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Y1 GI > Clinical Skills > Flashcards

Clinical Skills Flashcards

1
Q

What is koilonychia a sign of?

A

iron deficiency, haemochromatosis, infection, endocrine disorders, malnutrition

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2
Q

what is koilonychia?

A

spoon shaped nails

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3
Q

What is clubbing a sign of in respect of GI?

A

cirrhosis, IBD, GI lymphoma, Malabsorption

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4
Q

Palmar erythema is a sign of what in GI?

A

liver cirrhosis

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5
Q

significant past MH in GI history?

A

peptic ulcers, carcinoma, jaundice, hepatits, blood transfusions, tattoos, previous operations, last menstrual period, dietary changes

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6
Q

significant drug history in GI history?

A

NSAIDs, steroids, antibiotics

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7
Q

significant FH in the GI history?

A

IBS, IBD, peptic ulcer disease, polyps, cancer, jaundice

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8
Q

Questions to ask regarding nausea/vomiting?

A

timing, content, relation to meals, amount

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9
Q

Questions to ask regarding haematemesis?

A

frequency, fresh (red or dark), neoplasia (weight, dysphagia, pain), NSAIDs, warfarin, surgery, smoking

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10
Q

Questions to ask regarding dysphagia?

A

level, onset, intermittent, progressive, painful swallow

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11
Q

Questions regarding changes in bowel habit?

A

timing, consider neoplasia (weight loss, dysphagia, pain, melaena)

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12
Q

Questions regarding rectal bleeding?

A

pain, mucus, fresh dark/black, mixed with stool, on surface, on paper, in the pan?

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13
Q

Questions regarding jaundice?

A

pruritis, dark urine, pale stools

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14
Q

Questions regarding weight change and appetite?

A

deliberate, quantify, dysphagia, pain

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15
Q

What is melaena?

A

black, tarry faeces

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16
Q

what is pruritis?

A

itch

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17
Q

Common causes of GI vomiting (7)

A

gastroenteritis, peptic ulceration, pyloric stenosis, intestinal obstruction, paralytic ileus, acute cholecystits, acute pancreatitis

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18
Q

Pain in the epigastric region may indicate?

A

pancreatitis, gastritis, duodenitis, peptic ulcer, gallbladder disease, aortic aneurysm

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19
Q

Pain in the LUQ may indicate?

A

Peptic ulcer, gastric or colonic cancer, splenic rupture, subphrenic or perinephric abscess, renal colic or pyelonephritis

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20
Q

Pain in the RUQ may indicate?

A

cholecystitis, biliary colic, hepatitis, peptic ulcer, colonic cancer, renal colic or pyelonephritis, subphrenic, perinephric abscess

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21
Q

Pain in the loin may indiacte?

A

renal colic, pyelonephritis, renal tumour, perinephric abscess

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22
Q

Pain in the LIF may indicate?

A

diverticulitis, volvulus, colon cancer, pelvic abscess, IBD, hip pathology, renal colic, UTI, cancer in undescended testis, zoster, torsion of ovarian cyst, ectopic pregnancy

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23
Q

Pain in the RIF may indicate?

A

Appendicitis, Chrons ileitis, diverticulitis, volvulus, colon cancer, pelvic abscess, IBD, hip pathology, renal colic, UTI, cancer in undescended testis, zoster, torsion of ovarian cyst, ectopic pregnancy

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24
Q

Pain in the Pelvic region may indicate?

A

UTI, retention, stones, menstruation, pregnancy, endometriosis endometritis, ovarian cyst torsion

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25
Q

Generalised Pain in GI may indicate?

A

Gastroenteritis, IBS, peritonitis, constipation

26
Q

Central Pain in GI may indicate?

A

mesenteric ischaemia, abdominal aneurysm, pancreatitis

27
Q

MI referred pain may go to…

A

the epigastric region or pleura

28
Q

The five Fs of abdominal distension

A

Fat, Fluid, Faeces, Flatus, Fetus

29
Q

Flatus will be ____ to percussion

A

resonant

30
Q

Fluid will be _____ to percussion

A

dull

31
Q

Steatorrhoea is…

A

pale stools that are difficult to flush due to high fat content

32
Q

Causes of steatorrhoea are…

A

ileal disease, pancreatic disease, obstructive jaundice,

33
Q

Tenesmus is…

A

a feeling of incomplete emptying after defacation

34
Q

Causes of tenesmus are…

A

IBS but can be caused by tumours

35
Q

Halitosis is…

A

oral malodour

36
Q

Halitosis is the result of…

A

gingivitis, metabolic activity of bacteria in plaque

37
Q

Contributing factors of halitosis?

A

smoking, drugs, lung disease, hangovers

38
Q

General inspection of GI patient involves looking for?

A

vomit, stoma, jaundic, pale, BMI, scars on abdomen

39
Q

On the hands look for (8)

A

clubbing, koilonychia, leuconychia, meuhrckes lines, palmar erythema, dupuytrens contracture, pigmentation of palmar creases, asterixis

40
Q

Where will spider naevi be found?

A

arms, upper chest, upper back

41
Q

On the neck inspect and feel for?

A

lymph nodes, JVP, tricuspid regurgitation, tunnelled haemodialysis lines

42
Q

Why might JVP be raised in GI patient?

A

fluid overload, due to renal or liver dysfunction

43
Q

Why is tricuspid regurgitation relevant in GI patients?

A

can cause pulsatile hepatomegaly

44
Q

What signs are looked for in the eyes of GI patients?

A

jaundice, conjunctival pallor, Kayser-Fleischer rings, xanthelasma, sunken eyes

45
Q

What signs are looked for in the mouth of GI patients?

A

angular stomatisis, pigmentation, telangiectasia, ulcers, glossitis

46
Q

What are Kayser-Fleischer rings?

A

dark rings that encircle the iris, copper deposition due to liver diseases

47
Q

What might sunken eyes in a patient indicate?

A

dehydration

48
Q

What is angular stomatisis?

A

inflammation of the corners of the mouth

49
Q

What is telangiectasia?

A

spider veins

50
Q

what is glossitis?

A

soreness and redness of the tongue, can indicate depappilation

51
Q

before palpating the abdomen what should be asked?

A

if there is any tender areas

52
Q

You avoid palpating tender areas first, why?

A

patient will tense and thus cause difficulty in palpating the rest of the abdomen

53
Q

Which organs should you be able to percuss (GI)?

A

liver, spleen, bladder if enlarged

54
Q

What should be auscultated in GI patients?

A

bowel sounds, aortic and renal bruits

55
Q

what is leuconychia?

A

whitening of the nails due to hypoalbuminaemia

56
Q

What are Muehrchkes lines?

A

transverse white lines due to hypoalbuminaemia

57
Q

what are blue lanulae?

A

blueish discolouration of hands due to Wilsons disease

58
Q

What is dupuytrens contracture?

A

thickening and fibrous contraction of palmar fascia

59
Q

What causes dupuytrens contracture?

A

alcoholic liver disease

60
Q

What causes hepatic flap?

A

hepatic encephalopathy, uraemia from renal disease

61
Q

causes of hepatomegaly

A

malignancy, hepatic congestion, RHF, glandular fever, hepatitis, malaria, schistomiasis, amoebic disease, leukaemia, lymphoma, sickle cell, haemolytic disease, fatty liver, amylodosis

Y1 GI (5 decks)

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