Abdominal Exam

Question 1

Name the scar. What surgery may have been performed?

Answer 1

Midline laparotomy
Emergency laparotomy e.g. perforation/ ischaemic bowel

Question 2

Name the scar. What surgery may have been performed?

Answer 2

Paramedian
Rarely performed in UK
Lateral viscera: kidneys, spleen, adrenals

Question 3

Name the scar. What surgery may have been performed?

Answer 3

Kocher
Cholecystectomy

Question 4

Name the scar. What surgery may have been performed?

Answer 4

Mercedes Benz
Liver transplantation

Question 5

Name the scar. What surgery may have been performed?

Answer 5

Chevron/ Rooftop
Oesophagectomy, bilateral adrenalectomy, liver transplant

Question 6

Name the scar. What surgery may have been performed?

Answer 6

Lanz
More aesthetically pleasing than Gridiron

Appendicectomy

Question 7

Name the scar. What surgery may have been performed?

Answer 7

Gridiron
Appendicectomy

Question 8

Name the scar. What surgery may have been performed?

Answer 8

Rutherford Morrison
Kidney transplantation

Question 9

Name the scar. What surgery may have been performed?

Answer 9

Pfannenstiel
O+G
C-section

Question 10

Describe the layers cut through in a midline incision

Answer 10

Skin
Subcutaneous fat
Membranous fascia
Linea alba
Tranversalis fascia
Preperitoneal fat
Parietal peritoneum

Question 11

What is this?

Answer 11

Ileostomy

Question 12

What is this?

Answer 12

Colostomy

Question 13

Give 2 characteristics of an ileostomy

Answer 13

Spouted
Liquid output

Question 14

Give 2 characteristics of a colostomy

Answer 14

Flush
Solid output

Question 15

What is this?

Answer 15

NG tube

Question 16

What is this?

Answer 16

PEG

Question 17

RFs for Dupuytrens contracture

Answer 17

Excessive alcohol
Diabetes
Genetics
Male

Question 18

What is Dupuytrens contracture?

Answer 18

Thickening of palmar fascia resulting in development of cords of palmar fascia, eventually causing contracture deformities

Question 19

2 Causes of leukonychia

Answer 19

Hypoalbuminaemia:
End-stage liver disease
Protein losing enteropathy

Question 20

Cause of koilonychia

Answer 20

IDA

Question 21

What is asterixis? Name 2 GI causes

Answer 21

Irregular flapping motion of hands
Hepatic encephalopathy (hyperammonaemia)
Uraemia secondary to renal failure

Question 22

4 Gastrointestinal causes of clubbing

Answer 22

IBD
Coeliac
Liver Cirrhosis
Lymphoma of GIT

Question 23

Cause of angular stomatitis

Answer 23

Iron deficiency

Question 24

Cause of glossitis

Answer 24

Iron, folate + B12 deficiency
e.g. malabsorption due to IBD

Question 25

3 causes of acanthosis nigricans

Answer 25

Benign Insulin resistance (T2DM) GI malignancy: stomach cancer

Question 26

Cause of left supraclavicular lymphadenopathy

Answer 26

Virchow's node palpable = Troisers sign Metastatic intra-abdominal malignancy (mostly gastric cancer)

Question 27

Causes of right supraclavicular lymphadenopathy

Answer 27

Metastatic oesophageal cancer

Question 28

Drugs causes gynaecomastia

Answer 28

Digoxin Spironolactone

Question 29

Conditions causing gynaecomastia

Answer 29

Increased circulating oestrogen e.g. Cirrhosis

Question 30

What are Spider naevi? What causes them?

Answer 30

central red papules with fine red lines extending radially Increased circulating oestrogen

Question 31

3 causes of spider naevi

Answer 31

Liver cirrhosis (esp. if >5) COCP Pregnancy

Question 32

6 causes of abdominal distension

Answer 32

Fat Fluid Faeces Flatus Fetus Fulminant mass

Question 33

Caput medusae

Answer 33

Engorged paraumbilical veins a/w portal HTN

Question 34

5 Causes of Striae

Answer 34

Ascites Intra-abdominal malignancy Cushings syndrome Obesity Pregnancy

Question 35

6 Causes of ascites

Answer 35

CIRRHOSIS (portal HTN) Hepatocellular carcinoma HF Pancreatitis Hypoalbuminaemia Peritoneal TB

Question 36

6 causes of hepatomegaly

Answer 36

Hepatitis Hepatocellular carcinoma/ mets Wilson's disease Haemochromatosis PBC Glandular fever

Question 37

5 causes of splenomegaly

Answer 37

Portal HTN due to liver cirrhosis Haemolytic anaemia Congestive HF Splenic Mets Glandular fever

Question 38

Causes of bilaterally enlarged kidneys

Answer 38

Polycystic kidney disease Amyloidosis

Question 39

Cause of unilaterally enlarged kidneys

Answer 39

Renal tumour

Question 40

Cause of tinkling bowel sounds

Answer 40

Bowel obstruction

Question 41

Cause of renal bruits

Answer 41

Renal artery stenosis

Question 42

Cause of pedal oedema

Answer 42

Hypoalbuminaemia: liver cirrhosis, protein losing enteropathy

Question 43

What is seen here?

Answer 43

Umbilical hernia

Question 44

What is seen here?

Answer 44

Femoral hernia

Question 45

What is seen here?

Answer 45

Inguinal hernia

Question 46

What is seen here?

Answer 46

Incisional hernia