Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OSCE > Examination - Abdominal > Flashcards

Examination - Abdominal Flashcards

1
Q

What are the five F’s that can cause ascites?

A 
Flatus
Faeces
Foetus
Fat
Fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the main differential of a swollen abdomen with jaundice?

A

CLD - may have signs of decompensation

Transplant failure - rooftop scar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the signs of chronic liver disease?

A

GENERAL

  • Cachexia
  • Jaundice
  • Excoriciations
  • Bruiding
  • Lack of axillary hair

HANDS

  • Dupuytren’s contracture
  • Palmar erythema
  • Clubbing

FACE

  • Icteric sclera
  • Parotid swelling

Abdomen

  • Spider naevi
  • Hepatomegaly/splenomegaly
  • Ascites
  • Gynaecomastia
  • Caput medusae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes spider naevi?

A

Anything that results in a rise of oestrogen e.g. CLD, pregnancy, gynaecomastia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the causes of Dupuytren’c contracture?

A 
Trauma
Alcoholic liver disease
Valproate 
Manual labour 
Peyronie's
Epilepsy 
DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What could be causing CLD in a patient with needle marks or a tattoo?

A

Hep C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What could be causing CLD in a patient with parotid swelling?

A

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What could be causing CLD in a patient with a bronzed complexion or insulin injection sites?

A

Haemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What could be causing CLD in a patient with obesity/diabetes?

A

Non-alcoholic fatty liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What could be causing CLD in a patient with xanthelasma?

A

Cholestatic disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does asterixis (flapping tremor) indicate in chronic liver disease patients?

A

Hepatic encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the causes of chronic liver disease?

A

INFECTIVE

  • Hep B
  • Hep C

TOXIC
- Alcohol

METABOLIC

  • Non-alcoholic fatty liver disease
  • Haemochromatosis
  • Alpha-1-antirtypsin deficiency
  • Wilson’s disease

AUTOIMMUNE

  • Autoimmune hepatitis
  • Primary sclerosing cholangitis
  • Primary biliary cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the common features of decompensated liver disease?

A

Decompensation happens if there is a synthetic or metabolic malfunction of the liver i.e. it can no longer compensate for the damage.

A-G of decompensated liver disease

  • Ascites
  • Bile
  • Coagulopathy
  • Vitamin D
  • Encepthalopathy [asterexis]
  • Factor deficiencies
  • GI varicies due to portal HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What blood tests would you do to help to determine the cause of chronic liver disease?

A
  • Infection –> HBV and HCV serology
  • Metabolic –> Ferritin, transferrin, A1AT, caeruloplasmin
  • Autoimmune –> immunoglobulins, autoantibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the complications of cirrhosis?

A

PORTAL HTN

  • variceal haemorrhage
  • spontaneous bacterial peritonitis due to ascitic collection being stagnant
  • thrombocytopenia

HEPATOCELLULAR FAILURE

  • encephalopathy
  • hepatocellular carcinoma
  • hypoalbuminaemia
  • coagulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the main differential for a patient with a swollen abdomen, pallor and dullness in Traube’s space?

A

Splenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of splenomegaly?

A

‘M’assive splenomegaly

  • Malaria
  • chronic Myeloid leukaemia
  • Myelofibrosis

Others

  • Spherocytosis
  • EBV
  • Portal hypertension
  • Infiltration (amyloidosis)
  • Sarcoidosis
18
Q

What are the indications for splenectomy?

A
  • Traumatic rupture
  • Idiopatthic thrombocytopenia - remove spleen as it destroys platelets
  • Spherocytosis
19
Q

What treatments are required following splenectomy?

A

Spleen helps with immunity against encapsulated organisms so you must protect against them:

  • Pneumococcus meningococcus
  • Haemophilus influenzae B

> > Penicillin V prophylaxis

20
Q

Which type of patients commonly have arterio-venous fistulas?

A

Renal patients receiving dialysis

21
Q

How do you tell if an AV fistulae is still active?

A

Needle marks
Bandages
Ask the patient

22
Q

In what situation would you get a nephrectomy scar?

A

Usually diseased kidneys are left in the body but if they are polycystic and causing obstruction, it will have been removed.

23
Q

Where can renal transplants be felt on palpation?

A

Right iliac fossa

24
Q

What kind of scar is seen in a renal transplant?

A

Oblique iliac fossa scar

25
Q

What are the indications for a renal transplant?

A

Diabetic nephropathy –> insulin injection sites
Polycystic kidney disease –> flank scars to remove cystic kidney/s
Glomerulonephritis

26
Q

What are the complications of renal transplants?

A

Rejection –> renal failure
Cushing syndrome –> due to steroids for immunosuppression
Skin malignancy –> BCC and SCC due to immnosuppression
Ciclosporin causes gum hypertrophy

27
Q

What are the signs of renal failure?

A

Cachexia
Pallor
Pulmonary and peripheral oedema
Scars - old AV fistulae, neck line, peritoneal dialysis catheters

28
Q

What are the 4 reasons someone might have a stoma?

A

IBD - young, pallor, ileostomy
Diverticulitis - elderly, colostomy
Malignancy
Urostomy

29
Q

What is the main differential for a young person with a stoma?

A

IBD

30
Q

What are the signs of IBD?

A 
Young, pale, slim patient
Oral ulcers
Erythema nodosum or pyoderma gangrenosum
Clubbing
Medications
31
Q

How do you examine a stoma?

A

(5 S’s of stomas)
> Site - R ileostomy, L colostomy
> Skin - redness/infection
> Spouting - ileostomies spout to protect the surrounding skin from acidic contents
> Sack - check the contents - urostomy?
> Stenosis - check patency/ask patient/state you would do a digital exam to check

32
Q

What are the extra-intestinal manifestations of IBD?

A

Eyes - episcleritis, posterior uveitis, scleritis
Skin - pyoderma gangrenosum, erythema nodosum
Other: clubbing, oligoarthritis, anaemia of chronic disease

33
Q

What are the complications of Crohn’s disease?

A

strictures, obstruction, fistulae

34
Q

What are the complications of ulcerative colitis?

A

toxic mega-colon, colonic carcinoma, primary sclerosing cholangitis

35
Q

What are the indications for a stoma in Crohn’s disease?

A

Failure of medical management
Obstruction
Fistulae

36
Q

What are the indications for a stoma in ulcerative colitis?

A

Failure of medical management
Toxic megacolon
Malignancy

37
Q

Which type of ileostomy is used in Crohn’s disease?

A

defunctioning (loop) ileostomy

38
Q

Which 2 types of ileostomy is used in ulcerative colitis?

A 
End ileostomy (from pan-proctocolectomy)
Diversion ileostomy, with ileal rectal pouch formation
39
Q

How common is autosomal dominant polycystic kidney disease?

A

1 in 1000

40
Q

What are the differentials of bilateral renal masses?

A
  • Autosomal dominant PKD
  • Bilateral renal cysts
  • Bilateral renal cell carcinoma
  • Bilateral hydronephrosis
  • Amyloidosis
  • Tuberous sclerosis
41
Q

Other than renal cysts, what other 3 classic features are associated with autosomal dominant PKD?

A
  • hepatic cysts
  • berry aneurysms
  • mitral valve prolapse

OSCE (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions