What is your GI Sign (and assoc diagnosis)?

Question 1

Triad of 3 findings: R upper quadrant abdominal pain, jaundice, fever >40 (104F). Assoc Dx?

Answer 1

Charcot Triad; Cholangitis (inf of common bile duct)

Question 2

hypotension and AMS + Charcot’s triad. Assoc Dx?

Answer 2

Reynold’s pentad: Cholangitis

Question 3

Bruising and edema around subcutaneous tissue around umbilicus. Assoc Dx?

Answer 3

Cullen; seen in Pancreatitis or abdominal trauma or ruptured ectopic pregnancy

Question 4

Bruising of the flank

Answer 4

Grey Turner sign; seen in Pancreatitis or blunt abdominal trauma or ruptured ectopic pregnancy

Question 5

RUQ on palpation usually after full expiration on deep inspiration palpation of RUQ

Answer 5

Murphy’s sign; cholecystitis

Question 6

Palpation of the left lower quadrant elicits pain on the R lower quadrant of the abdomen

Answer 6

Rovsing sign; appendicitis

Question 7

Tenderness to palpation and rigidity over the R side of the abdomen that is one-third the distance from the ASIS to the umbilicus.

Answer 7

McBurney’s point; appendicitis

Question 8

Pt is lying on left side while R thigh is flexed backward

Answer 8

Psoas sign; appendicitis

Question 9

Pt in supine and pain is elicited as hip and knee is flexed to 90 degrees and internally and externally rotating flexed hip

Answer 9

Obturator sign: appendicitis

Question 10

R shoulder or scapular pain

Answer 10

Boas sign; acute cholecystitis

Question 11

Enlarged palpable non-tender gallbladder with jaundice

Answer 11

courvoisier’s gallbladder; assoc with cancer of the head of the pancreas

Question 12

calcified gallbladder on abdominal radiograph

Answer 12

porcelain gallbadder; may be seen in chronic cholelithiasis causes calcified scarring. Cholecystectomy due to association with gall bladder carcinoma

Question 13

irregular 1 cm nodule within the umbilicus

Answer 13

Sister Mary Joseph sign; GI cancer (gastric, colonic, pancreatic) Gynocologic (ovarian, uterine)

Question 14

enlargement of a left supraclavicular lymph node

Answer 14

Virchow’s node (aka Troisier sign); Pulmonary adenocarcinoma ( neuropathies of the brachial plexus and phrenic nerve as well as compression of the subclavian artery and vascular thoracic outlet syndrome due to its anatomical location)