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OSCEs > GI > Flashcards

GI Flashcards

1
Q

leukonychia: what is it and GI causes

A

whitening of nail bed

hypoalbuminaemia –> liver disease

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2
Q

koilonychia: what is it and GI causes

A

spoon nails

anaemia

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3
Q

GI causes of finger clubbing

A

liver cirrhosis
IBD
coeliac

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4
Q

GI cause of asterixis (flapping tremor)

A

hepatic encephalopathy

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5
Q

GI cause palmar erythema

A

chronic liver disease

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6
Q

cause of duputren’s contracture

A

alcohol

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7
Q

GI cause bruising

A

clotting abnormalities caused by liver dysfunction

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8
Q

GI cause scratch marks

A

chronic cholestasis

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9
Q

what is parotid swelling caused by

A

alcohol

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10
Q

what do look for in eyes of GI examination

A

jaundice

conjuncival pallor –> anaemia

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11
Q

what do look for in mouth when GI examination

A 
angular stomatitis (Fe def anaemia) 
odur of foetor hepaticus)
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12
Q

where is Virchow’s node

A

left supraclavicular fossa

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13
Q

what do we look for on chest during GI examination

A

spider naevii
gyncaecomastia
hair loss

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14
Q

leg signs during GI examination

A

peripheral oedema - hypoalbuminaemia (liver failure)
hair loss
erythema nodosum - IBD

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15
Q

9 regions abdomen

A 
R + L hypochondriac
epigastric 
R + L lumbar 
umbillical 
R + L inguinal 
hypogastric
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16
Q

what looks for when inspecting abdomen

A 
scars
adbominal distension 
caput medusae
striae 
movement with respiration 
stoma 
petechiae 
visible pulsation
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17
Q

causes of abdominal distension

A 
fat 
flatus
faeces 
fluid 
foetus
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18
Q

what are caput medusae a sign of

A

portal hypertension

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19
Q

what do we look for during light palpation of abdomen

A 
tenderness
rebound tenderness
involuntary guarding 
Rovsing's sign 
masses
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20
Q

what is rebound tenderness a sign of

A

peritonitis e.g. appendicitis

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21
Q

what is rovsing’s sign and what does it suggest

A

palpation of left iliac fossa causes pain in right iliac fossa

peritonitis

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22
Q

what may be felt normally during deep palpation of abdomen

A

pulsation of abdo aorta
caecum (R. iliac)
desc. and sigmoid colon (L)

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23
Q

what do we need to talk about when describing a mass felt

A

location: which region of abdomen
approx size and shape
consistency: smooth, soft, hard, irregular
mobility: is it attached to surrounding structures
does it pulse

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24
Q

when palpating liver what do need to talk about

A

is it palpable?
degree extension below costal margin (>2cm hepatomegaly)
consistency (nodular = cirrhosis)
tender (if so then hepatitis, cholecystitis)
is it pulsatile (tricuspid regurgitation)

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25
Q

causes of hepatomegaly

A 
hepatitis 
hepatocellular carcinoma 
haemachromatosis 
leukaemia 
myleoma 
haemolytic anaemia 
tricuspid regurgitation 
glandular fever
26
Q

causes of splenomegaly

A

congestive heart failure
haemolytic anaemia
portal HTN 2nd to cirrhosis
splenic metastases

27
Q

can kidneys be palpated

A

occasionally in very slim person may feel lower pole of R kidney

28
Q

causes of enlarged kidneys

A

polycystic kidney disease
renal tumour
amyloidosis

29
Q

tinkling bowel sound

A

bowel obstruction

30
Q

absent bowel sounda

A

> 2min listenign

paralytic ileus

31
Q

abominal aorta bruit

A

atheroma

aneurysm

32
Q

renal artery bruit

A

renal artery stenosis

33
Q

liver bruit

A

hepatocellular cancer

34
Q

splenic bruit

A

A-V fistula

35
Q

hepatic rub

splenic rub

A

rub indicated inflammation of capsule surrounding organ

36
Q

GI systemic enquiry

A 
appetite/weight loss or change 
mouth/teeth/tongue
dysphagia 
dyspepsia/heartburn 
nausea/vomitting 
haematemesis 
fat intolerance
jaundice
abdominal distension + bloating 
abdominal pain 
bowel habit (change, constipation, diarrhoea, blood, mucus, meleana, faecal incontinence)
perinanal symptoms - pain, itching
37
Q

jaundice: what is it and

GI causes of it

A

yellowing skin/sclera + dark urine

hepatitis, liver cirrrhosis and biliary obstruction (gallstone, pancreatic Ca)

38
Q

vomiting: GI causes of it

A 
gastroenteriris 
GORD
pyloric stenosis 
bowel obstruction 
gastropareis
39
Q

haematemesis: what is it and

GI causes of it

A

vomitting of blood

bright red: oesophageal varices rupture

coffee ground: gastric/duodenal ulcer

40
Q

dysphagia: what is it and

GI causes of it

A

difficulty swallowing

oesophageal cancer

41
Q

abdominal distension: GI causes

A

ascites
constipation
bowel obstruction
malignancy

42
Q

constipation: GI causes

A

dehydration
reduced bowel motility
medications e.g. opiates, Fe supplements

43
Q

diarrhoea: GI causes

A 
infection e.g. C.diff
IBS
IBD
medication e.g. laxative
constipation with overflow
malignancy
44
Q

steatorrhoea: what is it and

GI causes of it

A

excess fat in faeces causing them to appear pale and be difficult to flush

pancreatitis, pancreatic Ca, biliary obstruction, coeliac

45
Q

melaena: what is it and

GI causes of it

A

dark, tar-like stooks containing digested blood

upper GI bleeding - peptic ulcer

46
Q

causes of R. iliac fossa pain

A

appendicitis

Crohn’s

47
Q

causes of L. iliac fossa pain

A

diverticulitis

48
Q

causes of epigastric pain

A

oesophagitis

gastritis

49
Q

causes of R upper quadrant pain

A

cholecystitis

hepatitis

50
Q

causes of flank pain

A

renal colic

pyelonephritis

51
Q

causes of suprapubic pain

A

UTI

52
Q

GI risk factors

A 
pre-existing GI disease e.g. GORD, crohn's 
Fx GI disease 
alcohol (alcoholic hepatitis/cirrhosis) 
smoking (GI cancers, crohn's) 
rec. drugs (hepatitis) 
diet (coeliac)
53
Q

during DRE what to look for during inspection of perianal area

A

skin excoriation
anal fissure
external bleeding
anal fistula

ask pt to bear down

  • haemarrhoids
  • rectal prolapse
54
Q

assessing anal tone during DRE

and cause of reduced anal tone

A

with finger inserted ask them to bear down

IBD, prev rectal surgery, spinal cord pathology e.g. cauda equina syndrome

55
Q

assessing postelateral walls during DRE

A

sweep finger to right (upwards) for right posterolateral quadrant

sweep to left (downwards) for left posterolateral quadrant

56
Q

what can be palpated through anterior wall DRE

A

men: prostate
women: cervix/tampon

57
Q

what needs to be noted when examining rectal walls

A

presence/abscence of stools and consistency (e.g. hard = consipation)

ireegularities/masses

areas of tenderness

when bear down again if a lesion is brought down from higher up

58
Q

what do we inspect finger for once its withdrawn

A

stool

blood mucous

59
Q

blood on finger after DRE

A

meleana: upper GI bleed e.g. gastric ulcer

bright red: lower GI bleed e.g. rectal malignancy, fissure

60
Q

excess mucous on finger after DRE

A

IBD e.g. ulcerative colitis

OSCEs (18 decks)

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