gastrointestinal and DRE Flashcards
how should you describe the prostate
overall size and shape surface consistency firm or hard prescence of median sulcus comparison of the size of the two lobes
in what condition might the median sulcus be lost
prostatic carcinoma
what may be seen when the perianal area is inspected
haemorrhoids bleeding soiling fissures fistulae erythema warts
what do you look for on general examination
discomfort distension colour muscle wasting scratch marks spider naevi tattoos
what is Cullen’s sign
Ecchymosis around the umbilicus
what is Grey Turner’s sign
ecchymosis in flanks
where might tumours of the lower GI tract metastasis to
left posterior cervical triangle in the angle between sternocleidomastoid and the clavicle
what is asterixis a sign of
metabolic encephalopathy e.g. chronic renal failure, severe congestive heart failure, acute respiratory failure and commonly in decompensated liver failure.
what should you do when palpating
sit or kneel by the bed
look at the patient
how do you assess for shifting dulness
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
where do you listen for bowel sounds
either side of umbilicus
where do you listen for aortic bruits
above umbilicus
where do you listen for renal bruits
above and lateral to the umbilicus
what mnemonic can be used to remember GI causes of clubbing
4 Cs cirrhosis ulcerative colitis crohn's diseaes coeliac disease
what mnemonic can be used to remember stigmata on the hands
Cs clubbing leukonichia koilonychia palmar erythema dupuytren's contracture