Data - Gastrointestinal

Question 1

Signs of GI disease in the hands?

Answer 1

Clubbing
Koilonychia
Leukonychia (liver disease)
Palmar erythema (liver disease)
(and asterixis)

Question 2

Proper name for dry mouth

Answer 2

Xerostomia

Question 3

Proper name for altered taste sensation

Answer 3

Dysgeusia

Question 4

Proper name for foul taste sensation

Answer 4

Cacageusia

Question 5

Proper name for fatty pale greasy stools

Answer 5

Steatorrhoea

Question 6

Proper name for rectal bleeding

Answer 6

Haematochezia

Question 7

Dyspepsia relieved by meals?

Answer 7

Duodenal ulcer

Question 8

Dyspepsia worse 15-30 mins after eating?

Answer 8

Gastric ulcer

Question 9

Pain on swallowing?

Answer 9

Odynophagia

Question 10

Tongue appearance in Fe deficiency?

Answer 10

Atrophic glossitis (smooth, pale tongue)
(and angular chelitis)

Question 11

Tongue appearance in B12/folate deficiency?

Answer 11

Beefy, red tongue.

Question 12

Left supraclavicular lymphadenopathy?

Answer 12

Virchow’s node
Troisier’s sign
Sign of metastatic abdominal malignancy

Question 13

Cause of palmar erythema and spider naevi?

Answer 13

Excess oestrogen, not being broken down by liver.

May be present in pregnant women.

Question 14

Leukonychia pathology?

Answer 14

Hypoalbuminaemia,

loss of proteins (malabsorption, protein losing-enteropathy)

Question 15

Mousy odour of breath?

Answer 15

Fetor hepaticus - due to dimethyl sulphide - portosystemic shunting

Question 16

Draw and name abdominal surgical scars [7]

Answer 16

Upper midline
Kocher's - right subcosttal
Paramedian
Lower midline
Appendicectomy
Pfannenstiel
Inguinal

Question 17

Inflamed gallbladder - pain and arrest of inspiration on palpation?

Answer 17

Murphy’s sign

Question 18

Direct vs indirect inguinal hernia?

Answer 18

Direct: doesn’t follow inguinal canal
Indirect: follows inguinal canal - 85% all inguinal hernias

Question 19

Signs of strangulated hernia?

Answer 19

Tense and tender hernia
No cough impulse
Later:
Bowel obstruction
Shock, sepsis

Question 20

Name for infected fallopian tube?

Answer 20

Salpingitis

Question 21

Bruising and subcutaneous oedema around umbilicus, name and cause?

Answer 21

Cullen’s sign:
Ruptured ectopic
Aortic rupture
Acute pancreatitis

Question 22

Pain in left iliac fossa produces pain in right iliac fossa?

Answer 22

Rovsing’s sign - acute appendicitis

Question 23

How to separate internal and external haemorrhoids?

Answer 23

Pectinate line - embryological end of hind gut, lots of separate things, vascular, lymphatic drainage etc