GI - Peripheral Exam

Question 1

What do you look for on a patient’s hand?

Answer 1

• Tar Staining
  Colour - Anaemia or Leukonychia
  Shape - Clubbing or Koilonychia
  Palms - Erythaema, pale crease or dupuytren’s contracture

Question 2

What would leukonychia, clubbing, koilonychia and dupuytren’s contracture indicate?

Answer 2

Leukonychia - Hypoalbuminaemia
Clubbing - IBD, Cirrhosis or Coeliac
Koilonychia - Fe Deficiency Anaemia
Dupuytren’s Contracture - Alcohol

Question 3

What do you look for on a patients arms?

Answer 3

Bruising
Scratch marking/itching
Muscle wasting
Track marks
Dehydration
Flapping Tremor
Fine Tremor
Pulse,resp & BP

Question 4

What would the signs on a GI patients arms indicate?

Answer 4

Bruising - Liver Dysfunction
Itching - Chronic Cholestasis
Muscle wasting - Malnutrition or sepsis
TRack marks - IV drug abuse at risk of Hep B/C
Flapping tremor - Liver failure
Fine tremor - Alcohol (+/- withdrawal)

Question 5

What would you see on a patients face?

Answer 5

Eyes:

• Jaundice
• Anaemia

Parotid Swelling

Angular stomatits
Sore red tongue

Foetor hepaticus

Question 6

What would parotid swelling indicate?

Answer 6

alcohol

Question 7

What would angular stomatitis and a sore red tongue indicate?

Answer 7

Fe Deficiency Anaemia

Question 8

Mouth exam

Answer 8

Seperately noted

Question 9

What do you look for in the necklace region?

Answer 9

Spider naevia - Liver failure
Gynaecomastia
Loss of hair in males

Question 10

What do you look for on the legs?

Answer 10

Peripheral oedema
Loss of hair
Erythaema Nodosum

Question 11

Whay would peripheral oedema and erythaema nodosum indicate?

Answer 11

Peripheral Oedema - Hypoalbuminaemia or liver failure

Erythaema Nodosum - IBD

Question 12

Whats special about lymph nodes in a GI exam?

Answer 12

Carefully palpate the left scalene node aka virchows node.

Its where the thoracic duct drains you abdominal organs through