GI/GU

Question 1

Symptoms of GI problems

Answer 1

Abdominal pain

Weight loss/loss of appetite

Abdominal distension

Energy loss

Painful mouth

Diarrhoea

Constipation

Heartburn/acid reflux

Dyspepsia (indigestion)

Question 2

General observation

Answer 2

Jaundiced- liver problems, liver cancer, gallstones, hepatitis

Cachetic

Finger clubbing- Cirrhosis, ulcerative colitis and crohns

Leukochynia- deficiency of albumin due to liver disease

Koliochynia- anaemia, cirrhosis

palmar erythema

Dupytrens contracture

Question 3

Palpation and location

Answer 3

Liver- upper border 5th intercostal space down to the last chondral cartilage
– hepatomegaly means the liver will enlarge directly downwards

Spleen- underlies ribs 9, 10 and 11 on the left.
– splenomegaly will lead to the spleen enlarging centrally

Causes of hepatomegaly:
– chronic parenchymal liver disease:
—- cirrhosis etc
– malignancy:
—- primary cancer, secondary metastatic cancer
– right heart failure
– cor pulmonale

Causes of splenomegaly:
– portal hypertension
– infections:
—- glandular fever, bacterial endocarditis
– rheumatological conditions:
—- RA
—- systemic lupus erythramatosus

Always look at splenomegaly if there is suspected hepatomegaly as one can cause enlargement of the other, this is because they are close together and there is increased pressure on the other one.