Abdominal assessment

Question 1

What are you looking for in abdominal palpation?

Answer 1

Guarding
Rigidity
Tenderness

Question 2

What are the 9 sections of the abdomen?

Answer 2

Question 3

What kind of patients may have atypical presentation with abdominal assessment?

Answer 3

Elderly
Alcohol-dependent
Immunosuppressed

Question 4

What can referred right shoulder pain signify?

Answer 4

Liver injury/damage
Perforated duodernal ulcer

Question 5

What can referred left shoulder pain signify?

Answer 5

Pancreatitis

Question 6

How does knee flexion reduce pain in peritonitis?

Answer 6

Reduces strain on the abdomen

Question 7

What can (frank) red blood in vomit indicate?

Answer 7

Upper GI tear/lesions

Question 8

What can mouth ulcers signify?

Answer 8

B12/Folate deficiency
Crohn’s disease

Question 9

What is Crohn’s disease?

Answer 9

Long term inflammation of the bowel

Question 10

What can steatorrhoea signify?

Answer 10

Higher fat content in faeces
Causes include:
Pancreatitis
Pancreatic cancer
Biliary obstruction
Coeliac disease

Question 11

What the 6 Fs of abdominal distention?

Answer 11

Fat
Fluid
Flatus
Faeces
Foetus
Fulminant mass

Question 12

What conditions most often cause ascites?

Answer 12

Liver cirrhosis
Cancers

Question 13

What medications are not recommended for viral gastroenteritis?

Answer 13

Antibiotics, anti-diarrheal agents and anti-emetic

Question 14

What can bloody or severe diarrhoea along with general gastroenteritis symptoms signify?

Answer 14

Bacterial infection, should be confirmed with a stool sample

Question 15

What can severe lower abdominal pain with referred shoulder/neck pain signify in females?

Answer 15

Ectopic pregnancy

Question 16

What can severe sudden onset peri-umbilical pain with migration to right lower quadrant signify?

Answer 16

Appendicitis

Question 17

In suspected appendicitis what can sometimes cause a sudden reduction in pain?

Answer 17

Appendix rupture

Question 18

How can a AAA affect the lower extremities?

Answer 18

Discolouration due to ischemia

Question 19

What is the order of abdominal observations?

Answer 19

Inspect
Auscultate
Percuss
Palpate

Question 20

What can white spots in the nails signify and what does this indicate?

Answer 20

Low albumin
Can indicate malnutrition, liver disease, kidney disease, or an inflammatory disease.

Question 21

What can hyperactive bowel symptoms signify?

Answer 21

Diarrhoea, post-eating

Question 22

What can hypoactive or absent bowel signs signify?

Answer 22

Ileus, constipation, peritonitis

Question 23

What can abnormal bowel signs (e.g. tinkling) signify?

Answer 23

Bowel obstruction

Question 24

How often should you hear bowel sounds?

Answer 24

Every 5-10 seconds

Question 25

What is Blumberg's sign and what can it signify?

Answer 25

Rebound tenderness, peritonitis

Question 26

What is Rovsing's and what can it signify?

Answer 26

Pain in the right illiac fossa with pressure on the left illiac fossa. Appendicitis

Question 27

What is the psoas sign and what can it signify?

Answer 27

Lower right quadrant pain with extension (or flexion against resistance) of the right hip. Appendicitis, caused by the inflamed appendix coming into contact with the psoas muscle

Question 28

What is the obturator sign and what can it signify?

Answer 28

Lower right quadrant pain with internal and external rotation of the flexed hip with flexed right knee Appendicitis, caused by the inflamed appendix coming into contact with obturator internus muscle

Question 29

What is Murphy's sign and what can it signify?

Answer 29

Pain on deep inspiration when hand is placed below right costal margin along the mid clavicular line. Cholecystitis

Question 30

How do you test for ballot?

Answer 30

Left hand on patient's back (flank area) under the 12th rib, pushing upwards Right hand pushing down just below the anterior costal margin. Ask the patient to take a deep breath to help descend the kidneys and 'trap it' between your two hands

Question 31

What is ballot?

Answer 31

Kidney tenderness