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Flashcards in Gastrointestinal Examination Deck (28):
1

what can cause a flapping tremor?

hepatic encephalopathy

2

on examination, list changes which can be seen on the nails and what causes them?

clubbing (cirrhosis, IBD, coeliacs)
leukonychia -milk spots on nails - (hypoalbuminaemia in liver disease)
koilonychia - spooning of nails - (iron deficiency anaemia)

3

on examination, what changes can be seen on the hands and what causes them?

palmar erythema (hyperdynamic circulation from increased oestrogen in liver disease and pregnancy)
Dupuytren's contracture (familial, liver disease)
fingertip capillary glucose monitoring marks (diabetes)

4

on examination, what changes can be seen in the eyes? causes?

sclera for jaundice (liver disease)
conjunctival pallor (anaemia eg bleeding, malabsorption)
periorbital xanthelasma (hyperlipidaemia in cholestasis)

5

what changes can be seen in the mouth?

glossitis/stomatitis (iron/B12 deficiency anaemia)
aphthous ulcers (IBD)
breath odor (eg faeculent in obstruction, ketotic in ketoacidosis, alcohol)
lichen planus, xerostomia, angioedema

6

Virchow's node?

shows gastric malignancy - found in the supraclavicular fossa

7

what may be present on back inspection?

spider naevi (>5 significant)
skin lesions (immunosuppression)

8

what may be present on chest inspection?

spider naevi (>5 significant)
gynaecomastia, loss of axillary hair (increase oestrogen in liver disease/pregnancy)

9

name so signs which may be present on abdominal inspection, and what may be the causes of these signs?

distension (5F's)
incisional hernias - ask the patient to cough
scars, striae (pregnancy, Cushing's)
spider naevi
distended portal-systemic anastomoses (portal hypertension)

10

on superficial palpation, what are we checking for?

tenderness
guarding and rebound tenderness (peritonitis)

11

on deep palpation, what are we checking for?

masses, deep tenderness
if relevant, Rovsing's sign (appendicitis) and Murphy's sign (cholecystitis)

12

hepatomegaly may indicate what?

metastasis/HCC
cirrhosis
hepatitis
RVF
leukaemia/lymphoma

13

splenomegaly may indicate what?

lymphoma/leukaemia
myelofibrosis
malaria
portal hypertension
haemolysis

14

spleen vs kidney

can’t get above it spleen
spleen notched
spleen not ballotable
spleen moves down on inspiration

15

kidney ballot occurs at the renal angle - true or false?

true

16

you ballot the kidney by flexing your metatarsophalangeal joint in your hand - true or false?

false. metacarpophalangeal joint in the hand.
- metatarsophalangeal joint is in your foot -

17

what type of mass is a AAA? pulsatile or expansile?

expansile

18

tympanic on percussion would suggest...

flatus

19

when is a dull percussion note heard on the spleen?

only when the spleen is enlarged

20

"tinkling noise on auscultation would be suggestive of obstruction" - true or false

true

21

where is aortic and renal bruits listened at?

1cm superior and lateral to umbilicus bilaterally

22

what would ankle oedema be suggestive of?

hypoalbuminaemia

23

what additional equipment is required for a PR examination?

apron and gloves
lubricant
gauze

24

on inspection of the buttocks, what would you be looking for?

any blood, rashes, fistulae, fissures, excoriations and wa

25

asking the pateint to squeeze their bottom checks for anal sphincter competency - true or false?

true

26

what additional surfaces would you check in a PR exam?

feel for prostate and cervix

27

how would you describe a hernia?

(SSSCCCTTT): Site, Size, Shape, Consistency, Contours, Colour, Tenderness, Temperature, (Transillumination)

28

why is it important to check dentition during a GI exam?

could be indicative of (excessive) vomiting