Abdominal Examination - Signs

Question 1

What might palmar erythema suggest?

Answer 1

• Liver failure

Question 2

Give 3 abdo causes of clubbing

Answer 2

1. IBD
2. Coeliac’s
3. Cirrhosis

Question 3

Cause of koilonychia?

Answer 3

• Iron deficiency anaemia

Question 4

What is the underlying cause of leukonychia and give 3 pathologies that lead to this?

Answer 4

• Hypoalbuminaemia

1. Chronic liver disease
2. Nephrotic syndrome
3. Enteropathy

Question 5

Cause of Dupuytren’s contracture?

Answer 5

• Alcoholic cirrhosis

Question 6

Give 3 causes for a hepatic flap

Answer 6

1. Hepatic encephalopathy
2. Uraemia
3. CO2 retention

Question 7

Cause of conjunctival pallor

Answer 7

• Anaemia

Question 8

Cause of scleral icterus and give 4 causes of this cause

Answer 8

• Due to jaundice. Jaundice may be due to…

1. Haemolysis
2. Hepatitis
3. Cirrhosis
4. Biliary obstruction

Question 9

Cause of xanthelasma?

Answer 9

• Hyperlipidaemia

Question 10

2 causes of apthous ulcers?

Answer 10

1. Crohn’s
2. Coeliac’s

Question 11

2 causes of angular stomatitis?

Answer 11

1. Iron deficiency
2. B12 deficiency

Question 12

3 causes of atrophic glossitis?

Answer 12

1. Iron defiency
2. B12 deficiency
3. Folate deficiency

Question 13

2 causes of oral candidiasis?

Answer 13

1. Iron deficiency
2. Immunodeficiency

Question 14

On what side is Virchow’s node and what does it suggest?

Answer 14

• Left hand side supraclavicular fosssa
• Gastric malignancy

Question 15

When performing cervical lymph node examination, what might lymphadenopathy suggest - 3 causes?

Answer 15

1. Infection
2. Malignancy
3. Sarcoidosis

Question 16

1) How to check suspected spider naevi?
2) What are the causes of spider naevia?

Answer 16

1)

Press in the middle and then let go to check for central filling of colour

2)

• Chronic liver disease
• Cirrhosis

Question 17

Give 3 causes of gynaecomastia

Answer 17

1. Liver cirrhosis
2. Digoxin
3. Spironolactone

Question 18

Give 3 causes of abnormal hair distribution in the abdo exam

Answer 18

1. Pseudofeminisation
2. Malnourishment
3. Iron deficiency anaemia

Question 19

Scars

List 3 common scars you might find and what they could be for

Answer 19

1. Midline - laparotomy
2. RIF - appendectomy
3. Right subcostal - cholecystectomy

Question 20

What are the 5 causes of abdominal distension (not including masses)?

Answer 20

1. Fat
2. Fluid (ascites)
3. Faeces (constipation)
4. Flatus
5. Foetus

Question 21

2 causes of visible abdominal masses?

Answer 21

1. Malignancy
2. Organomegaly

Question 22

What are caput medusae and what causes them?

Answer 22

• Engorged paraumbilical veins
• Portal HTN

Question 23

1) What, and where are Cullen’s and Grey-Turner’s sign
2) Causes?

Answer 23

1)

• Cullen’s = paraumbilical bruising
• Grey-Turner’s = flank bruising

2)

• Retroperitoneal bleeding due to:

1. Pancreatitis
2. Ruptured AAA

Question 24

Give the 3 common stomas / nephrostomies (basic level not in-depth), and their location

Answer 24

1. Colostomy (LIF) - large intestine - hard stool
2. Ileostomy (RIF) - small intestine - soft stool
3. Urostomy (RIF) - urine

Question 25

Causes of guarding?

Question 26

Causes of rebound tenderness?

Answer 26

* Peritonitis

Question 27

Common causes for liver enlargement - a form of organomegaly felt on palpation

Answer 27

* Cirrhosis * Malignancy * Benign tumour * Polycystic liver disease * Abscesses

Question 28

What are the common causes of splenomegaly, emphasis on the abdo cause?

Answer 28

* **Portal HTN** * **​**Haemolytic anaemia * Infection e.g. mononucleiosis * Sickle-cell disease

Question 29

What 2 signs together make you worry about portal HTN?

Answer 29

* Caput medusae + splenomegaly

Question 30

Cause of shifting dullness? Give 2 abdo causes of this cause

Answer 30

1) * Ascites 2) * Cirrhosis * Pancreatitis

Question 31

2 causes of absent bowel sounds?

Answer 31

1. Ileus 2. Peritonitis

Question 32

What causes high-pitched tinkling sound on auscultation of bowel sounds?

Answer 32

* Bowel obstruction