Ch. 1 - Intro

Question 1

ABCDs of Melanoma

Answer 1

A: Asymmetry
B: Border irregularities
C: Color variation 
D: Diameter >0.6cm
E: Evolution

Question 2

What is the Allen’s Test?

Answer 2

Patency of ulnar/radial communicating arteries

Question 3

Ballance’s sign?

Answer 3

1. Constant dullness to percussion in the L flank/ LUQ
2. Resonance to percussion in R flank

= splenic rupture/hematoma

Question 4

Barrett’s esophagus

Answer 4

Squamous to Columnar metaplasia of distal esophagus

Question 5

Battle’s sign

Answer 5

Ecchymosis over mastoid process = basilar skull fracture

Question 6

Beck’s triad

Answer 6

1. JVD
2. Hypotension
3. Distant heart sounds

Question 7

Bergman’s triad?

Answer 7

1. Mental status change
2. Petechiae (axilla/thorax)
3. Dyspnea

= fat emboli

Question 8

Blumer’s shelf?

Answer 8

Metastatic dz to rectouterine (pouch of Douglas) or rectovesical pouch creating a shelf that is palpable on rectal exam

Question 9

Boas’ sign?

Answer 9

Right subscapular pain resulting from cholelithiasis

Question 10

Borchardt’s triad?

Answer 10

1. Emesis followed by retching
2. Epigastric distention
3. Failure to pass an NGT

= gastric volvulus

Question 11

Carcinoid Triad?

Answer 11

1. Flushing
2. Diarrhea
3. Right sided heart failure
   (FDR)
   = carcinoid syndrome

Question 12

Charcot’s triad?

Answer 12

1. Fever
2. Jaundice
3. RUQ pain

= cholangitis

Question 13

Chvostek’s sign?

Answer 13

Twitching of facial muscles upon tapping the facial nerve in puts with HYPOcalcemia

CHovostek’s = CHeek

Question 14

Courvoisier’s law

Answer 14

Enlarged nontender gall bladder seen with obstruction of the common bile duct

Usually pancreatic cancer NOT gallstones

Question 15

Cullen’s sign?

Answer 15

Bluish discoloration of the periumbilical area due to retroperitoneal hemorrhage tracking around anterior abdominal wall through facial planes

Ala acute hemorrhagic pancreatitis

Question 16

Cushing’s triad?

Answer 16

1. Hypertension
2. Bradycardia
3. Irregular respirations

= increased intracranial pressure

Question 17

Dance’s sign

Answer 17

Empty right lower quadrant in children with ileocecal INTUSSUSCEPTION

Question 18

Fothergill’s sign?

Answer 18

Used to differentiate an intra-abdominal mass from one in the abdominal wall
If mass if felt while there is tension on the musculature then it is in the wall = sitting halfway upright

Question 19

Fox’s sign?

Answer 19

Ecchymosis of inguinal ligament seen with retroperitoneal bleeding

Question 20

Goodsall’s rule?

Answer 20

Anal fistulae course in a straight path anteriorly and a curved path posteriorly from midline.

(Think of a dog with a straight anterior nose and a curved posterior tail)

Question 21

Grey Turner’s sign?

Answer 21

Ecchymosis or discoloration of the flanks in patients with retroperitoneal hemorrhage as a result of dissecting blood from the retro peritoneum (hemorrhagic pancreatitis)

(TURNer’s = TURN side to side)

Question 22

Hamman’s sign/crunch?

Answer 22

Crunching sound on auscultation of the heart resulting from emphysematous mediastinum

=pneumomediastinum & Boerhaave’s syndrome

Question 23

Howship-Romberg sign?

Answer 23

Pain along the inner aspect of the thigh

=obturator hernia as the result of nerve compression

Question 24

Kehr’s sign?

Answer 24

Severe left shoulder pain in patients with splenic rupture

As a result of referred pain from diaphragmatic irritation

Question 25

Kelly's sign?

Answer 25

Visible peristalsis of the ureter in response to squeezing or retraction; used to identify the ureter during surgery

Question 26

Krukenberg tumor?

Answer 26

Metastatic tumor to the ovary Classically from gastric cancer

Question 27

Laplace's law?

Answer 27

Wall tension = pressure x radius = colon perfs preferentially at the cecum bc of the increased radius and resultant increased wall tension

Question 28

McBurney's point?

Answer 28

1/3 the distance from the anterior iliac spine to the umbilicus on a line connecting the two

Question 29

Rule of 2s for Meckel's diverticulum

Answer 29

2% of population 2% symptomatic Occur with 2 feet of ileocecal valve Male:Female 2:1

Question 30

Obturator sign

Answer 30

internal/external rotation of leg = pain = appy

Question 31

Psoas sign

Answer 31

Pt on L side, extend hip with knee in full extension = appy

Question 32

Raccoon eyes?

Answer 32

B/l black eyes as a result of basilar skull fracture

Question 33

Reynold's Pentax

Answer 33

1. Fever 2. Jaundice 3. RUQ pain 4. Mental status changes 5. Shock/sepsis (Charcot's triad +) = supperative cholangitis

Question 34

Rovsing's sign?

Answer 34

Palpation of LLQ resulting in pain in RLQ = appy

Question 35

Saint's triad

Answer 35

1. Cholelithiasis 2. Hiatal hernia 3. Diverticular dz

Question 36

Silk glove sign?

Answer 36

Indirect hernia sac in a pediatric pt Feels like a finger of a silk glove when rolled under the examining finger

Question 37

Sister Mary Joseph's sign

Answer 37

Metastatic tumor to umbilical lymph node Aka Sister Mary Joseph Node

Question 38

Virchow's triad?

Answer 38

1. Stasis 2. Enothelial injury 3. Hypercoagulability

Question 39

Trousseau's sign?

Answer 39

Carpal spasm after occlusion of blood to the forearm with BP cuff in pts with HYPOcalcemia

Question 40

Valentino's sign?

Answer 40

RLQ pain from a perforated peptic ulcer d/t succus/pus draining into RLQ

Question 41

Westermark's sign?

Answer 41

Decreased pulmonary vascular markings on CXR in a pt with pulmonary embolus

Question 42

Whipple's triad?

Answer 42

Evidence for insulinoma 1. Hypoglycemia <50 2. CNS and vasomotor sxs ( syncope, diaphoresis) 3. Relief of sxs with administration of glucose