Abdominal signs

Question 1

Answer 1

Koilonychia

Spoon shaped nails

• Iron deficiency
• B12 deficiency
• Folate deficiency
• Raynaud’s disease
• Fungal nail infection

Question 2

Answer 2

Leukonychia

Whitening of the nails

• Hypoalbuminaemia

Question 3

Answer 3

Muehrcke’s lines

Transverse white lines

• Hypoalbuminaemia

Question 4

Answer 4

Splinter haemorrhages

Fine, longitudinal haemorrhagic streaks (under nails)

• Suggests infective endocarditis in a febrile patient

Question 5

Answer 5

Terry’s nails

Proximal portion of nail is white/pink, nail tip is red/brown

• Cirrhosis
• Chronic renal failure

Question 6

Answer 6

Dilated capillaries

Dilated capillaries at nail fold

• Pulmonary hypertension

Question 7

Answer 7

Clubbing

Greater curvature of the nails in all directions and loss of the angle between the nail and nail fold

• Inflammatory bowel disease (e.g. Crohn’s)
• Cirrhosis
• Gastrointestinal lymphoma
• Malabsorption (e.g. Coeliac disease)

Question 8

Answer 8

Beau’s lines

Transverse furrows from temporary arrest of nail growth at times of increased biological stress

• Malaria
• Typhus
• Rheumatic fever
• Kawasaki disease
• Myocardial infarct
• Chemotherapy
• Guillain-Barré
• Raynaud’s syndrome
• Trauma
• High altitude climbing
• Deep sea diving

Question 9

Answer 9

Dupuytren’s contracture

Thickening and fibrous contraction of palmar fascia

• Liver disease

Question 10

Answer 10

Hepatic flap/asterixis

When holding hands up, tremour occurs

• Hepatic encephalopathy

Question 11

Answer 11

Palmar erythema

Reddening of the skin on the palms of the hands

• Chronic liver disease

Question 12

Answer 12

Arachnodactyly

Spider fingers

• Marfan syndrome

Question 13

Answer 13

Anaemia

Pale white’s of eyes

• Anaemia

Question 14

Answer 14

Jaundice

Yellowing

• Jaundice

Question 15

Answer 15

Xanthelasma

Deposits of fat round the eyes

• Chronic obstruction
• Primary biliary cirrhosis

Question 16

Answer 16

Glossitis

Smooth, red, sore tongue

• Folate deficiency
• B12 deficiency

Question 17

Answer 17

Angular stomatitis

Fissuring of the mouth’s corners

• Dentures
• Candidiasis
• Iron deficiency
• Riboflavin deficiency

Question 18

Answer 18

Oral cavity hyperpigmentation

Overly red

• Addison’s disease
• Peutz-Jeghers syndrome

Question 19

Answer 19

Karposi’s sarcoma

Purple papules

• Caused by human herpes virus

Question 20

Answer 20

Virchow’s node

Can be enlarged

• Gastric carcinoma

Question 21

Answer 21

Gynaecomastia

Enlarged breasts on a man

• Chronic liver disease

Question 22

Answer 22

Venous thrombosis

Need to watch for

Question 23

Answer 23

Spider naevi

Spider-like red marks

• Chronic liver disease

Question 24

Answer 24

Purpura

Generalised purpling of the skin

• Chronic liver disease

Question 25

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Answer 25

**Ecchymoses** Bruising not caused by trauma * Low platelet count

Question 26

Answer 26

**Ileostomy** A surgical operation where a damaged part of the ileum is removed and an opening is made in the abdominal wall

Question 27

Answer 27

**Colostomy** Surgical operation where the colon is shortened to remove the damaged part and an artificial opening is made in the abdominal wall and a bag attached to collect the waste products

Question 28

Answer 28

**Grey Turner's sign** Bruising of the flanks, often accompanied by Cullen's sign * Acute pancreatitis

Question 29

Answer 29

**Cullen's sign** Periumbilical bruising * Acute pancreatitis

Question 30

Answer 30

**Visible peristalsis** Involuntary constriction and relaxation of the muscles of the intestine creating wave-like movements pushing the contents of the canal forward * Pyloric stenosis * Bowel obstruction * Herniation and tumour * Obstructed gastric outlet * Stenosing duodenal ulcer * Umbilical ulcer

Question 31

Answer 31

**Striae** Irregular areas of skin that look like bands, stripes or lines - also known as stretch marks * Weight gain * Pregnancy * Diabetes * Cushing's syndrome * Puberty

Question 32

Answer 32

**Caput medusa/portal systemic systems anastomoses** Connections made between adjacent blood vessels or parts of the intestine * Portal hypertension

Question 33

Answer 33

**Ascites** Accumulation of fluid in the peritoneal cavity causing abdominal swelling