Clinical Examination of Abdomen/GU Flashcards

1
Q

What are the red flags for testicular cancer?

A

hard, discrete and claggy lumps (tending to form clots, sticky?)

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2
Q

What is a red flag for endometrial carcinomas?

A

post-menopausal bleeding

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3
Q

What indicates possible pancreatic cancer?

A
  • painless jaundice
  • fatty stools
    (signifies non-functioning pancreatic enzymes)
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4
Q

What are the GI causes of finger clubbing?

A

MILC

  • malabsorption
  • inflammatory bowel disease
  • lymphoma
  • cirrhosis
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5
Q

What is asterixis and what is this a sign of?

A
  • course flapping tremor

- sign of hepatic encephalopathy

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6
Q

What is leuconychia?

A

white discolouration on the nail beds

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7
Q

What are some potential findings on close inspection of the hands?

A
  • palmar erythema (sign of cirrhosis/liver disease)
  • dupuytrens contracture (alcohol excess)
  • spider naevus (liver disease esp if many)
  • purpura (low platelets associated with liver dysfunction)
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8
Q

What are some potential findings on inspection of the face and mouth?

A
  • jaundice (yellowing of skin or sclera due to excess bilirubin)
  • pale conjunctiva
  • stomatitis (inflammation of mucous membranes of lips and mouth)
  • glossitis (inflammation of tongue)
  • candidiasis (yeast infection, yellow on top of tongue)
  • telangiectasia (spider veins, can be sun damage related)
  • gingivitis
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9
Q

What are things than can be spotted on inspection of the chest and axilla?

A
  • spider naevi
  • gynaecomastia
  • loss of axillary hair
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10
Q

What should you think of if you notice your patient’s abdomen is distended?

A

5 F’s

  • fat
  • fluid
  • faeces
  • foetus
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11
Q

What are you palpating for when feeling the stomach?

A
  • tenderness:
  • guarding: upon pressure
  • rebound: after removal of pressure
  • masses
  • organomegaly
  • abdominal aorta
  • important to look at patient’s face
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12
Q

How do you palpate for hepatomegaly?

A
  • liver descends with inspiration
  • start at right iliac fossa and ask patient to breathe in and out deeply
  • palpate upwards to right costal margin and feel for liver edge
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13
Q

What are the causes of hepatomegaly?

A
  • hepatitis
  • alcohol liver disease
  • right heart failure
  • fatty infiltration
  • biliary tract obstruction
  • malignancy
  • haematological disorders
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14
Q

What is Murphy’s sign?

A
  • method for feeling for gallbladder tenderness
  • patient breathes whilst you palpate the RUQ mid clavicular line
  • on liver descent, contact with inflamed gallbladder causes tenderness and sudden arrest of inspiration
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15
Q

What is Courvoisier’s sign?

A
  • painless jaundice and a palpable gallbladder

- likely due to extrahepatic obstruction (eg. pancreatic cancer)

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16
Q

How would you palpate for splenomegaly?

A
  • spleen descends on inspiration
  • ask patient to breathe in and out deeply and palpate upwards to left hypochondrium
  • move hands between each breath
17
Q

What are some causes of splenomegaly?

A
  • haematological
  • infective
  • portal hypertension
  • rheumatological disorders
  • rare causes (sarcoidosis/amyloidosis/glycogen storage disease)
18
Q

What are some causes of renal enlargement?

A
  • hydronephrosis (swelling due to build up of urine)
  • polycystic kidney disease
  • renal cell carcinoma
  • Wilm’s tumour
  • solitary cysts
19
Q

What are some causes of ascites?

A
  • hepatic cirrhosis
  • intra-abdo malignancy
  • nephrotic syndrome
  • pancreatitis
  • constrictive pericarditis
20
Q

What are the indications for a rectal examination?

A
  • rectal bleeding
  • prostatic symptoms
  • change in bowel habits
  • possible spinal cord injury
21
Q

What is a bi-manual pelvic exam?

A

one hand palpates the vagina and the other the abdomen

22
Q

What are some indications for a pelvic exam?

A
  • pelvic pain
  • abnormal vaginal bleeding or discharge
  • possible vaginal or uterine prolapse