Brainscape's Knowledge GenomeTM

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


See full index

OSCEs > GI > Flashcards

GI Flashcards

1
Q

what questions should be asked in the presenting complaint of a GI history?

A

weight alteration; how much
energy levels; fatigue?
dysphagia; food, liquids, getting worse?
dyspepsia; indigestion, acidic, waster brash, sour taste, bloating
nausea/vomiting; frequency, content, blood, bright red, coffee grounds
abdominal pain; SOCRATES
abdominal swelling; timing
bowels; diarrhoea, sluggish motions, watery, timing, nocturnal, constipation, frequency, alterations
tenesmus
blood PR; fresh, dark, black, separate, mixed, volume, mucous, pus

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

what are the causes of weight loss?

A

problems of digestion and absorption
malignancy
hyperthyroidism

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

what are the causes of dysphagia?

A

neuromuscular; liquids more than solids, choking due to aspiration
stricture; solids more than liquids
progressive; stricture due to tumour

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

what are the causes of haematemesis and melaena?

A

peptic ulcers
gastric erosions
oesophagitis
may be associated with taking aspirin or anti-inflammatory drugs

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

describe the pain coming from hollow viscera

A

colic
crampy/paroxysmal
often poorly localised
related to peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe the pain from peritoneal irritation

A 
more ominous
associated with peritonitis of any sort
steady/constant
not well localised
not related to peristalsis
patient often lies still with knees up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the causes of abdominal swelling?

A 
flatus (gas); bowel obstruction
faeces
fat
fluid
foetus
organomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the causes of diarrhoea?

A

e. coli
malabsorption syndrome
IBD, tumour; pathology in the rectal area which disturbs the defecation reflex

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

what conditions are important to ask about in the past medical history and family history in a GI history?

A 
bowel problems
gallstones
ulcers
arthritis
gynaecology problems

bowel cancer
IBD

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

describe the steps of an abdominal exam

A

exposure; nipples to symphysis pubis, flat bed
general inspection
superficial palpation
deep palpation
palpation for lower edge of liver
palpation for lower edge of spleen
palpation for kidneys
percussion for lower and upper edge of liver
percussion for lower edge of spleen
percussion for fluid level; shifting dullness, fluid thrill
auscultation
other examinations; external genitalia, hernia, groin, rectal

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

what is the cause of guarding?

A

inflamed viscus and peritoneum
local peritonitis
acute appendicitis

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

what is the cause of rigidity?

A

generalised peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what should you figure out if you feel the lower edge of the liver?

A

edge; smooth, irregular, pulsatile
distance from the liver edge and the costal margin
tenderness
consistency; hard or soft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the purpose of auscultation of the abdomen?

A

bowel sounds; 1 full minute
obstruction; tinkling bowel sounds
peritonitis; absent/reduced, widespread intra abdominal inflammation, loss of normal motility

bruits;
abdominal aorta; midline
renal arteries; right and left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe the steps of an oral cavity exam

A 
general inspection
extra-oral examination;
palpation;
salivary glands
cervical lymph nodes
muscles of mastication
temporomandibular joint
consider cranial nerve/sinus examination
intra-oral examination;
dentition
mucosal surfaces
gingiva
hard and soft palate
tongue
floor of the mouth
buccal mucosa
oropharynx
assess salivary flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are you looking for in a general examination of the face in an oral cavity exam?

A

face/neck
swelling
asymmetry
bruising

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

what are you palpating for in an oral cavity exam?

A 
glands;
enlarged
tender
firm
fixed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how do you palpate the muscles of mastication and the temporomandibular joint?

A

temporalis; end to end and centric occlusal biting positions
masseter; palpate over the check area, ask to bite
temporomandibular joint; ask to bite, click indicates dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are you looking for in an inspection of dentition?

A

identify incisor, canine, premolar and molar teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are you looking in an inspection of mucosal surfaces?

A

inflammation; redness, swelling
ulceration
pigmentation
lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how do you inspect the tongue?

A

ask the patient to stick their tongue out; examine the dorsal surface
identify circumvallate papillae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how do you examine the floor of the mouth?

A

ask the patient to touch the roof of the mouth with their tongue
examine the ventral surface of the tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are you looking for in an inspection of the buccal mucosa?

A

inflammation
ulceration
pigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how do you examine the oropharynx?

A

is the mouth dry?

can saliva be expressed from the glands?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

describe an examination of a hernia

A 
introduction
general inspection;
clinical signs
objects and equipment
differentiation a hernia from other types of lumps;
assess both sides
differentiating hernia subtypes;
position
reducibility
direct/indirect inguinal hernia
scrotal examination
finish exam; thank patient, summarise findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what should be done in the introduction of a hernia exam?

A 
wash hands and don PPE
introduce yourself
confirm patient details
explain procedure
get chaperone
have bed at a 45 degree angle
adequately expose the patients abdomen and inguinal region
ask if they have any pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what clinical signs are you looking for in a general inspection of a hernia exam?

