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Z Year3 Clinical Examinations > Abdominal Examination 2 > Flashcards

Abdominal Examination 2 Flashcards

(52 cards)

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1
Q

What do you look for on the axillae?

A
  1. acanthosis nigricans

2. hair loss

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2
Q

What is acanthosis nigricans?

A

darkening (hyperpigmentation) and thickening (hyperkeratosis) of the axillary skin

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3
Q

What is acanthosis nigricans associated with?

A
  1. benign
  2. insulin resistance
  3. GI malignancy (stomach cancer)
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4
Q

What is loss of axillary hair associated with?

A
  1. iron deficiency anaemia

2. malnutrition

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5
Q

What do you look for in the eyes?

A
  1. conjunctival pallor
  2. jaundice
  3. corneal arcus
  4. xanthelasma
  5. Kayser-Fleischer rings
  6. Perilimbal injection
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6
Q

What could conjunctival pallor suggest?

A

underlying anaemia

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7
Q

What would corneal arcus in under 50years suggest?

A

hypercholesterolaemia

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8
Q

What is xanthelasma associated with?

A

hypercholesterolaemia

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9
Q

What are kayser-fleischer rings?

A

dark rings that encircle the iris

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10
Q

What are kayser-fleischer rings assoicated with?

A

Wilson’s diases (abnormal copper processing by the liver, resulting in accumulation and deposition in various tissues (including the liver causing cirrhosis)

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11
Q

What is perilimbal injection?

A

inflammation of the area of conjunctiva adjacent to the iris

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12
Q

What is perilimbal injection a sign of?

A

sign of anterior uveitis, which can be associated with inflammatory bowel disease

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13
Q

What do you look for in the mouth of a patient?

A
  1. angular stomatitis
  2. glossitis
  3. oral candidasis
  4. aphthous ulceration
  5. hyperpigmented macules
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14
Q

What can cause angular stomatitis?

A

iron deficiency (e.g. gastrointestinal malignancy, malabsorption)

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15
Q

What is glossitis?

A

smooth erythematous enlargement of the tongue

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16
Q

What is glossitis associated with?

A

iron, B12 and folate deficiency (e.g. malabsorption secondary to inflammatory bowel disease).

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17
Q

What is oral candidasis associated with?

A

immunosuppression

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18
Q

What is aphthous ulceration?

A

round or oval ulcers occurring on the mucous membranes inside the mouth

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19
Q

What is aphthous ulceration associated with?

A
  • benign (stress, mechanical trauma)
  • iron, B12, folate deficiency
  • Crohn’s disease
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20
Q

What are hyperpigmented macules a sign of?

A

athognomonic for Peutz-Jeghers syndrome

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21
Q

What is Peutz-Jeghers sydnromes?

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A

autosomal dominant genetic disorder that results in the development of polyps in the gastrointestinal tract

22
Q

When is Virchow’s node felt?

Study These Flashcards
A

metastatic intrabdominal malignancy (gastric cancer)

23
Q

What do you look for on the patient’s chest?

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A
  1. spider naevi
  2. gynaecomstia
  3. hair loss
24
Q

What are spider naevi?

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A

skin lesions that have a central red papule with fine red lines extending radially caused by increased levels of circulating oestrogen

25
What pathology is spider naevi found in?
1. liver cirrhosis (more than 5) | 2. Normal if pregnancy or on combined pull
26
What is gynaecosmastia?
enlargement of male breast tissue caused by increased levels of circulating oestrogen
27
What can cause gynaecosmastia?
1. liver cirrhosis 2. digoxin 3. spironolactone
28
What can cause hair loss on abdomen?
1. increased level of circulating oestrogen | 2. general malnourishment
29
What are you looking for on abdominal inspection?
1. scars 2. abdominal distension 3. caput medusa 4. striae (strech marks) 5. hernias 6. Cullen's sign 7. Grey-Turner's sign
30
What can abdominal distension be caused by?
1. fat 2. fluid 3. flatus 4. faeces 5. fetus 6. fucking big mass
31
What is caput medusae?
engorged paraumbilical veins associated with portal hypertension
32
When may you see caput medusae?
liver cirrhosis
33
When may you see striae?
1. ascites 2. intrabdominal malignancy 3. Cushing’s syndrome 4. obesity 5. pregnancy
34
How can you see hernias?
ask the patient to cough and observe for any protrusions through the abdominal wall (e.g. umbilical hernia, incisional hernia)
35
What is Cullen's sign and what does it mean?
bruising of the tissue surrounding the umbilicus associated with haemorrhagic pancreatitis (a late sign)
36
What is Grey-Turner's sign? What does it mean?
bruising in the flanks associated with haemorrhagic pancreatitis (a late sign)
37
If a stoma is present what do you comment on?
1. location 2. contents 3. consistency of stool 4. spout
38
What stomas are usually in the left iliac fossa?
colostomies
39
What stomas are usually in the right iliac fossa?
ileostomies and urostomies
40
What can the contents of stomas be?
1. stool (colostomy or ileostomy) | 2. urine (urostomy)
41
What are the different consistency of stool in a stoma?
1. liquid (ileostomy) | 2. solid (colostomy)
42
Which stomas have a spout?
ileostomies and urostomies (not colostomies)
43
What condition has rebound tenderness?
non-specific but peritonitis e.g. appendicitis
44
When may patient be guarding?
peritonitis (appendicitis and diverticulitis)
45
What is Rovsing's sign?
palpation of the left iliac fossa causes pain to be experienced in the right iliac fossa
46
What is Rovsing's sign shown for?
unreliable - appendicitis but best indicates peritoneal inflammation of any cause affecting the left and/or right iliac fossa.
47
If you find a mass during palpitation what do you mention?
1. Location 2. size and shape 3. consistency 4. mobility 5. pulsatility
48
If you can feel the liver edge what should you comment on?
1. degree of extension below the costal margin | 2. consistency of live
49
What does it mean if the costal margin is greater than 2cm?
hepatomegaly
50
What would a nodular consistency of the liver edge suggest?
cirrhosis
51
What would hepatic tenderness suggest?
hepatitis or cholecystitis (as you may be palpating the gallbladder)
52
What is pulsatile hepatomegaly associated with?
tricuspid regurgitation

Z Year3 Clinical Examinations (33 decks)

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