Gastrointestinal Flashcards
Summarise what you are looking for on general inspection?
Abdominal swelling Obvious signs of smoking A drip Tube feeding (NG or IV) Cartons of food lying around Any medicines How patient generally looks - large/small body habitus?
Five Fs of abdominal swelling?
Fat Flatus Fluid Faeces Foetus
Summarise what looking for on inspection of hands?
Tattoos Clubbing Koilonychia Leuxonychia Beau's lines Terry's nails Dupyten's contracture Spider naevi Bruising Oedema Jaundice
GI causes of clubbing?
UC, Crohn’s, coeliac disease
What is koilonychia? What causes it?
Spoon shaped nails - sign of iron deficiency anaemia
What is leuconychia? What causes it?
White nails.
Sign of hypoalbuminaemia, and hence liver failure
What are Beau’s lines? What causes it?
White lines across nails (not raised). Sign of acute illness.
What are Terry’s nails? What is it a sign of?
‘Ground glass’ appearance. Can be a sign of liver or renal failure.
What is Dupytens contracture? What is it associated with?
When finger is vent towards palm of hands, palmar aponeurosis may be hard and tight.
Associated with alcoholic liver disease.
What are spider naevi? What is it associated with?
Little vascular raised things on the skin that blanch on pressure. Found anywhere drained by SVC - face, forearms, trunk.
Associated with any condition that causes increased circulating oestrogen eg cirrhosis or pregnancy.
What might bruising be associated with?
Chronic liver disease
What are the liver dependent clotting factors?
2, 7, 9 and 10
Summarise what looking for in the mouth?
Lips - angular stomatitis Gums - damage/inflammation/hypertrophy Teeth Candida Glossitis Ulceration Leukoplachia Anaphylaxis Cheeks Pigmentation around lips
What is angular stomatitis a sign of?
Iron deficiency anaemia or dehydration
When may gums be hypertrophied?
When being treated with cyclosporin or some epilepsy drugs
Teeth may lose enamel due to what?
Chronic gastric reflux/vomiting
Difference between candida and normal tongue covering?
Candida can’t be scraped off
Glossitis is a sign of what?
Iron deficiency anaemia
How does glossitis appear?
Smooth shiny and red
Ulceration may arise from what?
Ill-fitting dentures
What is leukoplachia?
White, hairy plaque on tongue
What is leukoplachia a sign of?
Pre-malignancy
What is anaphylaxis?
Rapid swelling of tongue due to hypersensitivity reaction
What is pigmentation around the lips a sign of?
Peutz-jegher’s syndrome. (Leads to polyp formation in digestive tract - high cancer risk)
How do you check for jaundice in the eyes?
Ask patient to look at floor and lift up their top eyelids.