Examination signs Flashcards
Increased body/facial hair
Ciclosporin
PCOS
Telangiectasia
Osler-Weber-Rendu
Perioral freckling
Peutz Jeghers
Cafe au lait spots
NF1
Finger clubbing
CF
Liver disease
IBD
Coeliac diseae
Koilonychia
Iron deficiency anaemia
Leuconychia
Cirrhosis
Palmar erythema
Chronic liver disease
Hepatic flap
Liver failure
Renal failure
CO2 retention
Tendon xanthomas
Hypercholesterolaemia
Facial plethora
Chronic liver disease
Aphthous ulcers
Crohn’s/UC
Coeliac
Behcet’s disease
Gum hypertrophy
Myeloid leukaemia
Ciclosporin
Phenytoin
Macroglossia
Down syndrome Hypothyroidism Beckwith-Wiedemann Mucopolysaccharidoses Glycogen storage disease Amyloid Haemangioma Lymphangioma
Glossitis
Iron, folate or B12 deficiency
5Fs of an abdominal mass
Faeces Flatus Fat Fluid Foetus
Scar below right subcostal margin
Kocher’s incision
Cholecystectomy
Any liver procedure
Rooftop scar
Liver transplant
Transverse upper abdominal incision
CDH repair
Upper abdominal midline incision
Nissen’s fundoplication
Small right upper transverse incision
Ramstedt’s pyloromyotomy
Bloodflow in caput medusae
Flows away from umbilicus
Main examination features of portal hypertension
Splenomegaly
Ascites
Portosystemic shunts: caput medusae, haemorrhoids, oesophageal varices
Causes of portal hypertension
Prehepatic: portal vein thrombosis, postnatal umbilical vessel catheterisation, sepsis
Hepatic: cirrhosis, congenital hepatic fibrosis
Posthepatic: Budd-Chiari, heart failure
Causes of hepatomegaly
Structural: biliary atresia, choledochal cyst, fibrosis
Storage/metabolic diseases
Haematological: haemoglobinopathies, leukaemia
Heart/vascular: congestive heart failure, constrictive pericarditis, obstructive IVC, Budd-Chiari
Infection
Causes of splenomegaly
Haematological: leukaemia, haemoglobinopathy Infection: Endocarditis, TB, parasites Inflammation: SLE, rheumatoid, ITP, sarcoid Portal hypertension Amyloidosis Gaucher Niemann Pick Tropical splenomegaly
Causes of ascites
Cirrhosis Congestive heart failure HYpoalbuminaemic states TB Malignancy Hepatic vein thrombosis Meigs syndrome Pancreatitiss
Main dysmorphic syndromes to look for in cardio exam
Down Williams DiGeorge Turner's Noonan's
Absent radii
VACTERL
Absent thumb
Holt-Oram
Thrill at suprasternal notch
Aortic stenosis
Raised JVP
Right heart failure, fluid overload
Harrison sulcus
Increased pulmonary bloodflow
Asthma
Right thoracotomy scar
Cardiac: BT shunt, PA banding
Non cardiac: lung, oesophageal or CDH surgery
Midline sternotomy scar
Complex cardiac surgery
Any bypass surgery
PA banding
Left thoracotomy scar
Cardiac: BT shunt, PA banding, PDA ligation, coarctation repair
Non cardiac: lung surgery
Apex displaced to the left
Cardiomegaly
Pectus excavatum
Scoliosis
Apex displaced to right
Dextrocardia e.g. Kartagener’s
Left diaphragmatic hernia
Collapsed lung on right
L pleural effusion or pneumothorax
Thrill at lower left sternal edge
VSD
Thrill at upper left sternal edge
Pulmonary stenosis
ESM at ULSE
Pulmonary stenosis
ASD
Innocent murmur
ESM at RUSE
Aortic stenosis
Continuous at RUSE
Right BT shunt
Pansystolic murmur at apex
Mitral regurgitation
VSD
Late systolic murmur at apex
Mitral valve prolapse
Ejection systolic murmur at apex
Aortic stenosis
Mid diastolic murmur at apex
Mitral stenosis
Pansystolic murmur at LLSE
Tricuspid regurgitation
VSD
Diastolic murmur at LLSE
Tricuspid stenosis
Aortic regurgitation
Systolic murmur at back:
Coarctation, peripheral pulmonary stenosis
Continuous murmur at back
PDA
Where does Still’s murmur occur?
LLSE
Murmur radiating to the back and axilla
Pulmonary stenosis
Murmur radiating to left axilla only
Mitral regurgitation
How to differentiate between aortic stenosis and pulmonary stenosis?
Louder in expiration - left heart disease = aortic stenosis
Louder in inspiration - right heart disease = pulmonary stenosis
Champagne bottle leg and high foot arch
HSMN type 1/charcot marie tooth
Pronator drift
Weakness
Cerebellar lesion if upward
