Signs And Triads

Question 0

Columnar metaplasia of the distal esophagus (hint: GERD related)

Answer 0

Barrett’s esophagus

Question 1

Constant dullness to percussion in the left flank/LUQ and resonance to percussion in the right flank seen with splenic rupture/hematoma.

Answer 1

Ballance’s sign

Question 2

Ecchymosis over the mastoid process in patients with basilar skull fractures

Answer 2

Battle’s sign

Question 3

Seen in pts with cardiac tamponade; jvd, decreased rl muffled heart sounds, decreased blood pressure

Answer 3

Beck’s triad

Question 4

Seen with fat emboli syndrome: mental status changes, petechia (often in axilla/thorax) and dyspnea

Answer 4

Bergman’s triad

Question 5

Metastatic dz to the pouch of Douglas creating a shelf that is palpable on rectal exam

Answer 5

Blumer’s shelf

Question 6

Right subscapular pain resulting from cholelothiasis

Answer 6

Boas’ sign

Question 7

Emesis followed by retching. Epigastric distention, and failure to pass NG tube

Answer 7

Gastric volvulus. Borchardt’a triad

Question 8

What is carcinoid triad?

Answer 8

FDR - flushing, diarrhea, right sided heart failure

Question 9

Fever (chills), jaundice, RUQ pain. See with cholangitis.

Answer 9

Charcot’s triad

Question 10

Enlarged non tender gallbladder seen with obstruction of the common bile duct. Most commonly seen with pancreatic CA

Answer 10

Courvoisier’s law. NOT SEEN with gallstone obstruction.

Question 11

Signs of increased intra cranial pressure

Answer 11

Cushing’s triad. HTN. Bradycardia. Irregular respirations.

Question 12

Empty RLQ in children with ileoceccal intusssception.

Answer 12

Dance’s sign

Question 13

Used to differentiate an intra abdominal mass from one in the abdominal wall; if the mass is felt while there is tension on the musculature, then it is in the wall

Answer 13

Fothergill’s sign

Question 14

Ecchymosis of inguinal ligament seen with retroperitoneal bleeding

Answer 14

Fox’s sign

Question 15

Anal fistulae course in a straight path anteriorly and a curved path posteriorly from the midline.

Answer 15

Goodsall’s rule

Question 16

Crunching sound on auscultation of the heart resulting from emphysematous mediastinum

Answer 16

Hamman’s sign/crunch; seen in Boerhaave’s syndrome, pneumomediastinum

Question 17

Calf pain on forced dorsiflexion of the foot in patients with DVT

Answer 17

Homan’s sign

Question 18

Pain along the inner aspect of the thigh; seen with obturator hernia as the result of nerve compression

Answer 18

Howship-Romberg sign

Question 19

Visible peristalsis of the ureter in response to squeezing or retraction; used to identify the ureter during surgery

Answer 19

Kelly’s sign

Question 20

Mets tumor to the ovary

Answer 20

Krukenberg tumor (typically from gastric CA)

Question 21

Wall tension = pressure X radius

Answer 21

Laplace’s law

Question 22

What is Meckel’s diverticulum rule of 2s?

Answer 22

2% of the population has it, 2% of them are symptomatic, and they occur with approx 2 feet of the ileocecal valve

Question 23

What is the triad for pheochromocytoma?

Answer 23

PHE - palpitations, HA, episodic diaphoresis

Question 24

What percent is associated with the rule of pheochromocytoma?

Answer 24

10% bilateral, 10% malignant, 10% in children, 10% extra adrenal, 10% have multiple tumors

Question 25

What is Reynold’s pentad?

Answer 25

fever, jaundice, RUQ pain, mental status changes, shock/sepsis. (seen in pts with suppurative cholangitis)

Question 26

Paplation of the LLQ resulting in pain of the right lower quadrant. Seen in appendicitis

Answer 26

Rovsing’s sign

Question 27

Amedical condition of concurrence of the following:

1. Cholelithiasis (gallstones)
2. Hiatal Hernia
3. Diverticular Disease

Answer 27

Saint’s triad

Question 28

Indirect hernia sac in the pediatric patient; the sac feels like a finger of a silk glove when rolled under the examining finger

Answer 28

silk glove sign

Question 29

Mets to the umbilical lymph nodes

Answer 29

Sister Mary Joseph’s sign

Question 30

Mets to the supraclavicular node

Answer 30

Virchow’s node (classically due to gastric CA)

Question 31

RLQ pain from a perforated peptic ulcer due to succus/pus draining into the RLQ

Answer 31

Valentino’s sign

Question 32

Evidence for insulinoma: Hypoglycemia, CNS and vasmotor sx (syncope and diaphoresis), and relief of sx with administration of glucose.

Answer 32

Whipple’s triad

Question 34

What 4 things comprise carcinoid syndrome?

Answer 34

bronchospasm, flushing, diarrhea, and right sided HF (causd by factors released by carcinoid tumor)

Question 35

What is Gardner’s syndrome?

Answer 35

GI polyps with associated findings of Sebaceous cysts, Osteomas, and Desmoids tumors (SOD)

Question 36

What is Leriche’s syndrome?

Answer 36

CIA - claudication of the buttocks and thigh; Impotencene; Atrophy of the legs (see in iliac occlusive disease)

Question 37

What is Mendelson’s syndrome?

Answer 37

chemical pneumonitis after aspiration of gastric contents

Question 38

What is is Mirizzi’s syndrome?

Answer 38

extrinsic obstruction of the common hepatic bile duct from a gallstone in the gallbladder or cystic duct.

Question 39

Massive nonobstructive colonic dilatation

Answer 39

Ogilvie’s syndrome

Question 40

What is Peutz-Jeghers syndrome?

Answer 40

Puetz=Pigmentation; Benign GI polyps and buccal pigmentation.

Question 41

What is plummer vinson syndrome?

Answer 41

esophageal webs, iron deficiency anemia, dysphagia, spoon shaped nails, and atrophic oral and tongue mucosa (common in elderly/post menopausal women) - knowing the first three are most important

Question 42

What is refeeding syndrome?

Answer 42

hypokalemia, hypomagnesemia, and hypophosphatemia.

Question 43

What is another name for Sipple’s syndrome?

Answer 43

MEN II

Question 44

This is the syndrome of DVT associated with carcinoma

Answer 44

Trousseau’s syndrome

Question 45

What is another name for Wermer’s syndrome?

Answer 45

MEN I

Question 46

What is ZES? (2)

Answer 46

Zollinger Ellison; gastrinoma and PUD