GI Flashcards
What are the causes of hepatomegaly?
Hepatitis, hepatocellular carcinoma, hepatic metastases, Wilson’s disease, haemochromatosis, leukaemia, myeloma, glandular fever, primary biliary cirrhosis, tricuspid regurgitation and haemolytic anaemia
What does the age of a patient mean in terms of a GI symptoms when completing an abdo examination?
- Younger patients more likely to be conditions such as IBD.
- Older patients more likely to be liver disease or malignancy.
What is confusion a sign of in terms of patients with GI conditions?
It can be a sign and feature of end stage liver disease, known as hepatic encephalopathy.
What can abdominal distention be a sign of in terms of GI conditions?
Presence of ascites or underlying obstruction and/or organomegaly.
What can underlying anaemia be a sign of in terms of GI conditions?
GI bleeding or malnutrition and patient presents with with pale looking skin.
What is jaundice a sign of in terms of GI conditions?
Acute hepatitis, liver cirrhosis, cholangitis, pancreatic cancer.
What is hyperpigmentation?
Bronzing of the skin associated with haemochromatosis
What is cachexia associated with?
Commonly associated with underlying malignancy and advanced liver failure.
What is cachexia?
Ongoing muscle loss that is not entirely reversed with nutritional supplementation.
What can palmar erythema be a sign of?
Chronic liver disease. Also a normal finding in pregnancy due to increased oestrogen levels.
What is duputren’s contracture a sign of?
Liver disease, excessive alcohol use, increase in age, males or diabetics.
What are Koilonychia and what can they be a sign of?
Spoon shaped nails Associated with iron deficiency anaemia such as malabsorption in Chron’s disease
What is leukonychia and what is this a sign of?
Whitening of the nail bed associated with hypoalbuminaemia
Associated with end stage liver disease, protein losing eteropathy, chemo
What are the abdominal causes of finger clubbing?
IBD, coeliac disease, liver cirrhosis and lymphoma of the GI tract.
What is asterixis and what is it a sign of in terms of abdo?
This is a flapping tremor and can indicate an underlying cause of hepatic encephalopathy or uraemia secondary to renal failure.
CO2 retention secondary to type 2 resp failure is another cause.
What are excoriations and what can they indicate?
Scratch marks that may be caused by patients trying to relieve pruritis and in terms of abdo examination, this can suggest underlying cholestasis.
What is acanthosis nigricans and what does it indicate?
This is darkening and thickening of the axillary skin which can be benign or associated with insulin resistance or GI malignancy.
What is corneal arcus and what does it show?
A hazy white, grey or blue opaque ring located in the peripheral cornea, typically occuring in patients over the age of 60.
It can be benign in the over 60’s but in younger patient under 50 can suggest hypercholesterolaemia.
What is angular stomatitis and what does it show?
This is a common inflammatory condition affecting the corners of the mouth.
Wide ranges of causes including iron deficiency (GI malignancy, malabsorption, poor oral hygiene)
What is glossitis and what does it show?
It’s a smooth erythematous enlargement of the tongue associated with B12 and folate deficiency.
It can indicate malabsorption secondary to inflammatory bowel disease.
What does enlargement of the left supraclavicular lymph node mean?
Enlargement of the Virchow’s node can be the first indication of metastatic intrabdominal malignancy (Most commonly gastric cancer)
What causes spider naevi and how many can indicate liver cirrhosis?
Caused by elevation of circulation oestrogen levels. They can be raised in pregnancy or in women taking the OCP. Allow up to 3. 5 or more are indicative of liver cirrhosis.
What is gynaecomastia and what does it indicate?
This is an enlargement of male breast tissue caused by increased circulation oestrogen levels through liver cirrhosis. It can also be caused by digoxin and spironolactone.
What are the six F’s?
Fat, fluid, flatus, faeces, fetus or fulminant mass
