Signs, Tests, Laws, Syndromes and Eponyms

Question 0

Allen’s test

Answer 0

Test of hand circulation.
Ask patient to drain hand by forming a fist and then compress the ulnar and radial arteries.
Ask patient to open fist.
Release one of the arteries and observe palmar flushing - indicates arterial patency.
Repeat for the other artery

Question 1

Aaron’s Sign

Answer 1

Pressure in the RIL causing epigastric pain and cardiac discomfort in chronic appendicitis

Question 2

Battle’s sign

Answer 2

Periorbital ecchymoses. Seen in a basal skull fracture

Question 3

Beck’s triad

Answer 3

Seen in cardiac tamponade:

   1. jugular venous distension 
   2. muffled heart sounds
   3. low BP

Question 4

Boas’ sign

Answer 4

Right subscapular pain in gall stones

Question 5

Boerhaave’s syndrome

Answer 5

Oesphageal rupture - traumatic or after binge drinking

Question 6

Carcinoid syndrome

Answer 6

Syndrome caused by serotonin release from a carcinoid tumour:

   1. broncospasm
   2. flushing 
   3. diarrhoea 
   4. right sided heart failure

Question 7

Charcot’s triad

Answer 7

Seen in ascending cholangitis:

   1. fever with rigors 
   2. jaundice
   3. RUQ pain

Question 8

Chvostek’s sign

Answer 8

Seen in hypocalcaemia.

Tapping of facial nerve causes twitching of facial muscles

Question 9

Compartment syndrome

Answer 9

Condition of increased pressure in a confined anatomical space adversely affected circulation and threatening the function and viability of tissues therein

Question 10

Courvoisier’s law

Answer 10

If in the presence of jaundice there is a mass in the RUQ the jaundice is unlikely to be due to stones.
The cause is therefore most likely to be due to pancreatic head carcinoma - in gallstones the gall bladder in fibrotic and shrivelled.

Question 11

Cullen’s sign

Answer 11

Periumbillical ecchymosis, secondary to retroperitoneal haemorrhage.
Seen in pancreatitis

Question 12

Cushing’s triad

Answer 12

Seen in ICP:

  1. increased BP
  2. bradycardia 
  3. irregular respirations

Question 13

Cushing’s syndrome

Answer 13

A clinical syndrome of glucocorticoid excess.

If due to excess ACTH levels (in pituitary tumour or ectopic production) known as Cushing’s disease

Question 14

Dercum’s disease

Answer 14

Multiple painful lipomatosis - often of the trunk

Question 15

Dumping syndrome

Answer 15

Seen after gastric vagotomy, pylorplasty, and gastrojejunostomy.
Caused by rapid passage of large amounts of hyperosmolar chyme into the small bowel.
1. Autonomic instability (flushing, sweating, dizziness, vasomotor collapse)
2. Abdominal pain
3. Diarrhoea

Question 16

Fox’s sign

Answer 16

Ingunial ligament ecchymosis secondary to retroperitoneal haemorrhage.
Seen in pancreatitis

Question 17

Gardener’s syndrome

Answer 17

Autosomal dominant premalignant syndrome:

 1. multiple colonic polposis 
 2. skill osteomoas
 3. epidermoid cysts 
 4. fibromas

Question 18

Goodsall’s line and law

Answer 18

Line:
draw a line horizontally through the anus of a patient in the lithotomy position

Law:
anal fistulae occurring above the line (anterior fistulae) take a straight course into the anal canal
anal fistulae occurring below the line (posterior fistulae) take a curved course into the anal canal

Question 19

Grey Turner’s Sign

Answer 19

Flank ecchymosis seen in retroperitoneal haemorrhage.

Seen in pancreatitis

Question 20

Kaposi - Stemmer sign

Answer 20

Inability to pick up skin in lymphoedema

Question 21

Kehr’s sign

Answer 21

Intense left shoulder tip pain in splenic rupture.

Caused by referred pain due to diaphragmatic irritation

Question 22

Krukenburg tumour

Answer 22

Metastatic tumour to ovary, classically from stomach

Question 23

Leriche’s syndrome

Answer 23

Seen in illiac occlusive disease:

   1. buttock claudication 
   2. buttock atrophy 
   3. impotence

Question 24

McBurney's point and sign

Answer 24

Point: Starting from the umbilicus, a point 2/3 along line drawn from the umbilicus to the right ASIS Sign: Pressure on this point causes pain in acute appendicitis

Question 25

Mendleson's syndrome

Answer 25

Chemical aspiration pneumonitis following aspiration of gastric contents

Question 26

Mirrizi's syndrome

Answer 26

Extraluminal compression of CBD from a cystic gallstone. | May cause obstructive jaundice

Question 27

Murphy's sign

Answer 27

Seen in cholecystitis. | Palpation of the RUQ causes pain on inspiration as the inflamed gall bladder moves down and hits the palpating hand

Question 28

Obturator sign

Answer 28

Seen in appendicitis and pelvic abscess. | Pain on internal rotation of right lower limb, with knee and hip flexed

Question 29

Peutz-Jegher's syndrome

Answer 29

Syndrome of benign GI polyps with circumoral pigmentation

Question 30

Plummer Vision syndrome

Answer 30

Syndrome of oesophgeal webs and dysphagia caused by iron deficiency. May develop into SCC

Question 31

Psoas sign

Answer 31

Seen in appendicits and psoas inflammation | Pain on extending the hip with the knee in full extension

Question 32

Racoon eyes

Answer 32

Bilateral orbital ecchymoses. | Seen in basal skull fracture

Question 33

Reynold's pentad

Answer 33

Seen in suprative cholangitis Charcots triad (fever and rigors + jaundice + RUQ pain) + CNS alteration Shock/ sepsis

Question 34

Rovsing's sign

Answer 34

Seen in appendicitis: | Palpation in the LIF causes pain in the RIL

Question 35

Saint's triad

Answer 35

3 conditions that usually coexist | Gall stones, hiatus hernia, diverticular disease

Question 36

Sister Mary Joseph's sign

Answer 36

Metastatic tumour to umbilical lymph nodes

Question 37

Superior vena cava syndrome

Answer 37

SVC obstruction causing engorged face, neck, and upper chest veins

Question 38

Tietze's syndrome

Answer 38

Costochondritis of rib cartilage presenting with pleuritic type pain. Aseptic Treat with NSAIDs

Question 39

Trousseau's sign

Answer 39

Seen in hypoglycaemia. | Carpopedal spasm after blood occlusion (with BP cuff) in forearm or leg.

Question 40

Virchow's node

Answer 40

Metatastic tumour to left supraclavicular node

Question 41

von Hippel Lindau syndrome

Answer 41

Autosomal dominant syndrome of retinal and cerebella angiomata. Occasionally associated with renal cell carcinoma and phaeochromocytoma.

Question 42

Whipple's triad

Answer 42

Seen in insulinoma. 1. hypoglyceamia 2. CNS and vasomotor symptoms 3. symptomatic relief following glucose

Question 43

Zollinger - Ellison's syndrome

Answer 43

Syndrome of gastrinoma and peptic ulcer disease