What signs might patients have on examination? Flashcards
GORD
Usually NORMAL
BUT red flag symptoms are upper abdominal mass, dysphagia, age >55yrs and weight loss
Peptic Ulcer
epigastric tenderness
if gastric emptying is slow, may be succussion splash (sloshing sound on auscultation)
Ulcerative Colitis
General inspection: pale (anaemia, caused by PR bleeding)
Distention and tenderness on palpation
PR exam: tenderness, blood/mucus
Crohn’s
weight loss
pale (anaemia)
Digital clubbing
Aphthous ulcers in mouth, abdo/right LQ tenderness and a right iliac fossa mass
PR examination to check for perianal skin tags
Acute Pancreatitis
Hypovolaemia
tachycardia
dry mucous membranes guarding (involuntary reaction to palpation)
Grey-Turner’s sign if haemorrhagic (bruised flanks)
Cullen’s sign (oedema and bruising in the fatty tissue around umbilicus)
gallstones
right upper quadrant pain- guarding
epigastric tenderness
jaundice
Acute Hepatitis
right upper quadrant pain jaundice hepatomegaly splenomegaly lymphadenopathy
Appendicitis
Pain on palpation over the right iliac fossa
Rovsing’s sign may be present (pain in right side when left side pressed)
McBurney’s sign positive (pain at his point: 2/3 umbilicus- ASIS
What is Rovsing’s sign
pain in the right lower quadrant with palpation pressure on the left lower quadrant
sometimes present in appendicits
What is McBurney’s sign
deep tenderness at McBurney’s point
which is 2/3 of the way between the umbilicus and the ASIS on the right
present in appendicits
small and large bowel obstruction
presents with abdo distention, tenderness and resonance
in a mechanical obstruction ywf a tinkling sound (as fluid drips from obstructed bit)
in a functional obstruction ywf decreased bowel sounds
femoral hernia
bulge/ painful mass in the groin region
tachycardia, fever, vomiting
inguinal hernia
single lump in the inguinal region soft on palpation