A 
pain
obvious scars
abdominal distension
pallor
cachexia
hernia; cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what objects or equipment are you looking for in a general inspection of a hernia exam?

A

stoma bag; colostomies LIF, ileostomies RIF
surgical drain; location, type/volume of contents
mobility aids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what features indicate a hernia of the groin?

A 
single lump in the inguinal region
positive cough impulse
soft on palpation
reducible; unless incarcerated
unable to get above the lump
painless; unless incarcerated
bowel sounds; may be absent if incarcerated
30
Q

what features indicate that a groin lump is not a hernia?

A 
multiple lumps; lymphadenopathy
hard/nodular consistency; malignancy
able to get above the lump; scrotal mass
transillumination; hydrocoele
bruits on auscultation; arteriovenous malformation
31
Q

how does the position of a hernia help differentiate from different subtypes?

A

above and medial to the pubic tubercle; inguinal

below and lateral to the pubic tubercle; femoral

32
Q

how does reducibility of a hernia help differentiate from different subtypes?

A

reducible; can be flattened by changes in position or application of pressure
supine; observe spontaneous reducibility
manually reduce it with your fingers
reappear; standing, cough, remove pressure

urgent surgical review; tender, irreducible, may be strangulated

33
Q

how do you determine if an inguinal hernia is direct or indirect?

A

locate the deep inguinal ring
manually reduce the hernia; press from the inferior aspect to the deep inguinal ring
once reduced; apply pressure over the deep inguinal ring and cough

reappears; direct inguinal hernia
does not reappear; indirect inguinal hernia

34
Q

describe inguinal hernias

A

protrusion of abdominal contents
emerges at the superficial inguinal ring
most commonly superomedial to the pubic tubercle

35
Q

describe femoral hernias

A

occur just below the femoral ligament
naturally occurring weakness in the abdominal wall; femoral canal
higher risk of strangulation and obstruction
usually inferolateral to the pubic tubercle and medial to the femoral pulse

36
Q

describe umbilical hernias

A

occur at the umbilicus
common
can be large
low risk of strangulation

37
Q

describe incisional hernias

A

occur at the sites of pervious operations/surgical incisions

tissue integrity has been compromised

38
Q

describe a scrotal examination in a hernia exam

A

palpation of the scrotum; if a scrotal mass is seen, with the patients consent
inguinal hernia in the scrotum; will not be able to get above the mass

39
Q

describe a stoma examination

A 
introduction
stoma assessment;
site
number of lumens
spout
effluent
surrounding skin
complications
complete examination
40
Q

what should be done in the introduction of a stoma exam?

A

wash hands
introduce
patient details
explain
expose abdomen
position the patient laying flat on the bed
ask if they have had any pain or recent changes in their stoma

41
Q

describe the site of a stoma

A

colostomies; LIF

ileostomies; RIF

42
Q

describe the number of lumens of a stoma

A

1 in RIF; end ileostomy or urostomy
1 in LIF; end colostomy
2 in RIF; loop ileostomy
2 in LIF; loop colostomy

43
Q

describe the spouts of a stoma

A

present; ileostomy/urostomy
absent; colostomy

prevent skin irritations

44
Q

describe the effluent of a stoma

A

semisolid faecal effluent; colostomy
liquid faecal effluent; ileostomy
urine; urostomy

45
Q

describe the surrounding skin of a stoma

A

inspect for erythema, tissue breakdown, fistulation

46
Q

what are the complications of a stoma?

A

parastomal hernia; reducible mass
infarction; necrosis, pain
prolapse; appears longer, increases when coughing or straining
retraction; skins below the level of the skin
haemorrhage

47
Q

what should be done to complete a stoma examination?

A

thank patient
wash hands
summarise findings
full abdominal examination

48
Q

what should be done to complete a hernia examination?

A 
thank patient
wash hands
summarise findings
testicular examination
abdominal examination
inguinal lymph node assessment
49
Q

describe the steps of a rectal exam

A 
introduction
patient position
inspection of anal area; bear down
palpation; clench
inspection of gloved finger
conclusion; clean area
50
Q

how should a patient be positioned in a rectal exam?

A

left lateral position
hips and knees well flexed
buttocks at the edge of the bed

51
Q

what are you looking for in the inspection of the anal area?

A

inspect the anus and the perianal area; separate the buttock
skin tags; crohn’s
anall fissure
fistula-in-ano; red spouting area, in ulcerative colitis
anal warts
external piles
anal carcinoma; fumigating mass at the anal verge
pruritus ani; red, weeping, excoriated area

ask the patient to bear down; rectal prolapse

52
Q

describe palpation in a rectal exam

A

lubricate index finger of right hand
place finger on anal verge and tell them you are going to insert finger
feel anterior, posterior and lateral aspects
men anteriorly; prostate
women anteriorly; cervix

ask patient to clench on finger; tests degree of anal tone

53
Q

what are you looking for when feeling the prostate?

