Medical Examinations

Question 1

Abdo ex

- Hand signs

Answer 1

Abdo ex hands

1. Pallor
   - Anaemia
2. Erythema
   - Chronic liver
   - Pregnancy
3. Dupuytren’s
   - ETOH
4. Koilonychia
   - Iron deficiency anaemia
   eg. Crohn’s
5. Leukonychia
   - Hypoalbuminaemia
   eg. ESLD
6. Clubbing
   - IBD, coeliac, cirrhosis, lymphoma
7. Asterixis
   - Hep encep
   - Renal uraemia
   - Type 2 resp fail

Question 2

Abdo ex

- Arm signs

Answer 2

Abdo ex arms

1. Bruising
   - cirrhosis
2. Excoriations
   - Pruritis/cholestasis
3. Needle tracks
   - Hep

Question 3

Abdo ex

- Face signs

Answer 3

Abdo ex face

1. Conjuctival pallor
   - Anaemia
2. Jaundice
   - Superia sclera
   (lift eyelid, look down)
3. Corneal arcus
   - Hypercholeterolaemia <50
4. Xanthelasma
   - Hypercholesteraemia
5. Kayser-Fleisscher
   - Wilsons
6. Perilimbal injection
   - Uveitis and IBD
7. Angular Stomatitis
   - Iron deficiency
8. Glossitis
   - Iron, B12, Folate def.
9. Candida
   - Immunosuppression
10. Apthous
    - Crohn’s, Fe, B12, Folate

Question 4

Abdo ex

- Neck sign

Answer 4

Abdo ex neck

• Virchow’s node
• Intra abdo malignancy

Question 5

Abdo ex

- Chest signs

Answer 5

Abdo ex chest

1. Spider naevi
   - Cirrhosis
   - Pregnancy/COCP
2. Gynacomastia
   - Cirrhosis oestrogen
3. Hair loss
   - Cirrhosis estrogen
   - Malnourishment

Question 6

Abdo ex

- Abdo inspection signs

Answer 6

Abdo inspection

1. Scars
2. Distension
   - Fat, fluid
   - Flatus, faces
   - Fetus, fulminant mass
3. Caput medusae
4. Striae
   - Ascities, malignancy, obesity, pregnancy
   - Cushing’s
5. Hernias
   - Cough
6. Cullen’s/Grey-Turner’s
7. Stomas

Question 7

Abdo ex

- Palpations

Answer 7

Abdo palpation
- Lying flat

1. Light palpation
   - Tenderness/guarding
   - Rovsing’s sign
   - Large masses
2. Deep palpation
   - Masses
3. Liver
4. Spleen
5. Kidneys
6. Bladder
7. Aorta

Question 8

Abdo ex

- Percussions

Answer 8

Abdo percussion

1. Liver
2. Spleen
3. Bladder
4. Shifting dullness
   - Left flank
   Find when dull
   - Roll
   - Percuss same spot

Question 9

Abdo ex

- Auscultations

Answer 9

Abdo auscultation

1. Bowel sounds
2. Aortic bruits
   - AAA
   - 1-2cm superior to umbilicus
3. Renal bruits
   - Lateral to aorta
   - Renal artery disease

Question 10

Abdo ex

- Completion

Answer 10

Abdo completion

1. Legs
2. Thank
3. Hernial orrifices
4. DRE
   GI Bleed
5. External genitalia
   - Testicular torsion
   - Inguinal hernia