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Year 3 - OSCE Abdo > Abdo exam > Flashcards

Abdo exam Flashcards

(57 cards)

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1
Q

General inspection

A 
Tattoos
Bruising
Total parental nutrition (TPN) 
Jaundice
Pallor 
Abdo distention
Stoma bag
Ask patient to lift head off bed or cough to show hernia
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2
Q

What might bruising indicate?

A

Liver disease - not producing clotting factors

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3
Q

What would you look for in the nails?

A

Koilonychia - IDA due to e.g. malabsorption in Crohn’s disease, GI bleed

Leukonychia - low albumin; chronic liver disease, protein-losing enteropathy (somewhere in gut it’s lost e.g. coeliac or IBD)

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4
Q

What would clubbing of the fingers suggest?

A

IBD
Coeliac disease
Liver cirrhosis
Lymphoma of GI tract

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5
Q

What would you look at in the hand?

A

Dupuytren’s contracture
- in alcohol related chronic liver disease

Palmar erythema
- caused by increased oestrogen levels
as well as in chronic liver disease (normally breaks down oestrogen, therefore seen in excess in liver disease)

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6
Q

What would asterix indicate

A 
Liver failure (hepatic enchephalopathy; build up of anaemia)
Renal failure (urea increase)
Respiratory failure (CO2 renetion)
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7
Q

What else would you inspect on the hands?

A

Temp
Capillary refill
Radial pulse

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8
Q

What is an arteriovenous fistula?

A

surgical connection between artery and vein

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9
Q

What must you never do on the fistula?

A

Never do venepuncture or blood pressure on the side of an AV fistula

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10
Q

What would you look for under the arms?

A

Acanthosis nigricans

  • benign
  • associated with insulin resistance
  • GI malignancy
  • feels velvety to touch
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11
Q

What else are you looking for in the arms?

A 
Bruising/petechiae
Excoriation marks (cholestasis; bile salts deposited in skin causing itchiness) 
Hair loss (IDA)
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12
Q

What do you look for in the neck?

A

JVP

Lymphadenopathy

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13
Q

Which lymph node are you specifically looking for?

A

Virchow’s node

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14
Q

Troisier’s sign

A

Palpable metastatic lymph node in left supraclavicular node

Receives drainage from intraabdominal areas therefore common sign of intraabdominal

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15
Q

What are two signs of high cholesterol in the eyes?

A

Corneal arcus
Xanthelasma

Primary biliary cholangitis (bile ducts are slowly destroyed, therefore bile builds up in liver and is deposited around the body)

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16
Q

What exactly is corneal arcus?

A

Phospholipid deposition around the eye

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17
Q

Jaundice in eye?

A

scleral icterus

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18
Q

Jaundice in eye?

A

Scleral icterus

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19
Q

What are you looking for in the mouth?

A

How hydrated is the mouth?

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20
Q

Fungal infection of the tongue is called?

A

Candidiasis

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21
Q

Candidiasis is commonly seen in patients with?

A

Patients with immunosuppression

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22
Q

Angular stomatitis is commonly caused by?

A

IDA

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23
Q

What do you called inflammation of the tongue?

24
Q

Glossitis is caused by

Study These Flashcards
A

B12 deficiency!

25
Ulcers of the gum are called?
Aphthous ulcers
26
Aphthous ulcers
Crohns folate deficiency IDA
27
Telanglectasia
Basically spider veins Can develop GI bleeds
28
Hyperpigmentation
Poisiagous syndrome - associated with GI malignancy
29
Hyperpigmentation of lips may indicate?
Poisiagous syndrome - associated with GI malignancy
30
What are spider naevi caused by?
Increased oestrogen Pregnancy Combined oral contraceptive pill Liver cirrhosis
31
Chest expansion
Scars Spider naevi Gynaecomastia Abnormal hair distribution
32
What are you looking for on general inspection
``` Scars Distention Hernias Caput medusa Pulsations Cullen's and Grey Turner's sign Striae Stoma ```
33
What scar do you see with cholecystectomy?
Kocher's scar | right side slanted
34
What scar do you see with liver transplant?
Mercedes benz scar
35
Distention may be caused by
``` 6Fs Fluid Fat Flatulence Faeces Fetus ? ```
36
Caput medusa is caused by
Liver cirrhosis and portal hypertension | tortorous vessels that resemble the hair on medusa's head!
37
What is cullen's sign?
Rare sign haemorrhagic pancreatitis bruising aroudn umbilicis
38
What is grey turner's sign?
Also rare sign | haemorrhagic pancreatitis bruising around flanks (laterally)
39
Abdo striae is caused by
Quick distension of abdo: Cushings Pregnancy Ascites
40
Stoma
Ileostomy - right colostomy - left e.g. after rectum has been removed Urostomy (opening from kidneys, containing urine) Look for: Is there a spout? Contents Side
41
What is a stoma?
Surgical opening of bowel so that the patient
42
What are you looking for on light palpation?
Tenderness
43
If rebound tenderness is present, how would you test for this and what can it suggest
Perforation of organ When you quickly remove your hand after light palpation, it causes pain for the patient
44
Guarding can be split into
Voluntary | Involuntary
45
If rebound tenderness and guarding is present, what could this suggest?
Peritonitis
46
If there is an abdominal mass, what are you looking for?
``` Location Size Consistency Mobile Pulsatile ```
47
How do you palpate for the liver?
Press deeply into right flank region when patient is taking a deep breath IN
48
What are you feeling for besides the spleen?
Splenic notch
49
How do you look for the abdominal aorta?
Superior to umbilicus | place both hands gently
50
What would lateral expansion of the abdominal aorta indicate?
AAA aneurysm
51
If you find an increased mass when balloting the kidneys, what do you have to look out for?
Size and consistency Unilateral - renal tumour Bilateral - PKD, amyloidosis
52
How would you differentiate between spleen and kidney?
Kidney can be knocked between two hands whereas spleen can't | you also can't palpate the upper border of a spleen, whereas you can on a kidney
53
If there is hepatomegaly, what do you need to assess?
``` Size Surface edge (smooth or regular) Consistency (soft or hard) Tenderness Pulsatility ```
54
How do you palpate the spleen?
Ask patient to take a deep breath in when you palpate left side
55
What would pitting oedema suggest?
``` Hypoalbuminemiaa e.g. protein losing enteropathy liver cirrhosis heart failure renal failure ```
56
What further examinations could you suggest?
Hernial orifices DRE External genitalia Urine dipstick
57
Why would you auscultate the liver?
To check for increased blood flow to liver E.g. in: Cancer Alcoholic liver disease

Year 3 - OSCE Abdo (4 decks)

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