A 
size; small, medium, large
consistency; soft, firm, hard
surface; smooth, irregular
lobes; symmetrical, asymmetrical
sulcus; present, absent
54
Q

what are you looking for when feeling the cervix?

A

masses
tenderness
abnormal indentations

55
Q

what are you looking for when inspecting the finger after removed from the rectum?

A 
bright blood
melaena
mucous
pus
colour of faeces
56
Q

describe the introduction of a rectal examination

A 
wash hands
introduce yourself
identify patient
gather equipment
explain procedure and gain consent
ask for a chaperone
57
Q

describe the steps of abdominal x-ray interpretation

A 
confirm details
assess image type and quality; projection, exposure
bowels and other organs
bones
calcification and artefact
present the x-ray
58
Q

what are you looking for when assessing the image type and quality?

A

projection; AP supine or AP erect
exposure; from diaphragm to pelvis, view both small and large bowel

CXR required for small bowel perforation; free gas under the diaphragm

59
Q

what are you looking for the in bowels and other organs section of the abdominal x-ray interpretation?

A

differentiate between the small and large bowel
bowel diameter; small bowel 3cm, large bowel 6cm, caecum 9cm
small bowel obstruction
large bowel obstruction
rigler’s (double wall) sign
inflammatory bowel disease
other organs and structures

60
Q

how do you differentiate between the small and lower bowel on an abdominal x-ray?

A

small bowel; central, large bowel frames it
valvulae conniventes; mucosal folds of the small bowel, cross the full width
haustra; large bowel pouches, not do completely transverse

61
Q

describe the features of small bowel obstruction on an abdominal x-ray

A

dilatation >3cm
prominent valvulae conniventes; coiled spring appearance
causes; adhesion, abdominal hernias, intrinsic or extrinsic compression by neoplastic masses

62
Q

describe the features of large bowel obstruction on an abdominal x-ray

A

sigmoid volvulus; coffee bean appearance
caecal volvulus; fetal appearance
causes; colorectal carcinoma, diverticular strictures, hernias, volvulus

63
Q

describe rigler’s sign on an abdominal x-ray

A

both sides of the bowel wall become visible; pneumoperitoneum
free air under diaphragm on erect CXR
causes; perforated bowel, perforated duodenal ulcer, recent abdominal surgery

64
Q

what are the features of inflammatory bowel disease on an abdominal x-ray?

A

thumb printing; mucosal thickening of the haustra due to inflammation and oedema
lead pipe colon; loss of normal haustra markings, chronic colitis
toxic megacolon; chronic dilatation without obstruction, colitis

65
Q

describe the important features of other organs and structures on an abdominal x-ray

A

lungs; basal pneumonia can cause abdominal pain
liver
gallbladder; calcified gallstones, cholecystectomy clips
stomach
psoas muscle
kidney
spleen; LUQ, superior to left kidney
bladder; variable appearance depending on fullness

66
Q

what are the bony structures usually visible on an abdominal x-ray?

A 
ribs
lumbar vertebrae
sacrum
coccyx
pelvis
proximal femurs

fractures, osteoarthritis, Paget’s disease, bony metastases

67
Q

what are the causes of calcification or artefact on an abdominal x-ray?

A 
calcified gallstones; RUQ
renal stones, staghorn caliculi
pancreatic calcification
vascular calcification
costochondral calcification
contrast; following barium
surgical clips
jewellery; belly button rings
68
Q

what questions should be asked in the presenting complaint of a urinary history?

A 
hesitancy
poor stream
incomplete emptying
terminal dribbling
urgency
frequency
nocturia
incontinence; stress, urge
dysuria
loin/back pain
fever/rigors
haematuria
cloudy/malodorous urine
polyuria
anuria/oliguria
sexual history
69
Q

describe the symptoms and causes of urinary voiding problems

A

hesitancy
poor stream; stops and starts, stops completely, irritative, voiding dysfunction
incomplete bladder emptying
terminal dribbling

bladder outflow obstruction; BPH, stricture, meatal stenosis

70
Q

describe the symptoms and causes of urinary storage problems

A 
urgency
frequency
nocturia
incontinence; stress incontinence, incontinence pads, volume, at night, after voiding
urge incontinence

overactive bladder, BPH

71
Q

what are the symptoms of renal disease

A 
tiredness
dyspnoea on exertion; anaemia, pulmonary oedema
chest pain; anaemia, pericarditis
nausea and vomiting
ankle oedema
abdominal swelling; ascites
pruritius
bone pain
thirst
72
Q

what questions should be asked during the past medical history of a urinary history?

A 
neurology; MS, cerebrovascular disease
HTN
diabetes
previous surgery; for urinary incontinence in women and prostatic hypertrophy in men, ureteric injury
obstetric history

OSCEs (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions