GI exam Flashcards
Rovsing’s sign?
L iliac fossa palpation= pain in R iliac fossa
usually due to peritonitis
Murphy’s sign?
right costal margin in the mid-clavicular line at the liver’s edge
deep breath
stops mid-breath due to pain= cholecystitis
Aorta palpation- abnormal finding?
hands move outwards= expandable mass
e.g. AAA
Causes of enlarged kidneys?
identified if ballotable kidneys
bilateral= polycystic kidney disease
unilateral= renal tumour
Aortic bruits where to listen?
auscultate 1-2 cm superior to the umbilicus
linked to AAA
Renal bruits where to listen?
auscultate 1-2 cm superior to the umbilicus and slightly lateral to the midline
linked to renal artery stenosis
Examining for ascites?
shifting dullness:
percuss from umbilical region to left flank
roll patient to right side- dullness no longer there and resonant now= ascites
Koilonychia?
spoon-shaped nails
associated with iron deficiency anaemia
Leukonychia?
whitening of the nail bed
associated with hypoalbuminaemia
Palmar erythma?
redness in heel of palm
linked to chronic liver disease
Dupuytren’s contracture?
thickening of palmar fascia
=development of cords of palmar fascia which eventually cause contracture deformities of the fingers and thumb
*found when palpate the palm feel cords/bands
Excoriations?
scratch marks that may be caused by the patient trying to relieve pruritis
acanthosis nigricans?
benign or linked to: insulin resistance or GI malignancy
Perilimbal injection?
inflammation of the area of conjunctiva adjacent to the iris
sign of anterior uveitis= linked to IBD
Hyperpigmented macules?
Peutz-Jeghers syndrome (AD genetic disorder- polyps in GI tract)
*usually in mouth
Virchow’s lymph node?
can be one of the first clinical signs of metastatic intra-abdominal malignancy
(receives lymphatic drainage from abdominal cavity)
physiological and medical causes of gynaecomastia?
physiological= excess oestrogen medical= digoxin and spironolactone
Cullen’s sign?
bruising of the tissue surrounding the umbilicus associated with haemorrhagic pancreatitis (a late sign)
Grey-Turner’s sign?
bruising in the flanks associated with haemorrhagic pancreatitis (a late sign)
Sign of portal hypertension?
caput medusae
stoma locations?
colostomies (no spout)= left iliac fossa
ileostomies and urostomies (spout)= right iliac fossa
Causes of hepatomegaly (11)?
Hepatitis (infective and non-infective) Hepatocellular carcinoma Hepatic metastases Wilson’s disease Haemochromatosis Leukaemia Myeloma Glandular fever Primary biliary cirrhosis Tricuspid regurgitation Haemolytic anaemia
Causes of splenomegaly (5)?
Portal hypertension secondary to liver cirrhosis Haemolytic anaemia Congestive heart failure Splenic metastases Glandular fever
