gastrointestinal and DRE Flashcards

1
Q

how should you describe the prostate

A
overall size and shape
surface
consistency
firm or hard
prescence of median sulcus
comparison of the size of the two lobes
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2
Q

in what condition might the median sulcus be lost

A

prostatic carcinoma

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3
Q

what may be seen when the perianal area is inspected

A
haemorrhoids
bleeding 
soiling
fissures
fistulae
erythema 
warts
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4
Q

what do you look for on general examination

A
discomfort
distension
colour 
muscle wasting
scratch marks
spider naevi
tattoos
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5
Q

what is Cullen’s sign

A

Ecchymosis around the umbilicus

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6
Q

what is Grey Turner’s sign

A

ecchymosis in flanks

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7
Q

where might tumours of the lower GI tract metastasis to

A

left posterior cervical triangle in the angle between sternocleidomastoid and the clavicle

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8
Q

what is asterixis a sign of

A

metabolic encephalopathy e.g. chronic renal failure, severe congestive heart failure, acute respiratory failure and commonly in decompensated liver failure.

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9
Q

what should you do when palpating

A

sit or kneel by the bed

look at the patient

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10
Q

how do you assess for shifting dulness

A
percuss towards the patients left side
ask patient to roll towards you 
wait ten secs
percuss where dulness was heard
if now resonant it suggests fluid in the abdomen
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11
Q

where do you listen for bowel sounds

A

either side of umbilicus

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12
Q

where do you listen for aortic bruits

A

above umbilicus

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13
Q

where do you listen for renal bruits

A

above and lateral to the umbilicus

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14
Q

what mnemonic can be used to remember GI causes of clubbing

A
4 Cs
cirrhosis
ulcerative colitis
crohn's diseaes
coeliac disease
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15
Q

what mnemonic can be used to remember stigmata on the hands

A
Cs
clubbing
leukonichia 
koilonychia 
palmar erythema
dupuytren's contracture
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16
Q

what is the main feature of a squamous cell carcinoma

A

painless non healing ulcer

17
Q

what should you do in the mouth

A

say ahh and look at tonsils

18
Q

what are the five Fs of distension

A

fluid, fat foetus, flatus and faeces

19
Q

what hormone problem can cause striae

A

cushing’s

20
Q

what is murphys sign

A

intense pain when palpating the gallbladder in inspiration- indication acute cholecystitis

21
Q

what part of the stethoscope should be used for auscultation

A

bell- aorta

diaphragm- bowel sounds

22
Q

what are some gastrointestinal causes of clubbing (4 Cs)

A

malabsorption e.g. coeliac disease
crohns and uc
cirrhosis

23
Q

what might xanthelasma suggest

A

cholestasis

24
Q

what does telangiectasia do

A

may cause severe bleeding in the gut

25
Q

where do you start palpation

A

right hypochondrium and go clockwise