GI Examination Flashcards
What mnemonic is used to remember the causes of clubbing
CLUBBING
Name the causes of clubbing
C - cyanotic heart disease/cystic fibrosis
L - Lung cancer/lung abscess
U - Ulcerative colitis
B - Bronchiectasis
B - Benign mesothelioma
I - Infective endocarditis/idiopathic pulmonary fibrosis
N - Neurogenic tumours
G - Gastrointestinal disease
What are the GI causes of clubbing
Malnutrition - UC, chrons and coeliac
Cirrhosis
GI lymphoma
What sign is present in clubbing
Schamroth’s sign
Describe Schamroth’s sign
In clubbing - window obliterated as distal angle increases and becomes wider caused by uniform swelling
Summarise Dupuytren’s contractures
Development of cords within the palmar fascia leading to contracture and flexion deformity - often ring finger
Fibrosis and shortening of the palmar aponeurosis
Usually idiopathic or familial. Is a possible link to trauma, diabetes, epilepsy, alcoholism and liver disease
In a GI exam what is Dupuytren’s contracture a possible sign of
Excess alcohol
What are the possible causes of Dupuytren’s contractures
Excess alcohol
Manual work (vibrations)
Smoking (x3)
DM (1 in 5)
70% hereditary
Describe a liver flap
Asterixis
Metabolic encephalopathy
Cock hands backwards - 30 seconds
What is acanthosis nigricans a sign of
Insulin resistance
In a GI exam what is bruising a sign of
Synthetic liver failure
What is the key lymph node in a GI exam
Left supraclavicular node - marker of gastric cancer
What enlarged lymph node can be a marker of GI cancer
Left supraclavicular node
What is conjunctival pallor a sign on
Severe anaemia
Define conjunctival pallor
Paleness on anterior rim of conjunctiva
Describe Kayser Fleicher rings
Dark rings encircle the iris
Wilson’s disease - abnormal copper
Brown rings that encricle the iris - resulting from copper deposition.
Early stages is seen with a silt lamp - later can be seen with the naked eye
Define angular stomatitis
Inflammation around the corners of the mouth
Sore corners of mouth
May be caused by deficency of vitamin B6, B12, folate or iron
Define glossitis
Abnormal smooth red apparence of the tongue
Painless = iron de
Piandul glossitis = vitamin B12 or folate deficenct
What is glossitis associated with
Painful - Iron, B12, Folate deficiency - think malabsorption (IBD)
Painless - Iron deficency
What is oral candidiasis associated with
Immunosuppression
Define aphthous ulceration
Round/oval ulcers on mucus membrane inside the mouth
Name the causes of aphthous ulceration
Usually - Benign (stress, mechanical trauma)
Other - iron, B12, folate deficiency, chron’s disease
When would hyperpigmented macules on the face be seen
Peutz-Jeghers syndrome
Autosomal dominant genetic disorder = polyps in the GI tract
Associated with small bowel hamartomas
What is the cause of spider naevi
Increased levels of oestrogen