
Pregnancy
Cushing’s
Obesity
What do you do during Palpation
- Lie them flat
- Palpate all 9 Regions
- DEEP Palpation
- Liver
What are we looking for in Palpation
- Tenderness
- Rebound Tenderness (Appendicitis)
- Guarding (Peritonitis/Appendicitis)
What condition can we see if there is Tenderness of the Liver?
Hepatitis or Cholecystitis
What condition can we see if there is Pulsatility of the Liver?
Tricuspid regurgitation
What condition can we see if there is extension of the Liver below the costal margin?
Hepatomegaly
What condition can we see if there is nodular consistency of the liver edge?
Cirrhosis
What conditions can lead to Hepatomegaly?
Hepatitis
Carcinoma
Metastasis
Leukaemia
