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OSCE > GI > Flashcards

GI Flashcards

1
Q

What are you looking for in the hands?

A

Clubbing, leuconychia, koilonychia, duputrens contracture, spider naevi, hepatic flap, palmar erythema

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2
Q

What is leuconychia? What is it caused by?

A

Leuconychia is whitening of the nail

Leuchonychia partialis is benign and only a small area of nail is whitened

Leuconychia totalis is total whitening of the nail and may be indicative of hypoalbuminaema

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3
Q

What is koilonychia? What is it caused by?

A

Spooning of the nails

caused by iron deficiency anaemia, folate or b12 deficiency

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4
Q

What are spider naevi? What causes them? How many would indicate an anormality?

A

spider naevi are small red dots with red lines projecting out of them like a spiders web

Caused by high levels of circulating estrogens which dilate arterioles. High levels of estrogens can be due to liver failure and cirrhosis as they are not broken down

More than 2 - abnormality

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5
Q

What is dupuytrens contracture?

A

Abnormal thickening of fascia in hand changing from collagen type 1 to type 3

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6
Q

What is palmar erythema? What causes it?

A

Reddening of the palms

Caused by portal hypertension and chronic liver disease

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7
Q

What do you look for in the face?

A

Jaundice, mouth ulcers, tongue disorders, dehydration of tongue

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8
Q

Why do you look for mouth ulcers in a GI exam?

A

Indicates crohns disease or coeliac disease

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9
Q

What is cullens sign?

A

bruising surrounding umbilicus due to retroperitoneal bleeding

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10
Q

What is grey-turners sign?

A

Bruising around the flanks due to retroperitoneal bleed

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11
Q

What does rebound tenderness indicate?

A

Peritonitis

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12
Q

What is shifting dullness testing for? What is it?

A

Ascites

percuss and if dull, get them to lie on their side and percuss again in the same place

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13
Q

What are liver bruits?

A

Turbulent flow in an artery of the liver

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14
Q

How would you complete the examination?

A

Inspect hernial orifices, external genitalia, DRE, temperature, and urinalysis

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15
Q

What can abdominal distension be due to?

A

6 F’s

Fat, Fluid, Fetus, Flatus, Faeces, Filthy big tumour

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16
Q

What could cause hepatomegaly?

A

Metastases, fatty liver, alcoholic liver disease, right heart failure, hepatitis

17
Q

What could cause splenomegaly?

A

malaria, portal hypertension, thalassema, haemolytic anemia, infection

18
Q

What are normal bowel sounds? What could it be increased or decreased by?

A

Gurgling every 10-20 seconds

increased - IBS, gastroenteritis

Decreased - surgery, paralytic ileus

19
Q

What is a direct and indirect inguinal hernia? Which sex is it more common in?

A

More common in males due to descent of testes

Direct - through hasselbachs triangle

Indirect - Through deep and superficial inguinal ring

20
Q

femoral hernia- which sex is it more common in?

A

More common in females

21
Q

What spinal level is the kidneys at?

A

Right - T12 to L3

Left - T11 to L2

22
Q

How would you treat a H Pylori infection?

A

Clarithromycin and amoxicillin and H2 antagonist or PPI

Stop NSAIDs

23
Q

What are biomarkers of pancreatic diseae?

A

Pancreatic amylase, decreased calcium, increased ALP, hyperglycaemia

24
Q

What LFTs are used?

A

ALT/AST

INR

Albumin

Bilirubin

Gamma-GT

25
Q

What would tests reveal in prehepatic jaundice?

A

Decreased haptoglobin, hyperbilirubinemia, Increased LDH

26
Q

What would tests reveal in hepatic jaundice

A

Increased ALT and AST, Increased INR, hyperbilirubinemia

27
Q

What would tests reveal in post hepatic jaundice

A

Dark urine due to bilirubin, pale stool

28
Q

How would you differentiate between crohns and UC?

A

UC - continuous rectal involvement results in gross bleeding and mucosal friability

Crohns thin friends fuck sexy customers - Transmucosal inflammation, fissures, fibrosis/fistulas, submucosal inflammation, cobblestoning

29
Q

What gram negative and positive bacteria usually cause a UTI

A

negative - e coli

Positive - enterococcus

30
Q

How would you treat a UTI complicated and uncomplicatd?

A

Complicated - 5 day course Trimethoprim or nitrofurantoin

Uncomplicated - 3 day course Trimethoprim

31
Q

How would you treat pyelonephritis?

A

Co-amoxiclav 14 day course

32
Q

What is nephrotic and nephritic syndrome?>

A

Nephrotic - Proteinuria (>5g/24hr), hyperlipidemia

Nephritic - Haematuria, midl hypertension, oligouria, small proteinuria

33
Q

Give examples of nephritic syndrome disease

A

VAIG nephritic syndrome

Vasculitis, Alport syndrome, IgA nephropathy, Goodpasture syndromes

34
Q

Give examples of nephrotic syndrome disease

A

Primary - Minimal change glomerulonephritis, minimal change focal segmental glomerulosclerosis, membranous glomerulonephritis

Secondary - SLE, amyloidosis, DM

35
Q

What would CKD lead to?

A

EPO anaemia, osteodystrophy (due to vit D hydroxylation in kidneys)

OSCE (12 decks)

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